Cross-sectional Study on Point-of-care Lung Ultrasound as a Diagnostic Tool in Patients with Acute Dyspnea Presenting to the Emergency Department

Document Type

Article

Publication Title

Indian Journal of Respiratory Care

Abstract

Background: Lung ultrasound relies on artifacts generated at the interface between the pleura and air within the lungs. Incorporating pointof-care lung ultrasound (POCUS) into emergency practice allows quicker and more accurate diagnoses and enables dynamic assessment of patients with dyspnea, facilitating ongoing monitoring and adjustments to treatment. The primary objective of this study was to estimate the proportion of different lung ultrasound findings in patients with acute dyspnea. The secondary objective was to assess the agreement of POCUS findings with clinical diagnosis made within 48 hours. Methods: This cross-sectional hospital-based study included patients aged more than 18 years presenting with the onset of dyspnea within the last 24 hours. Patients who did not consent, were not diagnosed within 48 hours, or were lost to follow-up were excluded. Ultrasound (Sonosite M Turbo) was used to evaluate 242 patients. Two observers assessed different lung ultrasound findings in patients, either in recumbent or semirecumbent positions. Each lung ultrasound finding was expressed in frequency (%), and its agreement with the final clinical diagnosis by the treating physician within 48 hours was calculated. Data were entered in a standard data sheet and analyzed using SPSS software. Results: Out of 242 patients, 45% had an A profile, 42.6% had a B profile, and 10% showed an AB profile. Effusion was observed in 0.1% of patients, and 0.02% showed an A’ profile. The shred sign indicating consolidation was present in 35% of patients, and lung sliding was not present in four patients, suggestive of pneumothorax. Ultrasound showed 92.9% sensitivity and 94.7% specificity for pleural effusion, and for pulmonary edema, it showed 96% sensitivity and 95.1% specificity. Also, it showed 90.7% sensitivity and 92.8% specificity for pneumonia, and 90.2% sensitivity and 99% specificity for chronic obstructive pulmonary disease (COPD)/asthma. Conclusion: Our study is in accordance with other similar studies, and we need more studies to further validate the use of lung ultrasound as a diagnostic tool in acute dyspnea patients.

First Page

159

Last Page

163

DOI

10.5005/jp-journals-11010-1200

Publication Date

7-1-2025

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