Diagnostic Accuracy of Bedside Lung Ultrasound and Chest Radiography Compared to Thoracic Computed Tomography in Critically Ill Patients (original) (raw)
2022, SN Comprehensive Clinical Medicine
Background: Bedside lung ultrasound (LUS) is being adopted in intensive care units (ICU) with a higher diagnostic accuracy for consolidation, interstitial syndrome, pleural effusion, and pneumothorax than chest radiography (CXR). Aims: To compare the diagnostic performance of LUS and CXR for the detection of pathologic abnormalities in critically ill patients in the ICU using thoracic computed tomography (CT) as the gold standard. Methods. Prospective and descriptive single-center study. Prior to CT, we performed bedside LUS and CXR, evaluated hemithoraces and characterized them as positive or negative for each of four abnormalities (consolidation syndrome, interstitial syndrome, pleural effusion, and pneumothorax). We decided therapeutic intervention after CT. Results. A total of 58 patients and 126 hemithoraces were evaluated by three imaging techniques. LUS and CT did not show signi cant differences in any of the conditions. CRX and CT showed signi cantly different proportions of consolidation, interstitial syndrome and pleural effusion. LUS performed better than CXR, with a higher sensitivity for four pathologies. CXR had a marginally higher speci city than LUS for consolidation, interstitial syndrome and pneumothorax. In 79% of patients, we performed a subsequent action based on the information provided by LUS. Conclusion. In ICU patients, bedside LUS offers a better diagnostic performance than CRX for the diagnosis of common pathologic conditions and could be an alternative to CT.
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