Thoracic Ultrasound: What Non-radiologists Need to Know

Williamson, Jonathan; Grainge, Christopher; Parameswaran, Ahilan; Twaddell, Scott

doi:10.1007/s13665-017-0164-1

Cited by 25 publications

(21 citation statements)

References 54 publications

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“…The ability of LUS to detect pleural effusion with high specificity is already known . In our experience, the qualitative aspect of the effusion could also be assessed and, in some cases, could differentiate between transudate, exudate and empyema (Fig.…”

Section: Discussionmentioning

confidence: 74%

Relevance of lung ultrasound in the diagnostic algorithm of respiratory diseases in a real‐life setting: A multicentre prospective study

et al. 2019

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Background and objective: The aim of this study was to assess the role of lung ultrasound (LUS) in a diagnostic algorithm of respiratory diseases, and to establish the accuracy of LUS compared with chest radiography (CXR). Methods: Over a period of 2 years, 509 consecutive patients admitted for respiratory-related symptoms to both emergency and general medicine wards were enrolled and evaluated using LUS and CXR. LUS was conducted by expert operators who were blinded to the medical history and laboratory data. Computed tomography (CT) of the chest was performed in case of discordance between the CXR and LUS, suspected lung cancer and an inconclusive diagnosis. Diagnosis made by CT was considered the gold standard. Results: The difference in sensitivity and specificity between LUS and CXR as demonstrated by ROC curve analyses (LUS-AUROC: 0.853; specificity: 81.6%; sensitivity: 93.9% vs CXR-AUROC: 0.763; specificity: 57.4%; sensitivity: 96.3%) was significant (P = 0.001). Final diagnosis included 240 cases (47.2%) of pneumonia, 44 patients with cancer (8.6%), 20 patients with chronic obstructive pulmonary disease (COPD, 3.9%), 24 patients with heart failure (4.7%) and others (6.1%). In 108 patients (21.2%) with any lung pathology, a CT scan was performed with a positive diagnosis in 96 cases (88.9%); we found that CXR and LUS detected no abnormality in 24 (25%) and 5 (5.2%) cases, respectively. LUS was concordant with the final diagnosis (P < 0.0001), and in healthy patients, there was a low percentage of false positives (5.9%). Conclusion:The results support the routine use of LUS in the clinical context. SUMMARY AT A GLANCELung ultrasound (LUS) provided a useful diagnostic workup of respiratory disease, either by directly identifying pathological findings or by detecting indirect signs of illness, as in lung cancer. Overall, LUS was not inferior to chest radiography and routine use in medical wards or in emergency department settings is beneficial. Respirology (2020) 25, 535-542 536 L Rinaldi et al. † EPA, pleural effusion, tuberculosis, fibrosis/restrictive syndrome and PTX. COPD, chronic obstructive pulmonary disease; EPA, acute pulmonary embolism; LUS, lung ultrasound; PTX, pneumothorax.Respirology (2020) 25, 535-542

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Section: Discussionmentioning

confidence: 74%

Relevance of lung ultrasound in the diagnostic algorithm of respiratory diseases in a real‐life setting: A multicentre prospective study

et al. 2019

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“…The evaluation of pleural gliding signs needs a duration of ventilation and working knowledge of the operators. [ 12 , 13 , 20 ] When LDLTs were used, the evaluation time of the FR was significantly shorter than the AR and UR. The evaluation time for ultrasound in the present study was shorter than that reported by Ramsingh, which was 162 ± 38 seconds.…”

Section: Discussionmentioning

confidence: 99%

“…Based on previous experiments, [ 4 , 20 , 21 ] the hypothesis of this study was that there would be a 20% difference between auscultation and ultrasound in terms of the accuracy of the evaluation of the DLT position. In order to detect this difference with a power of 80% and a P -value of .05, the power calculation indicated that a sample size of at least 35 experimental subjects and 35 control subjects is needed to reject the null hypothesis, in which the failure rates for the experimental and control subjects are equal, with a probability (power) of .8 and a type I error of 0.05.…”

Section: Methodsmentioning

confidence: 99%

Point-of-care ultrasound versus auscultation in determining the position of double-lumen tube

