Extended lung ultrasound protocol effective diagnostic tool in pulmonary consolidation

Written By :  Dr. Shravani Dali
Medically Reviewed By :  Dr. Kamal Kant Kohli
Published On 2022-06-01 14:15 GMT   |   Update On 2022-06-01 14:15 GMT
Advertisement

In the hands of experienced physicians, the extended lung ultrasound protocol can be a powerful diagnostic tool to determine the presence of pneumonia versus atelectasis in the general ICU population, according to a recent study published in the Critical Care Medicine

A study was conducted to determine the diagnostic accuracy of extended lung ultrasonographic assessment, including evaluation of dynamic air bronchograms and colour Doppler imaging to differentiate pneumonia and atelectasis in patients with consolidation on chest radiograph. Compare this approach to the Simplified Clinical Pulmonary Infection Score, Lung Ultrasound Clinical Pulmonary Infection Score, and the Bedside Lung Ultrasound in the Emergency protocol.

Advertisement

Adult patients that underwent a chest radiograph for any indication at any time during admission. Patients with acute respiratory distress syndrome, coronavirus disease 2019, severe thoracic trauma, and infectious isolation measures were excluded.

A lung ultrasound was performed within 24 hours of the chest radiograph. Consolidated tissue was assessed for the presence of dynamic air bronchograms and with colour Doppler imaging for the presence of flow. Clinical data were recorded after ultrasonographic assessment. The primary outcome was diagnostic accuracy of dynamic air bronchogram and colour Doppler imaging alone and within a decision, tree to differentiate pneumonia from atelectasis.

Results:

  • Of 120 patients included, 51 were diagnosed with pneumonia.
  • The dynamic air bronchogram had a 45% sensitivity and 99% doppler imaging had a 90% sensitivity and 68% specificity.
  • The combined decision tree had an 86% sensitivity and 86% specificity.
  • The Bedside Lung Ultrasound in Emergency protocol had a 100% sensitivity and 0% specificity, while the Simplified Clinical Pulmonary Infection Score and Lung Ultrasound Clinical Pulmonary Infection Score had a 41% sensitivity, 84% specificity and 68% sensitivity, 81% specificity, respectively.

Thus, in critically ill patients with pulmonary consolidation on chest radiograph, an extended lung ultrasound protocol is an accurate and directly bedside available tool to differentiate pneumonia from atelectasis. It outperforms standard lung ultrasound and clinical scores.

Reference:

Extended Lung Ultrasound to Differentiate Between Pneumonia and Atelectasis in Critically Ill Patients: A Diagnostic Accuracy Study by Haaksma, Mark E. et al. published in the Critical Care Medicine

doi: 10.1097/CCM.0000000000005303



Tags:    
Article Source : Critical Care Medicine

Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.

NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.

Our comments section is governed by our Comments Policy . By posting comments at Medical Dialogues you automatically agree with our Comments Policy , Terms And Conditions and Privacy Policy .

Similar News