Daniel A Lichtenstein1,2,3, Nathalie Lascols4, Gilbert Mezière5,4,6, Agnès Gepner6. 1. Service de Réanimation Médicale, Hôpital Ambroise-Paré, 9 avenue du Général Charles-de-Gaulle, 92100 , Boulogne (Paris-Ouest), France. dlicht@free.fr. 2. Cercle des Echographistes d'Urgence et de Réanimation Francophones, 14 rue Alfred Couturier, 78160 , Marly, France. dlicht@free.fr. 3. Service de Réanimation Polyvalente, Centre Hospitalier Général, 92210 , Saint-Cloud (Paris), France. dlicht@free.fr. 4. Cercle des Echographistes d'Urgence et de Réanimation Francophones, 14 rue Alfred Couturier, 78160 , Marly, France. 5. Service de Réanimation Médicale, Hôpital Ambroise-Paré, 9 avenue du Général Charles-de-Gaulle, 92100 , Boulogne (Paris-Ouest), France. 6. Service de Réanimation Polyvalente, Centre Hospitalier Général, 92210 , Saint-Cloud (Paris), France.
Abstract
OBJECTIVE: Alveolar consolidation is a basic concern in critically ill patients. Radiography is not a precise tool, and referral to CT raises problems (transport, irradiation). The aim of this study was to assess the utility of ultrasound in the diagnosis of alveolar consolidation. DESIGN: Prospective clinical study. SETTING: The medical ICU of a university-affiliated teaching hospital. PATIENTS: A total of 65 cases of alveolar consolidation proven on CT were compared to 53 CT controls. MEASUREMENTS: Alveolar consolidation was defined as a tissue-like pattern visible at the chest wall, arising from the pleural line and devoid of centrifugal inspiratory dynamics. RESULTS: Feasibility was 99%. In 65 cases of alveolar consolidation, ultrasound was positive in 59 and negative in 6. In 52 analyzable controls, ultrasound was negative in 51 and positive in 1. Sensitivity of ultrasound was 90% and specificity 98%. A concordance test showed a Kappa coefficient of 0.89. Among 62 posterior locations on CT, ultrasound showed posterior consolidation patterns in 56 cases and was negative in 6. Ultrasound showed anterior involvement in all 3 cases of whole lung consolidation. CONCLUSIONS: Ultrasound provides a reliable non-invasive, bedside method for accurate detection and location of alveolar consolidation in critically ill patients.
OBJECTIVE:Alveolar consolidation is a basic concern in critically illpatients. Radiography is not a precise tool, and referral to CT raises problems (transport, irradiation). The aim of this study was to assess the utility of ultrasound in the diagnosis of alveolar consolidation. DESIGN: Prospective clinical study. SETTING: The medical ICU of a university-affiliated teaching hospital. PATIENTS: A total of 65 cases of alveolar consolidation proven on CT were compared to 53 CT controls. MEASUREMENTS: Alveolar consolidation was defined as a tissue-like pattern visible at the chest wall, arising from the pleural line and devoid of centrifugal inspiratory dynamics. RESULTS: Feasibility was 99%. In 65 cases of alveolar consolidation, ultrasound was positive in 59 and negative in 6. In 52 analyzable controls, ultrasound was negative in 51 and positive in 1. Sensitivity of ultrasound was 90% and specificity 98%. A concordance test showed a Kappa coefficient of 0.89. Among 62 posterior locations on CT, ultrasound showed posterior consolidation patterns in 56 cases and was negative in 6. Ultrasound showed anterior involvement in all 3 cases of whole lung consolidation. CONCLUSIONS: Ultrasound provides a reliable non-invasive, bedside method for accurate detection and location of alveolar consolidation in critically illpatients.
Authors: G Mathis; R Bitschnau; O Gehmacher; M Scheier; A Kopf; B Schwärzler; T Amann; W Doringer; K Hergan Journal: Ultraschall Med Date: 1999-04 Impact factor: 6.548
Authors: Giovanni Volpicelli; Mahmoud Elbarbary; Michael Blaivas; Daniel A Lichtenstein; Gebhard Mathis; Andrew W Kirkpatrick; Lawrence Melniker; Luna Gargani; Vicki E Noble; Gabriele Via; Anthony Dean; James W Tsung; Gino Soldati; Roberto Copetti; Belaid Bouhemad; Angelika Reissig; Eustachio Agricola; Jean-Jacques Rouby; Charlotte Arbelot; Andrew Liteplo; Ashot Sargsyan; Fernando Silva; Richard Hoppmann; Raoul Breitkreutz; Armin Seibel; Luca Neri; Enrico Storti; Tomislav Petrovic Journal: Intensive Care Med Date: 2012-03-06 Impact factor: 17.440
Authors: Jonathan M Rubin; Jeffrey C Horowitz; Thomas H Sisson; Kang Kim; Luis A Ortiz; James D Hamilton Journal: Ultrasound Med Biol Date: 2016-08-10 Impact factor: 2.998
Authors: G Volpicelli; A Lamorte; M Tullio; L Cardinale; M Giraudo; V Stefanone; E Boero; P Nazerian; R Pozzi; M F Frascisco Journal: Intensive Care Med Date: 2013-04-13 Impact factor: 17.440