Hu¹,

Xu²,

Zhang³

et al. 2018

Medicine

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This study was designed to assess the accuracy of point-of-care ultrasound in determining the position of double-lumen tubes (DLTs).A total of 103 patients who required DLT intubation were enrolled into the study. After DLTs were tracheal intubated in the supine position, an auscultation researcher and ultrasound researcher were sequentially invited in the operating room to conduct their evaluation of the DLT. After the end of their evaluation, fiberscope researchers (FRs) were invited in the operating room to evaluate the position of DLT using a fiberscope. After the patients were changed to the lateral position, the same evaluation process was repeated. These 3 researchers were blind to each other when they made their conclusions. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were obtained by statistical analysis.When left DLTs (LDLTs) were used, the accuracy of ultrasound (84.2% [72.1%, 92.5%]) was higher than the accuracy of auscultation (59.7% [45.8%, 72.4%]) (P < .01). When right DLTs (RDLTs) were used, the accuracy of ultrasound (89.1% [76.4%, 96.4%]) was higher than the accuracy of auscultation (67.4% [52.0%, 80.5%]) (P < .01). When LDLTs were used in the lateral position, the accuracy of ultrasound (75.4% [62.2%, 85.9%]) was higher than the accuracy of auscultation (54.4% [40.7%, 67.6%]) (P < .05). When RDLT were used, the accuracy of ultrasound (73.9% [58.9%, 85.7%]) was higher than the accuracy of auscultation (47.8% [32.9%, 63.1%]) (P < .05).Assessment via point-of-care ultrasound is superior to auscultation in determining the position of DLTs.

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“…17 Moreover, the diagnosis of pneumothorax should be combined with the lung point, barcode sign on M mode and absence of lung sliding. 13,[18][19][20] On this basis, the absence of pleural sliding in the anterior, lateral or posterior chest on LUS was de ned as small, medium or large pneumothorax. 21 The presence of anechoic area uctuating with respiration indicated pleural effusion.…”

Section: Lung Ultrasound Examinationmentioning

confidence: 99%

Feasibility and Efficacy of Lung Ultrasound to Investigate Pulmonary Complications in Patients Who Developed Postoperative Hypoxaemia-A Prospective Study

Xie

Sun

You

et al. 2020

Preprint

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Background: Postoperative pulmonary complications (PPCs) and hypoxaemia is associated with morbidity and mortality. We aim to evaluate the feasibility and efficacy of lung ultrasound (LUS) to diagnose PPCs in patients suffering from hypoxemia after general anesthesia and compare the results to those of thoracic computed tomography (CT). Methods: Adult patients who received general anesthesia and suffered from hypoxaemia in the postanaesthesia care unit (PACU) were analyzed. Hypoxaemia was defined as an oxygen saturation measured by pulse oximetry (SPO 2 ) less than 92% for more than 30 seconds under ambient air conditions. LUS was performed by two trained anaesthesiologists once hypoxaemia occurred. After LUS examination, each patient was transported to the radiology department for thoracic CT scan within 1 hour before returning to the ward. Results: From January 2019 to May 2019, 113 patients (61 men) undergoing abdominal surgery (45 patients, 39.8%), video-assisted thoracic surgery (31 patients, 27.4%), major orthopaedic surgery (17 patients, 15.0%), neurosurgery (10 patients, 8.8%) or other surgery (10 patients, 8.8%) were included. CT diagnosed 327 of 1356 lung zones as atelectasis, while LUS revealed atelectasis in 311 of the CT-confirmed zones. Pneumothorax was detected by CT scan in 75 quadrants, 72 of which were detected by LUS. Pleural effusion was diagnosed in 144 zones on CT scan, and LUS detected 131 of these zones. LUS was reliable in diagnosing atelectasis (sensitivity 98.0%, specificity 96.7% and diagnostic accuracy 97.2%), pneumothorax (sensitivity 90.0%, specificity 98.9% and diagnostic accuracy 96.7%) and pleural effusion (sensitivity 92.9%, specificity 96.0% and diagnostic accuracy 95.1%). Conclusions: Lung ultrasound is feasible, efficient and accurate in diagnosing different aetiologies of postoperative hypoxia in healthy-weight patients in the PACU.

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Thoracic Ultrasound: What Non-radiologists Need to Know

Cited by 25 publications

References 54 publications

Relevance of lung ultrasound in the diagnostic algorithm of respiratory diseases in a real‐life setting: A multicentre prospective study

Relevance of lung ultrasound in the diagnostic algorithm of respiratory diseases in a real‐life setting: A multicentre prospective study

Point-of-care ultrasound versus auscultation in determining the position of double-lumen tube

Feasibility and Efficacy of Lung Ultrasound to Investigate Pulmonary Complications in Patients Who Developed Postoperative Hypoxaemia-A Prospective Study

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