The role of thoracic ultrasonography for evaluation of patients with decompensated chronic heart failure

Kataoka, Hiroyuki; Takada, S.

doi:10.1016/s0735-1097(00)00602-1

Cited by 98 publications

(121 citation statements)

References 45 publications

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“…14,20 All four studies included in this review also investigated the accuracy of radiography for detecting pleural effusion. 4,7,12,14 One of these studies found similar results for both methods, and all the other three showed significantly better results for sonography. For radiography, the sensitivity for detecting pleural effusion ranged from 24% to 100% and the specificity ranged from 85% to 100%.…”

Section: Discussionmentioning

confidence: 74%

“…7 One study performed the index test immediately after performing the reference standard. 4 In another study, 12 the time interval was shorter than two hours in 68% of the cases; shorter than 12 hours in 20% and shorter than 24 hours in 12%. One study 7 did not give such information, and one stated that the maximum time interval was one hour.…”

Section: Quality Of the Studies Includedmentioning

confidence: 88%

“…4,12,14 One study used computed tomography and thoracic drainage. 7 One study performed the index test immediately after performing the reference standard.…”

Section: Quality Of the Studies Includedmentioning

confidence: 99%

“…In addition to enabling evaluation of the pleural space, it allows accurate and detailed evaluation of the thoracic wall, lung parenchyma and mediastium. [12][13][14] Its limitations are its low availability in remote centers, high cost and high radiation dose, and the need to take patients to the examination room, which delays the diagnosis. 4,5,[12][13][14] This last item is particularly important in relation to seriously ill patients or trauma victims.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of sonography for pleural effusion: systematic review

et al. 2010

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CONTEXT AND OBJECTIVE: The initial method for evaluating the presence of pleural effusion was chest radiography. Isolated studies have shown that sonography has greater accuracy than radiography for this diagnosis; however, no systematic reviews on this matter are available in the literature. Thus, the aim of this study was to evaluate the accuracy of sonography in detecting pleural effusion, by means of a systematic review of the literature. DESIGN AND SETTING:This was a systematic review with meta-analysis on accuracy studies. This study was conducted in the Department of Diagnostic METHOD:The following databases were searched: Cochrane Library, Medline, Web of Science, Embase and Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs). The references of relevant studies were also screened for additional citations of interest. Studies in which the accuracy of sonography for detecting pleural effusion was tested, with an acceptable reference standard (computed tomography or thoracic drainage), were included.RESULTS: Four studies were included. All of them showed that sonography had high sensitivity, specificity and accuracy for detecting pleural effusions. The mean sensitivity was 93% (95% confidence interval, CI: 89% to 96%), and specificity was 96% (95% CI: 95% to 98%). CONCLUSIONS:In different populations and clinical settings, sonography showed consistently high sensitivity, specificity and accuracy for detecting fluid in the pleural space.RESUMO CONTEXTO E OBJETIVOS: O método inicial para a avaliação da presença dos derrames pleurais foi a radiografia de tórax. Estudos isolados demonstraram que a ultrassonografia apresenta uma acurácia maior que a radiografia para este diagnóstico, entretanto, não se encontram disponíveis na literatura revisões sistemáticas sobre este tema. Assim, o objetivo deste estudo é avaliar a acurácia da ultrassonografia na detecção de derrame pleural, por meio de revisão sistemática da literatura. Caribe em Ciências da Saúde (Lilacs). As referências de estudos relevantes foram verificadas para adicionais citações de interesse. Foram incluídos estudos nos quais a acurácia da ultrassonografia para a detecção de derrame pleural tenha sido testada, com padrão referência aceitável (tomografia computadorizada ou drenagem torácica). TIPO DE ESTUDO E LOCAL: RESULTADOS:Foram incluídos quatro estudos. Todos apresentaram alta sensibilidade, especificidade e acurácia para a detecção de derrame pleural pela ultrassonografia. A sensibilidade média foi de 93% (intervalo de confiança, IC 95%: 89% a 96%), e a especificidade 96% (IC 95%: 95% a 98%). CONCLUSÕES:A ultrassonografia, em diferentes populações e cenários clínicos, apresentou consistentemente alta sensibilidade, especificidade e acurácia na detecção de líquido no espaço pleural.

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Section: Discussionmentioning

confidence: 74%

Section: Quality Of the Studies Includedmentioning

confidence: 88%

“…4,12,14 One study used computed tomography and thoracic drainage. 7 One study performed the index test immediately after performing the reference standard.…”

Section: Quality Of the Studies Includedmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of sonography for pleural effusion: systematic review

et al. 2010

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“…The explanation for this difference between the two studies remains unclear, but the different approach used for diagnosing clinical deterioration or stability may have contributed. In the present study, the addition of thoracic ultrasonography 9 to standard physical examination may have yielded more accurate identification of patients with decompensated HF based on the objective sign of fluid retention, thus demonstrating the intimate relationship between changes in BNP levels and clinical HF deterioration. In contrast, many patients in the study by Lewin et al 8 were in a state of deterioration based on symptomatic criteria.…”

Section: Relationship Of Body Fluid Status With Levels and Fluctuatiomentioning

confidence: 63%

Relation of body fluid status to B‐type natriuretic peptide levels in patients with chronic heart failure during long‐term follow‐up

Kataoka

2006

Clinical Cardiology

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SummaryBackground: Little is known about the relationship of body fluid status with the levels and fluctuations of B-type natriuretic peptide (BNP) over the long term.Hypothesis: If BNP is to become useful for monitoring of patients with chronic heart failure (HF), the levels should reliably reflect both decompensation and improvement in the patient's condition.Methods: Forty-six patients with chronic HF who were stable at study entry but had previous decompensation were recruited and followed up between June 2003 and September 2005. At each visit, they were examined for BNP level and HF-related signs of body fluid retention based on physical evaluation and pleural ultrasonography.Results: During the study period, 26 patients developed decompensation and 20 maintained a stable clinical course. In the 26 decompensated patients, BNP levels fluctuated widely (110 ± 73.7 pg/ml; range 25-290 pg/ml) even during stable periods. In all but three patients in this group, the maximum BNP level during decompensation was higher than that reached during stable periods. The BNP levels also fluctuated widely (180 ± 123 pg/ml; range 16-489 pg/ml) in the 20 stable patients with HF. In all but one patient in this group, the BNP lev-

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Does This Patient Have a Pleural Effusion?

Wong

Holroyd‐Leduc

Straus³

2009

JAMA

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Based on the limited number of studies, dullness to percussion and tactile fremitus are the most useful findings for pleural effusion. Dull chest percussion makes the probability of a pleural effusion much more likely but requires a chest radiograph to confirm the diagnosis. When the pretest probability of pleural effusion is low, the absence of reduced tactile vocal fremitus makes pleural effusion less likely so that a chest radiograph might not be necessary depending on the overall clinical situation.

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The role of thoracic ultrasonography for evaluation of patients with decompensated chronic heart failure

Cited by 98 publications

References 45 publications

Diagnostic accuracy of sonography for pleural effusion: systematic review

Diagnostic accuracy of sonography for pleural effusion: systematic review

Relation of body fluid status to B‐type natriuretic peptide levels in patients with chronic heart failure during long‐term follow‐up

Does This Patient Have a Pleural Effusion?

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