Performance of Pleuropulmonary Ultrasound in the Diagonisis of Acute Respiratory Conditions in Intensive Care Patients: Case of the Sens Hospital Center

Abstract

Background and Objective: Despite its increasing use, in critical care, the diagnosis accuracy of Lung Ultransound Sonographye (LUS) is a topic that remains highly debated. The objective of our study was to evaluate the performance of LUS compared to chest computer tomography (CT) in the diagnosis of acute respiratory condictions in critical patients at Sens hospital from March 1st to September 31st 2023. Methods: Single-center, cross-sectional study of 54 patients, all adult with acute respiratory symptoms who benefited concurrent LUS and chest CT scan. The LUS was performed according to the BLUE-Protocol by the doctors of the department, within 8 hours before the chest CT scan was performed. The CT scan was interpreted by the hospital's radiologists who were also blinded by the LUS results. The performance of LUS was assessed by calculating sensitivity (se), specificity (sp), positive predictive values (PPV) and negative predictive values (NPV) compared to chest CT. Results: Pneumothorax had a Se=100%, Sp=100, PPV=100%, NPV=100%, Youden=1.00, AUC=1.00; Interstitial syndrome had a Se=100%, Sp=98.1%, PPV=50%, NPV=100%, Youden=0.98%, AUC=0.99 with p=0.14. Alveolar consolidation had Se=100%, Sp=90.5%, PPV=94.3%, NPV=100%, Youden=0.90%, AUC=0.95%. Pleural effusion had Se=100%, Sp=88.9%, PPV=90%, NPV=100%, Youden=0.89%, AUC=0.94%. Pulmonary embolism had a Se=66.7%; Sp=97.9%, PPV=80%, NPV=95.9%, Youden=0.65%, AUC=0.82% with p=0.11. As for COPD/ Asthma decompensation, she had a Se=NA (not applicable), Sp=100%, PPV=NA, NPV=100%, Youden=NA and AUC=100%. Conclusion: The performance of LUS in this study are satisfactory for the diagnosis of alveolar consolidation, pneumothorax, pleural fluid effusion and interstitial syndrome (only as a function of Youden's index). They are less good for the diagnosis of pulmonary embolism. Thus, we propose it as an alternative to CT in patients in critical resuscitation.