Antonella Vezzani1, Tullio Manca2, Claudia Brusasco3, Gregorio Santori3, Massimo Valentino4, Francesco Nicolini2, Alberto Molardi2, Tiziano Gherli2, Francesco Corradi5. 1. Department of Surgery, Cardiac Surgery Intensive Care Unit, University Hospital of Parma, Parma. Electronic address: avezzani@ao.pr.it. 2. Department of Surgery, Cardiac Surgery Intensive Care Unit, University Hospital of Parma, Parma. 3. University of Genova, Genova. 4. S.O.C. Radiology Azienda Servizi Sanitari 3 - Friuli Venezia Giulia. 5. Department of Surgery, Cardiac Surgery Intensive Care Unit, University Hospital of Parma, Parma; Department of Critical Care, Intensive Care Unit, E.O. Ospedali Galliera, Genova, Italy.
Abstract
OBJECTIVE: Chest auscultation and chest x-ray commonly are used to detect postoperative abnormalities and complications in patients admitted to intensive care after cardiac surgery. The aim of the study was to evaluate whether chest ultrasound represents an effective alternative to bedside chest x-ray to identify early postoperative abnormalities. DESIGN: Diagnostic accuracy of chest auscultation and chest ultrasound were compared in identifying individual abnormalities detected by chest x-ray, considered the reference method. SETTING: Cardiac surgery intensive care unit. PARTICIPANTS: One hundred fifty-one consecutive adult patients undergoing cardiac surgery. INTERVENTIONS: All patients included were studied by chest auscultation, ultrasound, and x-ray upon admission to intensive care after cardiac surgery. MEASUREMENTS AND MAIN RESULTS: Six lung pathologic changes and endotracheal tube malposition were found. There was a highly significant correlation between abnormalities detected by chest ultrasound and x-ray (k = 0.90), but a poor correlation between chest auscultation and x-ray abnormalities (k = 0.15). CONCLUSIONS: Chest auscultation may help identify endotracheal tube misplacement and tension pneumothorax but it may miss most major abnormalities. Chest ultrasound represents a valid alternative to chest x-ray to detect most postoperative abnormalities and misplacements.
OBJECTIVE: Chest auscultation and chest x-ray commonly are used to detect postoperative abnormalities and complications in patients admitted to intensive care after cardiac surgery. The aim of the study was to evaluate whether chest ultrasound represents an effective alternative to bedside chest x-ray to identify early postoperative abnormalities. DESIGN: Diagnostic accuracy of chest auscultation and chest ultrasound were compared in identifying individual abnormalities detected by chest x-ray, considered the reference method. SETTING: Cardiac surgery intensive care unit. PARTICIPANTS: One hundred fifty-one consecutive adult patients undergoing cardiac surgery. INTERVENTIONS: All patients included were studied by chest auscultation, ultrasound, and x-ray upon admission to intensive care after cardiac surgery. MEASUREMENTS AND MAIN RESULTS: Six lung pathologic changes and endotracheal tube malposition were found. There was a highly significant correlation between abnormalities detected by chest ultrasound and x-ray (k = 0.90), but a poor correlation between chest auscultation and x-ray abnormalities (k = 0.15). CONCLUSIONS: Chest auscultation may help identify endotracheal tube misplacement and tension pneumothorax but it may miss most major abnormalities. Chest ultrasound represents a valid alternative to chest x-ray to detect most postoperative abnormalities and misplacements.
Authors: H R Touw; K L Parlevliet; M Beerepoot; P Schober; A Vonk; J W Twisk; P W Elbers; C Boer; P R Tuinman Journal: Anaesthesia Date: 2018-03-12 Impact factor: 6.955
Authors: Kirubanand Senniappan; Rupa Sreedhar; M S Saravana Babu; Prasanta Kumar Dash; Shrinivas V Gadhinglajkar; Subin Sukesan Journal: Anesth Essays Res Date: 2019-12-16