Diagnostic accuracy of cardiopulmonary ultrasound for pulmonary embolism: A systematic review and meta‐analysis

Cao, Jingli; Wang, Yuanyuan; Wang, Lihong

doi:10.1111/echo.15280

Cited by 4 publications

(2 citation statements)

References 25 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A meta-analysis performed by Cao et al that included 4216 patients in 10 studies reported that the pooled sensitivity of cardiopulmonary ultrasound for PE was 77% (50%–92%, 95% CI) and specificity was 99% (97%–100%, 95% CI) [ 29 ]. Another meta-analysis by Kagima et al which included 3872 patients in seven studies, reported that using cardiopulmonary ultrasound had 91% sensitivity and 81% specificity for the diagnosis of PE compared with the gold standard CTPA [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Sensitivity and specificity of chest ultrasound in the diagnosis of pulmonary embolism in the emergency department: A case-control study

Mohamed,

Farouk,

Allam Abd Elnaeem

et al. 2023

Can J Respir Ther

View full text Add to dashboard Cite

Objectives: The present study was designed to evaluate the role of chest ultrasound in the diagnosis of acute pulmonary embolism (PE) and determine its accuracy using multi-detector CT-pulmonary angiography (MD-CTPA) as a gold standard technique for PE diagnosis. Patients and methods: A prospective case-control study was performed with 75 patients who presented to the emergency department of Minia Cardiothoracic University Hospital with clinical suspicion of PE. All patients were evaluated clinically and by laboratory tests to assess the risk of PE. Thoracic ultrasound (TUS) was then performed for all patients for signs suggestive of PE. Finally, MD-CTPA was performed to confirm or exclude the presence of PE. Results: Patients were subdivided into two groups according to the result of MD-CTPA; group I (patients with PE) and group II (control group without PE). In our study, PE was present in the lower lobe in 75% of cases, then in the middle in 13% and in the upper lobe in 3.8% of cases. The majority of lesions in TUS were wedge-shaped lesions. No vascular flow was detected in 83% of PE-confirmed patients. The current study revealed that TUS has 81.25% sensitivity, 95% specificity, 98.3% positive predictive value, 77.2% negative predictive value and 87% accuracy in the diagnosis of PE. Univariate regression analysis revealed that the presence of wedge-shaped pleural-based lesions in grayscale US and the absence of flow signals by colour Doppler sonography (CDS) increase the possibility of PE. Wedge-shaped pleural-based lesions increase the possibility of PE by 1.48 times (P=0.0001), and the absence of flow signals by CDS increases the possibility of PE by 92.89 times (P=0.00001). Multivariate regression analysis revealed that adding absent flow signals by CDS to wedge-shaped pleural-based lesions by grayscale US increases the possibility of a PE diagnosis by 50.28 times (P=0.001). Conclusion: Chest ultrasound is a simple, safe, noninvasive, inexpensive, bedside diagnostic radiological technique that can be used in the emergency department for suspected PE or as an alternative to MD-CTPA when CTPA is contraindicated. Wedge-shaped lesions and the absence of flow signals by CDS increase the diagnostic value of ultrasound for PE.

show abstract

Section: Discussionmentioning

confidence: 99%

Sensitivity and specificity of chest ultrasound in the diagnosis of pulmonary embolism in the emergency department: A case-control study

Mohamed,

Farouk,

Allam Abd Elnaeem

et al. 2023

Can J Respir Ther

View full text Add to dashboard Cite

show abstract

“…This study explores the potential of an expanded role for ultrasound in PE diagnostics, but further studies with greater statistical power are essential to conclusively determine its precision and safety. A systematic review covering studies on the possible role of ultrasound in PE diagnostics showed that cardiopulmonary ultrasound could supplement existing diagnostic imaging as a non-invasive method and play a role in PE diagnosis, but further research is needed to determine the ideal setup and how ultrasound will play a role within the context of PE [ 33 ].…”

Section: Group 101: Clinical Problemsmentioning

confidence: 99%

ERS International Congress 2023: highlights from the Respiratory Clinical Care and Physiology Assembly

Gonsard,

Mekov,

Barron

et al. 2024

ERJ Open Res

View full text Add to dashboard Cite

It is a challenge to keep abreast of all the clinical and scientific advances in the field of respiratory medicine. This article contains an overview of laboratory-based science, clinical trials and qualitative research that were presented during the 2023 European Respiratory Society International Congress within the sessions from the five groups of the Assembly 1 – Respiratory clinical care and physiology. Selected presentations are summarised from a wide range of topics: clinical problems, rehabilitation and chronic care, general practice and primary care, electronic/mobile health (e-health/m-health), clinical respiratory physiology, exercise and functional imaging.

show abstract

Point-of-care ultrasound improves clinical outcomes in patients with acute onset dyspnea: a systematic review and meta-analysis

et al. 2022

View full text Add to dashboard Cite

The early, appropriate management of acute onset dyspnea is important but often challenging. The aim of this study was to investigate the effects of the use of Point-of-Care Ultrasound (PoCUS) versus conventional management on clinical outcomes in patients with acute onset dyspnea. The Cochrane Library, MEDLINE, EMBASE and reference lists were searched to identify eligible trials (inception to October 14, 2021). There were no language restrictions. Randomized controlled trials (RCTs), and prospective and retrospective cohort studies that compared PoCUS with conventional diagnostic modalities (controls) in patients with acute onset dyspnea were included. Two independent reviewers extracted data and assessed the risk of bias. Disagreements were resolved by consensus. The primary study outcomes were time to diagnosis, time to treatment, and length of stay (LOS). Secondary outcomes included rate of appropriate treatment, 30-day re-admission rate, and mortality. We included eight RCTs and six observational studies with a total of 5393 participants. Heterogeneity across studies was variable (from low to considerable), with overall low or moderate study quality and low or moderate risk of bias (except one article with serious risk of bias). Time to diagnosis (mean difference [MD], − 63 min; 95% CI, − 115 to − 11 min] and time to treatment (MD, − 27 min; 95% CI − 43 to − 11 min) were significantly shorter in the PoCUS group. In-hospital LOS showed no differences between the two groups, but LOS in the Intensive Care Unit (MD, − 1.27 days; − 1.94 to − 0.61 days) was significantly shorter in the PoCUS group. Patients in the PoCUS group showed significantly higher odds of receiving appropriate therapy compared to controls (odds ratio [OR], 2.31; 95% CI, 1.61–3.32), but there was no significant effect on 30-day re-admission rate and in-hospital or 30-day mortality. Our results indicate that PoCUS use contributes to early diagnosis and better outcomes compared to conventional methods in patients admitted with acute onset dyspnea. Graphical abstract

show abstract

Diagnostic accuracy of cardiopulmonary ultrasound for pulmonary embolism: A systematic review and meta‐analysis

Cited by 4 publications

References 25 publications

Sensitivity and specificity of chest ultrasound in the diagnosis of pulmonary embolism in the emergency department: A case-control study

Sensitivity and specificity of chest ultrasound in the diagnosis of pulmonary embolism in the emergency department: A case-control study

ERS International Congress 2023: highlights from the Respiratory Clinical Care and Physiology Assembly

Point-of-care ultrasound improves clinical outcomes in patients with acute onset dyspnea: a systematic review and meta-analysis

Contact Info

Product

Resources

About