Interobserver agreement in the evaluation of B-lines using bedside ultrasound

IntroductionIn years gone by examination of patients with pulmonary disorders rested essentially on a clinician's bedside physical examination, of auscultation and percussion, complimented with blood gas analysis and X-ray imaging. Lung ultrasound has emerged into this context as a real-time bedside procedure, delivering information relevant to the clinician's differential diagnosis. A large part of sonographic lung examination involves the interpretation of artefacts, thus knowledge of the origin of typical artefacts is important. Although indirect sonographic signs, nonetheless reliable conclusions on the condition of the lung can be inferred. Particularly the of quantity and distribution of B-lines can establish important assessment of the cause and degree of fluid load within the interstitium.All focused ultrasound investigations, including bedside lung ultrasound, allow symptom evaluation considering multiple organ-systems yet with minimal time delay. Such integration of imaging with clinical assessment and treatment is called Point-of-Care Ultrasound (POCUS) and should be understood as an extension of the physical examination. POCUS offers a unique but crucial role, integrating clinical and other imaging findings, including cardiac ultrasound (echocardiography), chest radiography, and computed tomography (CT) scans is crucial, which alone may lack the required accuracy.The emergence of differences in approach to lung sonography, technique and nomenclature, provided the AbstractThe science of lung ultrasound has grown tremendously over the last two decades and lung ultrasound has not only entered the mainstream of point of care ultrasound but has become a dominant topic. Understanding lung ultrasound signs and artifacts is critical to being able to correlate findings with actual pathology and normal anatomy and physiology. Investigators have described multiple lung ultrasound artifacts and findings and it is important to understand both the physics and anatomic basis behind them. Additionally, ultrasound machine use and transducer selection can significantly affect results obtained on patient during an examination and the provider must carefully choose the correct settings. This manuscript describes the state of the art in ultrasound artifact recognition and correlation as well as management of ultrasound technology to optimize diagnostic success.Keywords: ultrasound, lung, artifacts, pathology, guidelines [2,[11][12][13][14][15] we discuss the prominent role of the particular artefacts of lung sonography answering differential-diagnostic questions in patients with cardio-pulmonary diseases. Lung artefacts

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“…Agreement in the lateral/inferior lung zones was overall inferior. Intrarater agreement was highest at extreme high or low numbers of BLA [42].…”

Section: Focusmentioning

confidence: 90%

Lung artefacts and their use

Dietrich

Mathis²,

Blaivas

et al. 2016

Med Ultrason

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“…BLA is reproducible and identifying them is easy to learn by operators with different skill and expertise (15,20,(22)(23)(24)(25)(26)(27)(28).…”

Section: Are Bla Reproducible?mentioning

confidence: 99%

Lung B-line artefacts and their use

Dietrich

Mathis

Blaivas³

et al. 2016

J. Thorac. Dis.

195

145

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“…Furthermore, although many ultrasound examinations require considerable training for proficiency, preliminary studies show that sonographers can effectively perform LUS including for pCAP with limited training. LUS for identification of B‐lines has shown good interrater reliability, given that LUS does not seem to require a high level of spatial aptitude …”

Section: Introductionmentioning

confidence: 99%

“…LUS for identification of B-lines has shown good interrater reliability, given that LUS does not seem to require a high level of spatial aptitude. 21,22 In our study, we aim to compare the accuracy of LUS to the current standard initial imaging modality of CXR in diagnosing bacterial pCAP.…”

Section: Introductionmentioning

confidence: 99%