Diagnostic accuracy of the Bedside Lung Ultrasound in Emergency protocol for the diagnosis of acute respiratory failure in spontaneously breathing patients,
Objective: Bedside lung ultrasound (LUS) is a noninvasive, readily available imaging modality that can complement clinical evaluation. The Bedside Lung Ultrasound in Emergency (BLUE) protocol has demonstrated a high diagnostic accuracy in patients with acute respiratory failure (ARF). Recently, bed...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Pneumologia e Tisiologia
2015-02-01
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| Series: | Jornal Brasileiro de Pneumologia |
| Subjects: | |
| Online Access: | http://www.scielo.br/pdf/jbpneu/v41n1/pt_1806-3713-jbpneu-41-01-00058.pdf |
| _version_ | 1818889462943318016 |
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| author | Felippe Leopoldo Dexheimer Neto Juliana Mara Stormovski de Andrade Ana Carolina Tabajara Raupp Raquel da Silva Townsend Fabiana Gabe Beltrami Hélène Brisson Qin Lu Paulo de Tarso Roth Dalcin |
| author_facet | Felippe Leopoldo Dexheimer Neto Juliana Mara Stormovski de Andrade Ana Carolina Tabajara Raupp Raquel da Silva Townsend Fabiana Gabe Beltrami Hélène Brisson Qin Lu Paulo de Tarso Roth Dalcin |
| author_sort | Felippe Leopoldo Dexheimer Neto |
| collection | DOAJ |
| description | Objective: Bedside lung ultrasound (LUS) is a noninvasive, readily available imaging modality that can complement clinical evaluation. The Bedside Lung Ultrasound in Emergency (BLUE) protocol has demonstrated a high diagnostic accuracy in patients with acute respiratory failure (ARF). Recently, bedside LUS has been added to the medical training program of our ICU. The aim of this study was to investigate the accuracy of LUS based on the BLUE protocol, when performed by physicians who are not ultrasound experts, to guide the diagnosis of ARF. Methods: Over a one-year period, all spontaneously breathing adult patients consecutively admitted to the ICU for ARF were prospectively included. After training, 4 non-ultrasound experts performed LUS within 20 minutes of patient admission. They were blinded to patient medical history. LUS diagnosis was compared with the final clinical diagnosis made by the ICU team before patients were discharged from the ICU (gold standard). Results: Thirty-seven patients were included in the analysis (mean age, 73.2 ± 14.7 years; APACHE II, 19.2 ± 7.3). LUS diagnosis had a good agreement with the final diagnosis in 84% of patients (overall kappa, 0.81). The most common etiologies for ARF were pneumonia (n = 17) and hemodynamic lung edema (n = 15). The sensitivity and specificity of LUS as measured against the final diagnosis were, respectively, 88% and 90% for pneumonia and 86% and 87% for hemodynamic lung edema. Conclusions: LUS based on the BLUE protocol was reproducible by physicians who are not ultrasound experts and accurate for the diagnosis of pneumonia and hemodynamic lung edema. |
| first_indexed | 2024-12-19T17:09:25Z |
| format | Article |
| id | doaj.art-ae20886fbc5742c5afc14217d1f02fcb |
| institution | Directory Open Access Journal |
| issn | 1806-3756 |
| language | English |
| last_indexed | 2024-12-19T17:09:25Z |
| publishDate | 2015-02-01 |
| publisher | Sociedade Brasileira de Pneumologia e Tisiologia |
| record_format | Article |
| series | Jornal Brasileiro de Pneumologia |
