Multidisciplinary Intensive Care Unit, Department of Anesthesiology and Critical Care Medicine, La Pitié-Salpêtrière Hôpital, Assistance Publique Hôpitaux de Paris, UPMC Univ Paris 06, Paris, France.
Intensive Care Med. 2010 Apr;36(4):656-64. doi: 10.1007/s00134-010-1769-9. Epub 2010 Feb 6.
To assess the accuracy of a multiplane ultrasound approach to measure pleural effusion volume (PEV), considering pleural effusion (PE) extension along the cephalocaudal axis and PE area.
Prospective study performed on 58 critically ill patients with 102 PEs. Thoracic drainage was performed in 46 patients (59 PEs) and lung computed tomography (CT) in 24 patients (43 PEs). PE was assessed using bedside lung ultrasound. Adjacent paravertebral intercostal spaces were examined, and ultrasound PEV was calculated by multiplying the paravertebral PE length by its area, measured at half the distance between the apical and caudal limits of the PE.
Ultrasound PEV was compared to either the volume of the drained PE (59 PE) or PEV assessed on lung CT (43 PE). In patients with lung CT, the accuracy of this new method was compared to the accuracy of previous methods proposed for PEV measurement. Ultrasound PEV was tightly correlated with drained PEV (r = 0.84, p < 0.001) and with CT PEV (r = 0.90, p < 0.001). The mean biases between ultrasound and actual volumes of PE were -33 ml when compared to drainage (limits of agreement -292 to +227 ml) and -53 ml when compared to CT (limits of agreement -303 to +198 ml). This new method was more accurate than previous methods to measure PEV.
Using a multiplane approach increases the accuracy of lung ultrasound to measure the volume of large to small pleural effusions in critically ill patients.
评估一种多平面超声方法测量胸腔积液量（PEV）的准确性，考虑胸腔积液（PE）沿前后轴的延伸和胸腔积液面积。
对 58 例重症患者的 102 例胸腔积液进行前瞻性研究。46 例患者（59 例胸腔积液）进行了胸腔引流，24 例患者（43 例胸腔积液）进行了肺部计算机断层扫描（CT）。使用床边肺部超声评估胸腔积液。检查相邻的椎旁肋间间隙，并通过将椎旁胸腔积液长度乘以其在胸腔积液上下限中间一半距离处测量的面积，计算出超声胸腔积液量。
将超声胸腔积液量与引流胸腔积液量（59 例胸腔积液）或肺部 CT 评估的胸腔积液量（43 例胸腔积液）进行比较。在有肺部 CT 的患者中，将这种新方法的准确性与以前提出的用于胸腔积液量测量的准确性进行比较。超声胸腔积液量与引流胸腔积液量（r = 0.84，p < 0.001）和 CT 胸腔积液量（r = 0.90，p < 0.001）密切相关。与引流相比，超声和实际胸腔积液量之间的平均偏差为 -33 ml（一致性界限为-292 至 +227 ml），与 CT 相比为 -53 ml（一致性界限为-303 至 +198 ml）。这种新方法比以前的方法更准确地测量胸腔积液量。
使用多平面方法可提高肺部超声测量重症患者大至小量胸腔积液量的准确性。
