Prehospital lung ultrasound for the diagnosis of cardiogenic pulmonary oedema: a pilot study

Laursen, Christian B.; Hänselmann, Anja; Posth, Stefan; Mikkelsen, Søren; Videbæk, Lars; Berg, H.

doi:10.1186/s13049-016-0288-2

Cited by 41 publications

(56 citation statements)

References 22 publications

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“…In contrast to CT scans and even chest X-ray, LUS is available in most hospitals around the world including developing countries and, as such, has been implemented as standard procedure for the diagnosis of ARDS according to the Kigali modification of the Berlin definition (Riviello et al 2016). Due to its high mobility, LUS can be applied at the bedside, intraoperatively, or even in emergency medicine settings (Laursen et al 2016). Most importantly, however, LUS generally outperforms conventional imaging techniques in terms of accuracy (i.e., sensitivity and specificity) and interobserver variability.…”

Section: Discussionmentioning

confidence: 99%

“…In patients, the most common cause for acute cardiogenic lung edema is MI. As LUS facilitates evaluation of pulmonary congestion and cardiogenic edema, it represents a powerful tool not only to rule out cardiogenic edema in prehospital emergency scenarios (Laursen et al 2016) but putatively also for longitudinal monitoring of disease status, progression, resolution and therapeutic effectiveness in these patients. Yet, although animal models of MI, e.g., due to ligation of the left anterior descending coronary artery (Neye et al 2012) are a mainstay of preclinical models of cardiovascular disease and are characteristically associated with the formation of cardiogenic lung edema as evident from increased wet-to-dry lung weight ratio at necropsy (Yin et al 2008;Solymosi et al 2013), LUS has so far not been applied to preclinical models of MI.…”

Section: Lus In Experimental Cardiogenic Edemamentioning

confidence: 99%

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From bedside to bench: lung ultrasound for the assessment of pulmonary edema in animal models

et al. 2020

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Traditionally, the lung has been excluded from the ultrasound organ repertoire and, hence, the application of lung ultrasound (LUS) was largely limited to a few enthusiastic clinicians. Yet, in the last decades, the recognition of the previously untapped diagnostic potential of LUS in intensive care medicine has fueled its widespread use as a rapid, non-invasive and radiation-free bedside approach with excellent diagnostic accuracy for many of the most common causes of acute respiratory failure, e.g., cardiogenic pulmonary edema, pneumonia, pleural effusion and pneumothorax. Its increased clinical use has also incited attention for the potential usefulness of LUS in preclinical studies with small animal models mimicking lung congestion and pulmonary edema formation. Application of LUS to small animal models of pulmonary edema may save time, is cost-effective, and may reduce the number of experimental animals due to the possibility of serial evaluations in the same animal as compared with traditional end-point measurements. This review provides an overview of the emerging field of LUS with a specific focus on its application in animal models and highlights future perspectives for LUS in preclinical research.

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Section: Discussionmentioning

confidence: 99%

Section: Lus In Experimental Cardiogenic Edemamentioning

confidence: 99%

From bedside to bench: lung ultrasound for the assessment of pulmonary edema in animal models

et al. 2020

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“…We also found high coincidence rate between CXR and LUS results after treatment; the result indicates that LUS is valuable for the surveillance of HAPE. Compared to CXR, LUS is more convenient and faster and is especially suitable for use in emergency departments [ 20 , 21 ]. LUS is also suitable for use in pediatrics due to the advantage of not incorporating radiation during the imaging process [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Lung Ultrasound Is Accurate for the Diagnosis of High-Altitude Pulmonary Edema: A Prospective Study

