The diagnostic performance of chest ultrasonography in the up-to-date work-up of the critical care setting

Abstract

BackgroundManagement of patients in the critical care setting is crucial. The availability, the absence of ionizing radiation and the non invasive nature of chest ultrasonography (US) have currently increased its use in the up-to-date work-up of various pleuropulmonary abnormalities in the critical care setting. ObjectiveTo evaluate the sensitivity, specificity and diagnostic accuracy of chest US for various pleuropulmonary abnormalities in intensive care unit (ICU) patients. Materials and methodsNinety consecutive patients admitted in chest ICU with respiratory distress were assessed clinically and by chest radiography (CXR). They were suspected to have a provisional diagnosis of any of the following pathological entities: pneumonic consolidation, bronchogenic carcinoma, metastatic pulmonary nodules, pleural effusion, pneumothorax, hydropneumothorax and mesothelioma. These patients were scheduled for chest computed tomography (CT) and prospectively reviewed using chest US. The results of chest US were compared with these of chest CT for each encountered pathological entity using chest CT as the diagnostic standard of reference to subsequently calculate the sensitivity, specificity and diagnostic accuracy of chest US. ResultsThe sensitivity, specificity and diagnostic accuracy of chest US were 100%, 96% and 97% for pneumonic consolidation, 71%, 100% and 98% for bronchogenic carcinoma and 92%, 100% and 99% for pneumothorax respectively. The sensitivity, specificity and diagnostic accuracy of 100% for the rest of the included pathological entities were obtained. ConclusionChest ultrasonography has a considerable diagnostic performance for various pleuropulmonary pathological conditions that may be encountered in the ICU patients making it as an adjunct tool in the up-to-date work-up of the ICU setting.