Abstract:
OBJECTIVES:Lung CT is the reference imaging technique for acute respiratory distress syndrome, but requires transportation outside the intensive care and x-ray exposure. Lung ultrasound is a promising, inexpensive, radiation-free, tool for bedside imaging. Aim of the present study was to compare the global and regional diagnostic accuracy of lung ultrasound and CT scan. DESIGN:A prospective, observational study. SETTING:Intensive care and radiology departments of a University hospital. PATIENTS:Thirty-two sedated, paralyzed acute respiratory distress syndrome patients (age 65 ± 14 yr, body mass index 25.9 ± 6.5 kg/m, and PaO2/FIO2 139 ± 47). INTERVENTIONS:Lung CT scan and lung ultrasound were performed at positive end-expiratory pressure 5 cm H2O. A standardized assessment of six regions per hemithorax was used; each region was classified for the presence of normal aeration, alveolar-interstitial syndrome, consolidation, and pleural effusion. Agreement between the two techniques was calculated, and diagnostic variables were assessed for lung ultrasound using lung CT as a reference. MEASUREMENTS AND MAIN RESULTS:Global agreement between lung ultrasound and CT ranged from 0.640 (0.391-0.889) to 0.934 (0.605-1.000) and was on average 0.775 (0.577-0.973). The overall sensitivity and specificity of lung ultrasound ranged from 82.7% to 92.3% and from 90.2% to 98.6%, respectively. Similar results were found with regional analysis. The diagnostic accuracy of lung ultrasound was significantly higher when those patterns not reaching the pleural surface were excluded (area under the receiver operating characteristic curve: alveolar-interstitial syndrome 0.854 [0.821-0.887] vs 0.903 [0.852-0.954]; p = 0.049 and consolidation 0.851 [0.818-0.884] vs 0.896 [0.862-0.929]; p = 0.044). CONCLUSIONS:Lung ultrasound is a reproducible, sensitive, and specific tool, which allows for bedside detections of the morphologic patterns in acute respiratory distress syndrome. The presence of deep lung alterations may impact the diagnostic performance of this technique.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Chiumello D,Umbrello M,Sferrazza Papa GF,Angileri A,Gurgitano M,Formenti P,Coppola S,Froio S,Cammaroto A,Carrafiello Gdoi
10.1097/CCM.0000000000003971subject
Has Abstractpub_date
2019-11-01 00:00:00pages
1599-1606issue
11eissn
0090-3493issn
1530-0293journal_volume
47pub_type
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journal_title:Critical care medicine
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journal_title:Critical care medicine
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doi:10.1097/00003246-198607000-00005
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abstract::High frequency positive pressure ventilation (HFPPV) was compared with normal frequency positive pressure ventilation (NFPPV) during diagnostic fiberoptic-bronchoscopy. HFPPV was achieved by a simple modification of the Minivent, and gave satisfactory alveolar ventilation and oxygenation. In all 11 patients and over p...
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journal_title:Critical care medicine
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doi:10.1097/00003246-198509000-00001
更新日期:1985-09-01 00:00:00
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doi:10.1097/00003246-198408000-00020
更新日期:1984-08-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
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更新日期:2008-08-01 00:00:00
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更新日期:1983-07-01 00:00:00
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doi:10.1097/00003246-199405000-00027
更新日期:1994-05-01 00:00:00
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doi:10.1097/CCM.0000000000001264
更新日期:2015-11-01 00:00:00
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更新日期:2014-09-01 00:00:00
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doi:10.1097/00003246-199102000-00023
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更新日期:1990-04-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2008-03-01 00:00:00
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更新日期:2005-01-01 00:00:00
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更新日期:2016-05-01 00:00:00
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更新日期:2007-06-01 00:00:00
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更新日期:2020-12-01 00:00:00
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更新日期:2007-11-01 00:00:00
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更新日期:2009-08-01 00:00:00