Yang¹,

Yu-liang²,

Qiu³

et al. 2018

Canadian Respiratory Journal

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Objective The aim of this study was to assess the diagnostic accuracy of lung ultrasonography (LUS) for high-altitude pulmonary edema (HAPE). Background LUS has proven to be a reliable tool for the diagnosis of pulmonary diseases, including pneumonia, acute respiratory distress syndrome (ARDS), and pneumothorax. LUS also has potential for the diagnosis of HAPE. However, the actual diagnostic value of LUS for HAPE is still unknown. Our objective was to determine the feasibility of using LUS for the diagnosis of HAPE. Materials and Methods A prospective clinical research study of adult HAPE patients was conducted. LUS and chest X-ray (CXR) were performed in patients with suspected HAPE before and after treatment, and pulmonary moist rales were recorded concurrently. The diagnostic value of LUS, CXR, and moist rales for HAPE (i.e., their sensitivity, specificity, and positive and negative predictive values) were assessed, and the results were compared. The gold standard was the final diagnosis. Results In total, 148 patients were enrolled in the study, 126 of which were diagnosed with HAPE (85.14%). Before treatment, the diagnostic accuracy of LUS for HAPE was as follows: sensitivity, 98.41% (95% confidence interval (CI) 100.60–96.23%); specificity, 90.91% (95% CI 102.92–78.90%). LUS had higher sensitivity (0.98 vs. 0.81, P < 0.01 using the McNemar test) than moist rales for the diagnosis of HAPE. LUS also had higher sensitivity than CXR (0.98 vs. 0.93, P < 0.05 using the McNemar test). After treatment, LUS was consistent with CXR in 96.55% of HAPE patients, and the concordance between LUS and CXR was high (k statistic = 0.483 P ≤ 0.001; 95% CI −0.021 to −0.853). Conclusion The results indicate that LUS is a reliable method for the diagnosis and surveillance of HAPE. This trial is registered with Chinese Clinical Trial Registry (No. ChiCTR-DDD-16009841).

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“…One might argue that the inclusion period could be extended further back in time. In recent years, however, the treatment possibilities have expanded within the prehospital medical services [ 36 , 37 ], alongside improved diagnostic capabilities through point of care ultrasound and arterial blood gas analysis [ 38 ]. Therefore, the authors believe that the possible adjustments to create a larger sample size would result in a more heterogeneous patient population.…”

Section: Discussionmentioning

confidence: 99%

Prehospital prognosis is difficult in patients with acute exacerbation of chronic obstructive pulmonary disease

Lindvig

Brøchner

Lassen

et al. 2017

Scand J Trauma Resusc Emerg Med

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BackgroundPatients with acute exacerbation of chronic obstructive pulmonary disease often require prehospital emergency treatment. This enables patients who are less ill to be treated on-site and to avoid hospital admission, while severely ill patients can receive immediate ventilatory support in the form of intubation. The emergency physician faces difficult treatment decisions, however, and prognostic tools that could assist in determining which patients would benefit from intubation and ventilator support would be helpful. The aim of the current study was to identify prehospital clinical variables associated with mortality from acute exacerbation of chronic obstructive pulmonary disease. As part of the study, we estimated the 30-day mortality for patients with this prehospital diagnosis.MethodsA retrospective study was performed using data collected by the mobile emergency care unit in Odense, Denmark, combined with data from the patients’ medical records. Patients with the tentative diagnosis of acute exacerbation of chronic obstructive pulmonary disease between 1st July 2011 and 31st December 2013 were included in the study.ResultsBased on data from 530 patients, we found no statistically significant associations between prehospital clinical variables and mortality, apart from a minor association between older age and higher mortality. The overall 30-day mortality was 10%, while that for patients admitted to the intensive care unit was 30%.ConclusionNo specific prehospital prognostic factors for mortality were identified. Prognostic assessment and the decision to withhold treatment for acute exacerbation of chronic obstructive pulmonary disease seem inadvisable in the prehospital setting.

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Prehospital lung ultrasound for the diagnosis of cardiogenic pulmonary oedema: a pilot study

Cited by 41 publications

References 22 publications

From bedside to bench: lung ultrasound for the assessment of pulmonary edema in animal models

From bedside to bench: lung ultrasound for the assessment of pulmonary edema in animal models

Lung Ultrasound Is Accurate for the Diagnosis of High-Altitude Pulmonary Edema: A Prospective Study

Prehospital prognosis is difficult in patients with acute exacerbation of chronic obstructive pulmonary disease

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