Diagnosis of pleural effusion by portable ultrasound and chest radiography in intensive care unit
Pleural effusion (PE) is common among ICU and acutely ill patients. Traditionally plain chest radiography (CXR) has been done for pleural effusion evaluation in ICU. However, better results have been reported by ultrasound for the diagnosis of this condition in ICU. In this study, we compared two m...
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| Format: | Article |
| Language: | fas |
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Tehran University of Medical Sciences
2014-10-01
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| Series: | Tehran University Medical Journal |
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| Online Access: | http://tumj.tums.ac.ir/browse.php?a_code=A-10-25-5253&slc_lang=en&sid=1 |
| _version_ | 1811263763155779584 |
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| author | Mohammadreza Kasraei Hamidreza Abtahi Niloofar Eyoobi Yazdi Enayat Safavi Shahram Firoozbakhsh Mostafa Mohammady |
| author_facet | Mohammadreza Kasraei Hamidreza Abtahi Niloofar Eyoobi Yazdi Enayat Safavi Shahram Firoozbakhsh Mostafa Mohammady |
| author_sort | Mohammadreza Kasraei |
| collection | DOAJ |
| description | Pleural effusion (PE) is common among ICU and acutely ill patients. Traditionally plain chest radiography (CXR) has been done for pleural effusion evaluation in ICU. However, better results have been reported by ultrasound for the diagnosis of this condition in ICU. In this study, we compared two methods of ultrasound and CXR in PE detection in ICU patients. Also we studied the percentage of thoracentesis by physician after detection of PE by ultrasonography or CXR.
Methods: Portable supine CXR and chest ultrasound were done in Thirty-nine non-surgical patients who were admitted to the Medical and General ICUs of Imam Khomeini hospital in Tehran from Oct 2013 to Mar 2014. Ultrasound was done and interpreted by radiologist and CXR by patient' physician. Thoracentesis or CT-scan was used as gold standard for PE diagnosis.
Results: Ultrasound in 29 patients (74.3%) showed PE. In 21 patients thoracentesis was done by patient’s physician and all had PE with mean volume of 447.2(417.6). In 13 of 18 patients without thoracentesis chest CT scan was available. It shows PE in 6 cases (all with positive PE in ultrasonography). CXR in 9 patients (23.1%) was positive for PE and in 30 patients (76.9%) was negative. The ability of chest ultrasound and CXR for diagnosis of PE was significantly different (P= 0.0.1). In 68.9 % of cases that ultrasound was positive, the CXR was negative and only in 34.5% of cases both methods had negative results. The sensitivity, specificity, positive and negative predictive values were 100% (87.1-100), 100% (58.9-100), 100% (87.1-100), 100% (58.9-100) respectively for ultrasonography. For CXR there were 33% (16.6-54.0), 100% (58.9-100), 100% (66.2-100), 28% (12.1-49.4) respectively.
Conclusion: Ultrasonography for diagnosis of pleural effusion in ICU patients has better diagnostic performance than portable CXR |
| first_indexed | 2024-04-12T19:51:05Z |
| format | Article |
| id | doaj.art-6af8d033e7524ecaa8fd6442406746a0 |
| institution | Directory Open Access Journal |
| issn | 1683-1764 1735-7322 |
| language | fas |
| last_indexed | 2024-04-12T19:51:05Z |
| publishDate | 2014-10-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Tehran University Medical Journal |
| spelling | doaj.art-6af8d033e7524ecaa8fd6442406746a02022-12-22T03:18:50ZfasTehran University of Medical SciencesTehran University Medical Journal1683-17641735-73222014-10-01727463470Diagnosis of pleural effusion by portable ultrasound and chest radiography in intensive care unitMohammadreza Kasraei 0Hamidreza Abtahi1Niloofar Eyoobi Yazdi2Enayat Safavi3Shahram Firoozbakhsh4Mostafa Mohammady5 Department of Pulmonary, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Pulmonary, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran Department of Pulmonary, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Pulmonary, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran Pleural effusion (PE) is common among ICU and acutely ill patients. Traditionally plain chest radiography (CXR) has been done for pleural effusion evaluation in ICU. However, better results have been reported by ultrasound for the diagnosis of this condition in ICU. In this study, we compared two methods of ultrasound and CXR in PE detection in ICU patients. Also we studied the percentage of thoracentesis by physician after detection of PE by ultrasonography or CXR. Methods: Portable supine CXR and chest ultrasound were done in Thirty-nine non-surgical patients who were admitted to the Medical and General ICUs of Imam Khomeini hospital in Tehran from Oct 2013 to Mar 2014. Ultrasound was done and interpreted by radiologist and CXR by patient' physician. Thoracentesis or CT-scan was used as gold standard for PE diagnosis. Results: Ultrasound in 29 patients (74.3%) showed PE. In 21 patients thoracentesis was done by patient’s physician and all had PE with mean volume of 447.2(417.6). In 13 of 18 patients without thoracentesis chest CT scan was available. It shows PE in 6 cases (all with positive PE in ultrasonography). CXR in 9 patients (23.1%) was positive for PE and in 30 patients (76.9%) was negative. The ability of chest ultrasound and CXR for diagnosis of PE was significantly different (P= 0.0.1). In 68.9 % of cases that ultrasound was positive, the CXR was negative and only in 34.5% of cases both methods had negative results. The sensitivity, specificity, positive and negative predictive values were 100% (87.1-100), 100% (58.9-100), 100% (87.1-100), 100% (58.9-100) respectively for ultrasonography. For CXR there were 33% (16.6-54.0), 100% (58.9-100), 100% (66.2-100), 28% (12.1-49.4) respectively. Conclusion: Ultrasonography for diagnosis of pleural effusion in ICU patients has better diagnostic performance than portable CXRhttp://tumj.tums.ac.ir/browse.php?a_code=A-10-25-5253&slc_lang=en&sid=1chest X-ray intensive care unit lung pleural effusion ultrasonography |
| spellingShingle | Mohammadreza Kasraei Hamidreza Abtahi Niloofar Eyoobi Yazdi Enayat Safavi Shahram Firoozbakhsh Mostafa Mohammady Diagnosis of pleural effusion by portable ultrasound and chest radiography in intensive care unit Tehran University Medical Journal chest X-ray intensive care unit lung pleural effusion ultrasonography |
| title | Diagnosis of pleural effusion by portable ultrasound and chest radiography in intensive care unit |
| title_full | Diagnosis of pleural effusion by portable ultrasound and chest radiography in intensive care unit |
| title_fullStr | Diagnosis of pleural effusion by portable ultrasound and chest radiography in intensive care unit |
| title_full_unstemmed | Diagnosis of pleural effusion by portable ultrasound and chest radiography in intensive care unit |
| title_short | Diagnosis of pleural effusion by portable ultrasound and chest radiography in intensive care unit |
| title_sort | diagnosis of pleural effusion by portable ultrasound and chest radiography in intensive care unit |
| topic | chest X-ray intensive care unit lung pleural effusion ultrasonography |
| url | http://tumj.tums.ac.ir/browse.php?a_code=A-10-25-5253&slc_lang=en&sid=1 |
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