Diagnostic comparison of bedside lung ultrasound and chest radiography in the intensive care unit
Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Bedside lung ultrasound (POCUS) offers advantages over chest X-ray, including better cost-effectiveness for diagnosing certain pulmonary pathologies. This study compares the diagnostic concordance between portable chest X-rays and bedside lung ultrasounds in the intensive care unit (ICU). METHODS: Adult ICU patients were included. POCUS was performed using the abbreviated BLUE protocol. Diagnostic results from POCUS and chest radiographies were compared using the intensivist clinical diagnosis - based on clinical examinations and lung ultrasounds - as the reference. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the ultrasounds were calculated. RESULTS: A total of 100 patients were included, 71 with pulmonary pathologies. The average time to perform the ultrasound was 308 seconds. Ultrasound identified pathology in 20 patients with a normal chest radiographs. Diagnostic discrepancies occurred in 30 patients, highlighting ultrasound´s superior sensitivity in detecting atelectasis, pleural effusions, and pulmonary edema. Ultrasound demonstrated sensitivity (S) of 85%, specificity (E) of 100%, positive predictive value (PPV) of 100%, and negative predictive value (NPV) of 55%. CONCLUSION: Lung point-of-care ultrasound at ICU admission detects more pathologies and does not miss significant abnormalities seen on chest X-rays. It also shows good diagnostic accuracy. These findings suggest that pulmonary POCUS, using an abbreviated protocol, could be a viable alternative to chest radiography for initial evaluation and follow-up of pulmonary pathologies in critically ill patients, potentially improving care quality and management.
DOI: 10.23938/assn.1088
Authors: Juan-Ambrosio Martínez-Molina, Miguel Angel Martínez-González, Marc Vives Santacana, Ariel Duilio González Delgado, Karlos Reviejo Jaka, Pablo Monedero
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4404392369