Chest X-rays and Lung Ultrasound Are Not Interchangeable in Intensive Care Practice
Purpose: Data comparing lung ultrasound (LUS) and chest X-rays (CXRs) have increased over the past years. However, there still is a lack of knowledge as to how these modalities compare with one another in the critical care setting, and several factors, including artificial study conditions, limit th...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/14/1/82 |
| _version_ | 1797358928408870912 |
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| author | Stefan Schmidt Nico Behnke Jana-Katharina Dieks |
| author_facet | Stefan Schmidt Nico Behnke Jana-Katharina Dieks |
| author_sort | Stefan Schmidt |
| collection | DOAJ |
| description | Purpose: Data comparing lung ultrasound (LUS) and chest X-rays (CXRs) have increased over the past years. However, there still is a lack of knowledge as to how these modalities compare with one another in the critical care setting, and several factors, including artificial study conditions, limit the generalizability of most published studies. Our study aimed to analyze the performance of LUS in comparison with CXRs in real-world critical care practice. Materials and Methods: This study presents new data from the prospective FASP-ICU trial. A total of 209 corresponding datasets of LUS and CXR results from 111 consecutive surgical ICU patients were subanalyzed, and categorial findings were compared. Statistical analysis was performed on the rates of agreement between the different imaging modalities. Results: A total of 1162 lung abnormalities were detected by LUS in ICU patients compared with 1228 detected by CXR, a non-significant difference (<i>p</i> = 0.276; 95% CI −0.886 to 0.254). However, the agreement rates varied between the observed abnormalities: the rate of agreement for the presence of interstitial syndrome ranged from 0 to 15%, consolidation from 0 to 56%, basal atelectasis from 33.9 to 49.34%, pleural effusion from 40.65 to 50%, and compression atelectasis from 14.29 to 19.3%. The rate of agreement was 0% for pneumothorax and 20.95% for hypervolemia. Conclusions: LUS does not detect more lung abnormalities in real-world critical care practice than CXRs, although a higher sensitivity of LUS has been reported in previous studies. Overall, low agreement rates between LUS and CXRs suggest that these diagnostic techniques are not equivalent but instead are complementary and should be used alongside each other. |
| first_indexed | 2024-03-08T15:09:16Z |
| format | Article |
| id | doaj.art-4c82e2e2bf214718be05dfd9b88eaa42 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-08T15:09:16Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-4c82e2e2bf214718be05dfd9b88eaa422024-01-10T14:53:55ZengMDPI AGDiagnostics2075-44182023-12-011418210.3390/diagnostics14010082Chest X-rays and Lung Ultrasound Are Not Interchangeable in Intensive Care PracticeStefan Schmidt0Nico Behnke1Jana-Katharina Dieks2Department of Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Goettingen, Georg August University, Robert-Koch-Str. 40, 37075 Goettingen, GermanyInstitute for Diagnostic and Interventional Radiology, University Hospital Goettingen, Georg August University, Robert-Koch-Str. 40, 37075 Goettingen, GermanyDepartment of Pediatric Cardiology and Pediatric Intensive Care Medicine, University Hospital Goettingen, Georg August University, Robert-Koch-Str. 40, 37075 Goettingen, GermanyPurpose: Data comparing lung ultrasound (LUS) and chest X-rays (CXRs) have increased over the past years. However, there still is a lack of knowledge as to how these modalities compare with one another in the critical care setting, and several factors, including artificial study conditions, limit the generalizability of most published studies. Our study aimed to analyze the performance of LUS in comparison with CXRs in real-world critical care practice. Materials and Methods: This study presents new data from the prospective FASP-ICU trial. A total of 209 corresponding datasets of LUS and CXR results from 111 consecutive surgical ICU patients were subanalyzed, and categorial findings were compared. Statistical analysis was performed on the rates of agreement between the different imaging modalities. Results: A total of 1162 lung abnormalities were detected by LUS in ICU patients compared with 1228 detected by CXR, a non-significant difference (<i>p</i> = 0.276; 95% CI −0.886 to 0.254). However, the agreement rates varied between the observed abnormalities: the rate of agreement for the presence of interstitial syndrome ranged from 0 to 15%, consolidation from 0 to 56%, basal atelectasis from 33.9 to 49.34%, pleural effusion from 40.65 to 50%, and compression atelectasis from 14.29 to 19.3%. The rate of agreement was 0% for pneumothorax and 20.95% for hypervolemia. Conclusions: LUS does not detect more lung abnormalities in real-world critical care practice than CXRs, although a higher sensitivity of LUS has been reported in previous studies. Overall, low agreement rates between LUS and CXRs suggest that these diagnostic techniques are not equivalent but instead are complementary and should be used alongside each other.https://www.mdpi.com/2075-4418/14/1/82chest ultrasoundpoint-of-care lung ultrasoundthoracic ultrasoundcritical carechest radiography |
| spellingShingle | Stefan Schmidt Nico Behnke Jana-Katharina Dieks Chest X-rays and Lung Ultrasound Are Not Interchangeable in Intensive Care Practice Diagnostics chest ultrasound point-of-care lung ultrasound thoracic ultrasound critical care chest radiography |
| title | Chest X-rays and Lung Ultrasound Are Not Interchangeable in Intensive Care Practice |
| title_full | Chest X-rays and Lung Ultrasound Are Not Interchangeable in Intensive Care Practice |
| title_fullStr | Chest X-rays and Lung Ultrasound Are Not Interchangeable in Intensive Care Practice |
| title_full_unstemmed | Chest X-rays and Lung Ultrasound Are Not Interchangeable in Intensive Care Practice |
| title_short | Chest X-rays and Lung Ultrasound Are Not Interchangeable in Intensive Care Practice |
| title_sort | chest x rays and lung ultrasound are not interchangeable in intensive care practice |
| topic | chest ultrasound point-of-care lung ultrasound thoracic ultrasound critical care chest radiography |
| url | https://www.mdpi.com/2075-4418/14/1/82 |
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