| spelling | doaj.art-ae20886fbc5742c5afc14217d1f02fcb2022-12-21T20:13:04ZengSociedade Brasileira de Pneumologia e TisiologiaJornal Brasileiro de Pneumologia1806-37562015-02-01411586410.1590/s1806-37132015000100008Diagnostic accuracy of the Bedside Lung Ultrasound in Emergency protocol for the diagnosis of acute respiratory failure in spontaneously breathing patients,Felippe Leopoldo Dexheimer NetoJuliana Mara Stormovski de AndradeAna Carolina Tabajara RauppRaquel da Silva TownsendFabiana Gabe BeltramiHélène BrissonQin LuPaulo de Tarso Roth DalcinObjective: Bedside lung ultrasound (LUS) is a noninvasive, readily available imaging modality that can complement clinical evaluation. The Bedside Lung Ultrasound in Emergency (BLUE) protocol has demonstrated a high diagnostic accuracy in patients with acute respiratory failure (ARF). Recently, bedside LUS has been added to the medical training program of our ICU. The aim of this study was to investigate the accuracy of LUS based on the BLUE protocol, when performed by physicians who are not ultrasound experts, to guide the diagnosis of ARF. Methods: Over a one-year period, all spontaneously breathing adult patients consecutively admitted to the ICU for ARF were prospectively included. After training, 4 non-ultrasound experts performed LUS within 20 minutes of patient admission. They were blinded to patient medical history. LUS diagnosis was compared with the final clinical diagnosis made by the ICU team before patients were discharged from the ICU (gold standard). Results: Thirty-seven patients were included in the analysis (mean age, 73.2 ± 14.7 years; APACHE II, 19.2 ± 7.3). LUS diagnosis had a good agreement with the final diagnosis in 84% of patients (overall kappa, 0.81). The most common etiologies for ARF were pneumonia (n = 17) and hemodynamic lung edema (n = 15). The sensitivity and specificity of LUS as measured against the final diagnosis were, respectively, 88% and 90% for pneumonia and 86% and 87% for hemodynamic lung edema. Conclusions: LUS based on the BLUE protocol was reproducible by physicians who are not ultrasound experts and accurate for the diagnosis of pneumonia and hemodynamic lung edema.http://www.scielo.br/pdf/jbpneu/v41n1/pt_1806-3713-jbpneu-41-01-00058.pdfUltrasonography, interventionalRespiratory insufficiencyIntensive care units |
| spellingShingle | Felippe Leopoldo Dexheimer Neto Juliana Mara Stormovski de Andrade Ana Carolina Tabajara Raupp Raquel da Silva Townsend Fabiana Gabe Beltrami Hélène Brisson Qin Lu Paulo de Tarso Roth Dalcin Diagnostic accuracy of the Bedside Lung Ultrasound in Emergency protocol for the diagnosis of acute respiratory failure in spontaneously breathing patients, Jornal Brasileiro de Pneumologia Ultrasonography, interventional Respiratory insufficiency Intensive care units |
| title | Diagnostic accuracy of the Bedside Lung Ultrasound in Emergency protocol for the diagnosis of acute respiratory failure in spontaneously breathing patients, |
| title_full | Diagnostic accuracy of the Bedside Lung Ultrasound in Emergency protocol for the diagnosis of acute respiratory failure in spontaneously breathing patients, |
| title_fullStr | Diagnostic accuracy of the Bedside Lung Ultrasound in Emergency protocol for the diagnosis of acute respiratory failure in spontaneously breathing patients, |
| title_full_unstemmed | Diagnostic accuracy of the Bedside Lung Ultrasound in Emergency protocol for the diagnosis of acute respiratory failure in spontaneously breathing patients, |
| title_short | Diagnostic accuracy of the Bedside Lung Ultrasound in Emergency protocol for the diagnosis of acute respiratory failure in spontaneously breathing patients, |
| title_sort | diagnostic accuracy of the bedside lung ultrasound in emergency protocol for the diagnosis of acute respiratory failure in spontaneously breathing patients |
| topic | Ultrasonography, interventional Respiratory insufficiency Intensive care units |
| url | http://www.scielo.br/pdf/jbpneu/v41n1/pt_1806-3713-jbpneu-41-01-00058.pdf |
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