Louise Hansell1, Maree Milross2, Anthony Delaney3, David H Tian4, George Ntoumenopoulos5. 1. Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Physiotherapy Department, Royal North Shore Hospital, Sydney, Australia. Electronic address: Louise.Hansell@health.nsw.gov.au. 2. Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. 3. Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia; Division of Critical Care, The George Institute for Global Health, University of New South Wales, Sydney, Australia; Northern Clinical School, Faculty of Medicine, The University of Sydney, Sydney, Australia; ANZIC Research Centre, Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia. 4. Department of Anaesthesia and Perioperative Medicine, Westmead Hospital, Sydney, Australia. 5. Physiotherapy Department, St Vincent's Hospital, Sydney, Australia.
Abstract
QUESTION: In mechanically ventilated adults in intensive care, what is the accuracy of lung ultrasound (LUS) for the diagnosis of pleural effusion, lung consolidation and lung collapse when compared with chest radiograph (CXR) and lung auscultation, with computed tomography (CT) as the reference standard? DESIGN: Systematic review with meta-analysis of prospective cohort studies. PARTICIPANTS: Adult patients admitted to intensive care, with diagnostic uncertainty at enrolment regarding pleural effusion, lung consolidation and/or collapse/atelectasis. INDEX TEST: The diagnostic accuracy of LUS as the index test was estimated against CXR and/or lung auscultation as comparators, with thoracic CT scan as the reference standard. OUTCOME MEASURES: Measures of diagnostic accuracy. RESULTS: Seven eligible studies were identified, five of which (with 253 participants) were included in the meta-analysis. It was found that LUS had a pooled sensitivity of 92% and 91% in the diagnosis of consolidation and pleural effusion, respectively, and pooled specificity of 92% for both pathologies. CXR had a pooled sensitivity of 53% and 42% and a pooled specificity of 78% and 81% in the diagnosis of consolidation and pleural effusion, respectively. A meta-analysis for lung auscultation was not possible, although a single study reported a sensitivity and specificity of 8% and 100%, respectively, for diagnosing consolidation, and a sensitivity and specificity of 42% and 90%, respectively, for diagnosing pleural effusion. CONCLUSION: This systematic review with meta-analysis demonstrated high sensitivity of LUS compared with CXR, with similar specificities when diagnosing pleural effusion and lung consolidation/collapse. REGISTRATION: PROSPERO CRD42018095555.
QUESTION: In mechanically ventilated adults in intensive care, what is the accuracy of lung ultrasound (LUS) for the diagnosis of pleural effusion, lung consolidation and lung collapse when compared with chest radiograph (CXR) and lung auscultation, with computed tomography (CT) as the reference standard? DESIGN: Systematic review with meta-analysis of prospective cohort studies. PARTICIPANTS: Adult patients admitted to intensive care, with diagnostic uncertainty at enrolment regarding pleural effusion, lung consolidation and/or collapse/atelectasis. INDEX TEST: The diagnostic accuracy of LUS as the index test was estimated against CXR and/or lung auscultation as comparators, with thoracic CT scan as the reference standard. OUTCOME MEASURES: Measures of diagnostic accuracy. RESULTS: Seven eligible studies were identified, five of which (with 253 participants) were included in the meta-analysis. It was found that LUS had a pooled sensitivity of 92% and 91% in the diagnosis of consolidation and pleural effusion, respectively, and pooled specificity of 92% for both pathologies. CXR had a pooled sensitivity of 53% and 42% and a pooled specificity of 78% and 81% in the diagnosis of consolidation and pleural effusion, respectively. A meta-analysis for lung auscultation was not possible, although a single study reported a sensitivity and specificity of 8% and 100%, respectively, for diagnosing consolidation, and a sensitivity and specificity of 42% and 90%, respectively, for diagnosing pleural effusion. CONCLUSION: This systematic review with meta-analysis demonstrated high sensitivity of LUS compared with CXR, with similar specificities when diagnosing pleural effusion and lung consolidation/collapse. REGISTRATION: PROSPERO CRD42018095555.
Authors: J Pérez Pallarés; F Lerenas Bernal; M R Cabello Jabalquinto; A A Jiménez Romero Journal: Rev Esp Quimioter Date: 2022-04-22 Impact factor: 2.515
Authors: Luigi Vetrugno; Francesco Mojoli; Enrico Boero; Paola Berchialla; Elena Giovanna Bignami; Daniele Orso; Andrea Cortegiani; Francesco Forfori; Francesco Corradi; Gianmaria Cammarota; Edoardo De Robertis; Silvia Mongodi; Davide Chiumello; Daniele Poole; Mariachiara Ippolito; Daniele Guerino Biasucci; Paolo Persona; Tiziana Bove; Lorenzo Ball; Paolo Pelosi; Paolo Navalesi; Massimo Antonelli; Antonio Corcione; Antonino Giarratano; Flavia Petrini Journal: Ultraschall Med Date: 2021-11-03 Impact factor: 5.445