Chaitra S, Hattiholi Virupaxi V
Department of Radio-diagnosis, Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
J Med Ultrasound. 2021 Aug 31;30(2):94-100. doi: 10.4103/JMU.JMU_25_21. eCollection 2022 Apr-Jun.
The multifactorial etiology of acute respiratory failure (ARF) often complicates diagnosis at an early stage of clinical presentation. Despite being a common life-threatening disorder, accurate and timely diagnosis is hindered by bad quality of bedside radiographs and nonavailability of immediate computed tomography imaging. This study was an attempt to evaluate the diagnostic accuracy of ultrasound in diagnosing ARF.
This hospital-based cross-sectional study investigated the underlying etiological factor in 130 patients presenting with ARF and admitted to the intensive care unit. Lung ultrasound was performed according to the Bedside Lung Ultrasound in Emergency (BLUE) protocol. The diagnostic accuracy of lung ultrasound by emergency protocol was measured against each final diagnosis.
The mean age observed was 49.28 ± 14.9 years among the cohort. Of the 130 patients, pneumonia was the most common cause of ARF, seen in 42 patients. Breathlessness (56.15%) and fever accompanied by cough (25.38%) were the chief complaints. Diagnostic accuracy of ultrasound lung emergency protocol was 95.38% in the diagnosis of pulmonary edema, 100% for pneumothorax, 93.85% for pneumonia, 96.92% for chronic obstructive pulmonary disease, 99.23% for pulmonary thromboembolism, and 95.38% for acute respiratory distress syndrome.
Lung ultrasound is a reliable modality that provided accurate and timely diagnosis of ARF in this study. Therefore, BLUE protocol is feasible, easily implementable in the intensive care unit, and must be scaled up in respiratory health-care settings.
急性呼吸衰竭（ARF）的多因素病因常常使临床表现早期的诊断变得复杂。尽管它是一种常见的危及生命的疾病，但床边X线片质量不佳以及无法立即进行计算机断层扫描成像阻碍了准确及时的诊断。本研究旨在评估超声在诊断ARF中的诊断准确性。
这项基于医院的横断面研究调查了130例出现ARF并入住重症监护病房的患者的潜在病因。根据急诊床边肺部超声（BLUE）方案进行肺部超声检查。针对每个最终诊断测量通过急诊方案进行肺部超声检查的诊断准确性。
该队列中观察到的平均年龄为49.28±14.9岁。在130例患者中，肺炎是ARF最常见的病因，有42例患者。主要症状为呼吸困难（56.15%）和伴有咳嗽的发热（25.38%）。肺部超声急诊方案在诊断肺水肿方面的诊断准确性为95.38%，气胸为100%，肺炎为93.85%，慢性阻塞性肺疾病为96.92%，肺血栓栓塞为99.23%，急性呼吸窘迫综合征为95.38%。
在本研究中，肺部超声是一种可靠的检查方法，能够准确及时地诊断ARF。因此，BLUE方案是可行的，易于在重症监护病房实施，并且必须在呼吸保健环境中扩大应用。
