Use of Lung Ultrasound For Diagnosing  Acute Heart Failure in Emergency  Department of Southern India

Aggarwal, Manav; Gupta, Mrigakshi; Vijan, Vikrant; Vupputuri, Anjith; Chintamani, Sanjeev; Rajendran, Bishnukiran; Thachathodiyal, Rajesh; Chandrasekaran, R.

doi:10.7860/jcdr/2016/20661.8814

Cited by 5 publications

(5 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our cohort showed a median age of 73 years and was therefore older than cohorts of comparable studies (73 years vs. median age of 64 [ 18 ] and 53 [ 20 ]). In contrast to other ED studies, almost all of our AHF patients had a history of CHF (97.9% compared to 75% described by Anderson [ 15 ]).…”

Section: Discussionmentioning

confidence: 65%

“…We decided to count the highest number of B-lines during the runtime of the recording, as in our opinion this is the most useful method to identify ED patients with AHF using LUS. As there exists no standardization in the evaluation of B-lines, it seems reasonable to hypothesize that the wide range of sensitivity (58−92%) and specificity (75–100%) is affected by the method used [ 15 , 16 , 17 , 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to other ED studies, almost all of our AHF patients had a history of CHF (97.9% compared to 75% described by Anderson [ 15 ]). Furthermore, there are notable differences in the inclusion criteria compared to other studies as patients with renal dysfunction and preexisting lung diseases were not excluded [ 18 , 21 , 22 ]. Higher age is associated with an increased number of comorbidities and might, therefore, hinder the visibility of B-lines causing a lower sensitivity.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Lung Ultrasound Eight-Point Method in Diagnosing Acute Heart Failure in Emergency Patients with Acute Dyspnea: Diagnostic Accuracy and 72 h Monitoring

et al. 2020

View full text Add to dashboard Cite

Background and Objectives: Acute dyspnea is a common chief complaint in the emergency department (ED), with acute heart failure (AHF) as a frequent underlying disease. Early diagnosis and rapid therapy are highly recommended by international guidelines. This study evaluates the accuracy of point-of-care B-line lung ultrasound in diagnosing AHF and monitoring the therapeutic success of heart failure patients. Materials and Methods: This is a prospective mono-center study in adult patients presenting with undifferentiated acute dyspnea to a German ED. An eight-zone pulmonary ultrasound was performed by experienced sonographers in the ED and 24 and 72 h after. Along with the lung ultrasound evaluation patients were asked to assess the severity of shortness of breath on a numeric rating scale. The treating ED physicians were asked to assess the probability of AHF as the underlying cause. Final diagnosis was adjudicated by two independent experts. Follow-up was done after 30 and 180 days. Results: In total, 102 patients were enrolled. Of them, 89 patients received lung ultrasound evaluation in the ED. The sensitivity of lung ultrasound evaluation in ED in diagnosing AHF was 54.2%, specificity 97.6%. As much as 96.3% of patients with a positive LUS test result for AHF in ED actually suffered from AHF. Excluding diuretically pretreated patients, sensitivity of LUS increased to 75% in ED. Differences in the sum of B-lines between admission time point, 24 and 72 h were not statistically significant. There were no statistically significant differences in the subjectively assessed severity of dyspnea between AHF patients and those with other causes of dyspnea. Of the 89 patients, 48 patients received the final adjudicated diagnosis of AHF. ED physicians assessed the probability of AHF in patients with a final diagnosis of AHF as 70%. Roughly a quarter (23.9%) of the overall cohort patients were rehospitalized within 30 days after admission, 38.6% within 180 days of follow-up. Conclusion: In conclusion, point-of-care lung ultrasound is a helpful tool for the early rule-in of acute heart failure in ED but only partially suitable for exclusion. Of note, the present study shows no significant changes in the number of B-lines after 24 and 72 h.

show abstract

Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Lung Ultrasound Eight-Point Method in Diagnosing Acute Heart Failure in Emergency Patients with Acute Dyspnea: Diagnostic Accuracy and 72 h Monitoring

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Our findings were consistent with these observations. A small study from south India (n = 42) had looked into correlation of number of B-lines (comet score), echocardiography, BNP and chest X-ray findings in decompensated heart failure in an all-comer population and had reported similar findings 10 . However, we have found the comet score to have rapid temporal variation related to fluid status and hence have avoided using this number as a clinical tool.…”

Section: Discussionmentioning

confidence: 88%

Lung ultrasound evaluation of diabetic patients with acute onset dyspnea and its relationship with established markers of heart failure

Sikdar

Panja

Das

et al. 2018

Indian Heart Journal

View full text Add to dashboard Cite

ObjectiveThe aim of the study was to assess the interrelation between sonographic pleural B-Line, left ventricular function and Naturetic Peptides in type 2 Diabetics with acute onset class III-IV dyspnea. There is dearth of data in this subset of patients in Asian population.MethodsSubjects (n = 73) were divided into those with pleural B line (Group A, n = 41) and those without (Group B) and their serum B type Naturetic Peptide (BNP) and Echocardiography evaluated.ResultsThe serum BNP was significantly higher and mean Left Ventricular Ejection Fraction (LVEF) lower in Group A compared to Group B (p < 0.001). There was a significant negative correlation between LVEF and BNP and positive correlation between E/E’ and BNP. Among patients with LVEF 40% and above (n = 36), patients with B line had significantly higher BNP and E/E’ compared to those without. Group A had significantly more patients on insulin therapy and troponin positivity than Group B (p < 0.01). On auscultation though crepitations was found more frequently in group A but it was present in only 50% of the subset.ConclusionPleural B-Lines, LVEF and mitral inflow E/septal E’ can be used to rule in heart failure in the above population.

show abstract

“…Experts’ comments [ 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 ,…”

Section: Recommendationsunclassified

Recommendations for Lung Ultrasound in Internal Medicine

et al. 2020

View full text Add to dashboard Cite

A growing amount of evidence prompts us to update the first version of recommendations for lung ultrasound in internal medicine (POLLUS-IM) that was published in 2018. The recommendations were established in several stages, consisting of: literature review, assessment of literature data quality (with the application of QUADAS, QUADAS-2 and GRADE criteria) and expert evaluation carried out consistently with the modified Delphi method (three rounds of on-line discussions, followed by a secret ballot by the panel of experts after each completed discussion). Publications to be analyzed were selected from the following databases: Pubmed, Medline, OVID, and Embase. New reports published as of October 2019 were added to the existing POLLUS-IM database used for the original publication of 2018. Altogether, 528 publications were systematically reviewed, including 253 new reports published between September 2017 and October 2019. The new recommendations concern the following conditions and issues: pneumonia, heart failure, monitoring dialyzed patients’ hydration status, assessment of pleural effusion, pulmonary embolism and diaphragm function assessment. POLLUS-IM 2020 recommendations were established primarily for clinicians who utilize lung ultrasound in their everyday clinical work.

show abstract

Use of Lung Ultrasound For Diagnosing Acute Heart Failure in Emergency Department of Southern India

Cited by 5 publications

References 15 publications

Lung Ultrasound Eight-Point Method in Diagnosing Acute Heart Failure in Emergency Patients with Acute Dyspnea: Diagnostic Accuracy and 72 h Monitoring

Lung Ultrasound Eight-Point Method in Diagnosing Acute Heart Failure in Emergency Patients with Acute Dyspnea: Diagnostic Accuracy and 72 h Monitoring

Lung ultrasound evaluation of diabetic patients with acute onset dyspnea and its relationship with established markers of heart failure

Recommendations for Lung Ultrasound in Internal Medicine

Contact Info

Product

Resources

About