Critical Care
Moloud Balafar; Mahboub Pouraghaei; Mahnaz Ranjkesh; Mahshid Dehghan; Ali Delkhorrami; Samad Shams Vahdati
Volume 9, Issue 2 , July 2023, , Pages 87-91
Abstract
Objective: According to the most recent guidelines, the recommended imaging approaches for the diagnosis of pneumonia are chest X-ray (CXR) and computed tomography (CT) scan. However, there are limitations to these approaches. Lung ultrasound (LUS) has attracted a lot of attention in intensive care units ...
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Objective: According to the most recent guidelines, the recommended imaging approaches for the diagnosis of pneumonia are chest X-ray (CXR) and computed tomography (CT) scan. However, there are limitations to these approaches. Lung ultrasound (LUS) has attracted a lot of attention in intensive care units (ICUs) and emergency departments. Considering the importance of the timely diagnosis and proper treatment of pneumonia, this study aimed to determine the diagnostic value of bedside LUS in comparison to chest CT scans in patients with suspected pneumonia or unspecified CXR findings in the emergency department.Methods: This prospective descriptive-analytic study was conducted in the emergency department of Imam Reza hospital. Patients aged 3 years and older with early diagnosis of pneumonia or any unspecified CXR findings with an indication of CT scan were included in the study. LUS was performed with a deep curved and linear surface probe. The results obtained from the chest ultrasound were compared with the results obtained by CT scan as the diagnostic gold standard.Results: A total of 175 patients were included in this study. According to the results, the sensitivity and specificity of LUS in the diagnosis of subpleural consolidation were 94.1% and 100%, respectively, and the positive predictive value and the negative predictive value were 100% and 33.3%, respectively. The sensitivity and specificity of LUS in diagnosing pleural effusion were 69.2% and 100%, respectively, and the positive predictive value and the negative predictive value were 100% and 90.7%, respectively. Furthermore, the sensitivity of LUS in diagnosing dynamic airbronchogram was 98%.Conclusion: According to the findings of the present study, in patients suspected of pneumonia, LUS is more sensitive and specific in the diagnosis of pneumonia and is less time-intensive and costly. Additionally, the ultrasound device is easily portable and accessible. It can be widely used and does not have the secondary side effects of ionizing radiation in patients. However, the technician’s skill in performing ultrasound is a matter of importance.
Emergency medicine
Payman Moharamzadeh; Kavous Shahsavari Nia; Mohammadhossein Somi; Mahboub Pouraghaei; Akbar Fadaeihaghi; Farzad Rahmani
Volume 4, Issue 1 , January 2018, , Pages 34-38
Abstract
Objective: In recent years, there has been a great attention concerning red blood cell distribution width (RDW) in clinical decisions as well as determining the severity of diseases. This study was conducted to evaluate the primary level of RDW to predict hospital mortality in pancreatitis.
Methods: ...
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Objective: In recent years, there has been a great attention concerning red blood cell distribution width (RDW) in clinical decisions as well as determining the severity of diseases. This study was conducted to evaluate the primary level of RDW to predict hospital mortality in pancreatitis.
Methods: This was a descriptive analytical study performed on 100 patients with acute pancreatitis in the emergency department of Imam Reza hospital of Tabriz University of Medical Sciences. In this study, the primary level of RDW in patients with acute pancreatitis presenting to the emergency ward was collected and after patients’ admission we followed them. Also, the admission outcome (mortality or discharge) of patients was registered, and finally we evaluated the predictive value of RDW in determining the patient’s outcome in hospital.
Results: In our study, 47 patients were male, and 53 patients were female. Mean RDW in patients was 13.82 ± 1.69. Five patients died during the study. Mean RDW in dead patients and other patients was 16.44 ± 4.22 and 13.68 ± 1.37, respectively (P < 0.001). The cut-off point of 14.55 for RDW with 80% sensitivity and 85% specificity was determined for predicting mortality in patients.
Conclusion: Based on our study results, the initial RDW level is an independent factor for predicting in-hospital mortality in pancreatitis but not for determining the need for surgery or admission to the intensive care unit (ICU).