Nurse-Performed Lung Ultrasound Shows High Specificity for Pulmonary Congestion: Study

The objective was to establish how precisely nurse-administered LUS can diagnose pulmonary congestion and whether these ultrasound results reflect nursing diagnostic models, specifically NANDA-I classification of "Excess Fluid Volume."

Key Findings

• 14 out of 64 patients (21.9%) were detected to have pulmonary congestion by the radiological standard.

• LUS was 50% sensitive (95% CI: 23%–77%), i.e., correctly detected half of the true congestion.

• Specificity was 94% (95% CI: 89%–99%), i.e., LUS correctly excluded congestion in nearly all patients without it.

• Positive predictive value (probability that patients with positive LUS actually had congestion) was 70%, and the negative predictive value (probability that patients with negative LUS were actually congestion-free) was 87%.

• Nurse-performed LUS showed high agreement with radiology, with a Gwet's AC1 coefficient of 0.77 (95% CI: 0.63–0.92).

• There were no reported adverse events from conducting LUS.

• The significant sonographic marker, ≥3 B-lines, correlated with NANDA-I defining characteristic of "pulmonary congestion" for the diagnosis code 00026 of Excess Fluid Volume.

In this pilot study, one experienced nurse could perform LUS with very good specificity to exclude pulmonary congestion in AKI patients admitted to intensive care units. The present results bring a new avenue for equipping nurses with point-of-care imaging, pointing out further research with greater numbers for full utilization of its diagnostic capabilities.

Reference:

Barbeiro, B. G., do Prado, P. R., Santos, V. B., Menegueti, M. G., Boling, B., & Gimenes, F. R. E. (2025). Diagnostic accuracy of nurse‑performed lung ultrasound for pulmonary congestion in acute kidney injury: An exploratory study. International Journal of Nursing Knowledge, 2047-3095.70018. https://doi.org/10.1111/2047-3095.70018