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Diagnostic Accuracy of Bedside Lung Ultrasound and Chest Radiography Compared to Thoracic Computed Tomography in Critically Ill Patients

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Abstract

Bedside lung ultrasound (LUS) is being adopted in ICUs, with a higher diagnostic accuracy for consolidation, interstitial syndrome, pleural effusion, and pneumothorax when compared with chest radiography (CXR). Compare the diagnostic performance of LUS and CXR for the detection of pathologic abnormalities in critically ill patients in ICU, using thoracic computed tomography (CT) as a gold standard. Prospective and descriptive single-center study. Prior to CT, we performed bedside LUS and CXR, evaluating hemithoraces and characterized them as positive or negative for each of four abnormalities (consolidation syndrome, interstitial syndrome, pleural effusion, and pneumothorax). We decided therapeutic intervention after CT. A total of 58 patients were evaluated. With CT, consolidation was present in 100 (89.3%) of the evaluated hemithoraces, followed by pleural effusion in 74 (66.1%), interstitial syndrome in 40 (35.7%), and pneumothorax in 4 (3.6%). LUS performed better than CXR, exhibiting significantly higher sensitivity for all conditions. CXR had a marginally higher specificity than LUS for consolidation, interstitial syndrome, and pneumothorax. In 42 (72%) patients, imaging studies led to a specific action; in 33 (79%) patients, a subsequent measure was performed based on the information provided by LUS. In critically ill patients, bedside LUS shows better diagnostic performance than CXR for the diagnosis of common pathologic conditions and could be an alternative to CT scans.

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Data Availability

Data are available upon request to authors.

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Authors and Affiliations

  1. Intensive Care Unit, German Hospital (Hospital Aleman), Pueyrredón 1640, 1118, Buenos Aires, Argentina

    Fernando Ariel Sosa, Mercedes Kleinert, Agustín Matarrese, Juan José Folco, Santiago Saavedra, Graciela Dorotesky, Javier Roberti & Francisco Tamagnone

  2. Intensive Care Unit, Sanatorio de Los Arcos, Buenos Aires, Argentina

    Isaac Cheong & Federico Matías Alvarez

  3. CIESP-CONICET, Buenos Aires, Argentina

    Javier Roberti

Authors
  1. Fernando Ariel Sosa
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  2. Mercedes Kleinert
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  3. Agustín Matarrese
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  4. Isaac Cheong
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  5. Juan José Folco
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  6. Santiago Saavedra
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  7. Graciela Dorotesky
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  8. Javier Roberti
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  9. Federico Matías Alvarez
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  10. Francisco Tamagnone
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Contributions

FAS and MK: concept, design, investigation, data analysis, draft writing, review. JR: data analysis, investigation, writing, editing, review. JC, JJF, SS, GD, FT: investigation, data analysis, data curation, draft writing, review. IC and FMA: data analysis, interpreted results, draft writing, editing and revisions.

Corresponding author

Correspondence to Javier Roberti.

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This study was approved by the Ethics Committee of the Hospital Alemán (German Hospital) of Buenos Aires, Argentina.

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Informed consent was obtained from patients or their families.

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Informed consent for publication was obtained from patients or their families. All information from patients was anonymised.

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The authors declare no competing interests.

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Sosa, F.A., Kleinert, M., Matarrese, A. et al. Diagnostic Accuracy of Bedside Lung Ultrasound and Chest Radiography Compared to Thoracic Computed Tomography in Critically Ill Patients. SN Compr. Clin. Med. 4, 256 (2022). https://doi.org/10.1007/s42399-022-01337-4

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  • DOI: https://doi.org/10.1007/s42399-022-01337-4

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