Critical Care
Mahshid Dehghan; Moloud Balafar; Mahboub Pouraghaei; Mahnaz Ranjkesh; Ali Delkhorrami; Samad Shams Vahdati
Articles in Press, Accepted Manuscript, Available Online from 13 April 2024
Abstract
Objective: According to the most recent guidelines, the recommended imaging approaches forthe 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 attentionin intensive care units ...
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Objective: According to the most recent guidelines, the recommended imaging approaches forthe 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 attentionin intensive care units (ICUs) and emergency departments. Considering the importance of thetimely diagnosis and proper treatment of pneumonia, this study aimed to determine the diagnosticvalue of bedside LUS in comparison to chest CT scans in patients with suspected pneumonia orunspecified CXR findings in the emergency department.Methods: This prospective descriptive-analytic study was conducted in the emergency departmentof Imam Reza hospital. Patients aged 3 years and older with early diagnosis of pneumonia orany unspecified CXR findings with an indication of CT scan were included in the study. LUS wasperformed with a deep curved and linear surface probe. The results obtained from the chestultrasound 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 sensitivityand 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% and33.3%, respectively. The sensitivity and specificity of LUS in diagnosing pleural effusion were69.2% and 100%, respectively, and the positive predictive value and the negative predictive valuewere 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 andcostly. Additionally, the ultrasound device is easily portable and accessible. It can be widely used anddoes not have the secondary side effects of ionizing radiation in patients. However, the technician’sskill in performing ultrasound is a matter of importance.