Lung Ultrasound for the Evaluation of Pulmonary Congestion in Heart Failure Outpatients: A Comparison With Clinical Assessment, Natriuretic Peptides and Echocardiography

Miglioranza, Marcelo Haertel; Gargani, Luna; Sant’Anna, Roberto T.; Rover, Marciane Maria; Martins, Vítor Magnus; Mantovani, Augusto; Weber, Cristina Klein; Moraes, Maria Antonieta; Feldman, Carlos Jader; Sicari, Rosa; Kalil, Renato; Leiria, Tiago Luiz Luz

doi:10.1016/s0735-1097(13)60868-2

Cited by 59 publications

(107 citation statements)

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“…BLA and their changes after therapy correlated with chest x-ray water score. A Bline cutoff ≥15 provided a quick and reliable assessment of decompensation in outpatients with significant pulmonary congestion (sensitivity 85%, specificity 83%) [48].…”

Section: Geriatric Patientsmentioning

confidence: 99%

Lung artefacts and their use

Dietrich

Mathis²,

Blaivas

et al. 2016

Med Ultrason

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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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Section: Geriatric Patientsmentioning

confidence: 99%

Lung artefacts and their use

Dietrich

Mathis²,

Blaivas

et al. 2016

Med Ultrason

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show abstract

“…6 In our study, we used phased array transducers as described in prior studies. [7][8][9][10][11] While interrater variability is an important aspect of any imaging study, prior data from our own group and other investigators report close correlation between observers' independent B-line interpretation (r = 0.92 À 0.96). 7,12 As Dr. Trovato et al point out, both pulmonary fibrosis and lung cancer related lymphangitis have been reported to demonstrate B-lines on LUS.…”

Section: Replymentioning

confidence: 91%

“…18 Despite these known limitations, other studies in heart failure populations found correlations between estimated pulmonary artery pressures and B-lines. 11 Data from several recent studies suggest that sonographic B-lines represent a potentially useful diagnostic tool in the assessment of dyspneic patients that may provide incremental value over traditional approaches, including physical examination and chest x-ray. We agree that further research is needed to determine the relationship between B-lines and pleural effusions in heart failure populations, as well as the prognostic value of these imaging modalities.…”

Section: Replymentioning

confidence: 99%

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Platz

Hempel²,

Pivetta³

et al. 2014

Echocardiography

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“…In many situations it has a reliability comparable with that of a CT-scan of the lung, and better compared to that of the chest X-ray, as well as a better performance than standard auscultation [6,7]. Further, it also reduced interobserver variability for the interpretation of lung sounds [2].…”

Section: Insights In Chest Diseasesmentioning

confidence: 99%

“…A major advantage of lung ultrasonography is that some lung abnormalities can be easily detected, sometimes within seconds, at the patient's bedside. For example, pneumothorax can reliably be assessed with ultrasonography, as can many other causes of acute dyspnoea such as heart failure, pleural effusions, atelectasis, and pulmonary consolidations due to pneumonia [7][8][9][10][11][12][13]. Although, a chest-CT scan is generally considered the gold standard in these cases, it is logistically cumbersome and much more expensive; moreover, ultrasonography performs better compared with plain chest X-rays.…”

Section: Insights In Chest Diseasesmentioning

confidence: 99%

Explaining Snowstorms

Foudraine¹

2016

Insights Chest Dis

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Lung Ultrasound for the Evaluation of Pulmonary Congestion in Heart Failure Outpatients: A Comparison With Clinical Assessment, Natriuretic Peptides and Echocardiography

Cited by 59 publications

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Lung artefacts and their use

Lung artefacts and their use

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