Utility of point-of-care lung ultrasound for initial assessment of acute respiratory distress syndrome patients in the emergency department

A. Sanjan, S. Vimal Krishnan, Siju V. Abraham, Babu Urumese Palatty

Research output: Contribution to journalArticle

Abstract

Aim: Lung ultrasound (LUS) has been extensively used in the evaluation of acute respiratory distress syndrome (ARDS) in the critical care setting. In our study, we aim to assess the utility of point-of-care ultrasound (POCUS)-LUS in the initial assessment of ARDS patients presenting to the emergency department (ED). Subjects and Methods: We evaluated a prospective convenience sample of 73 adult patients presenting to the ED. The bedside LUS was performed by the trained emergency physician on patients with undifferentiated dyspnea with a clinical diagnosis of ARDS according to the Berlin's criteria. The four major LUS findings were examined on structured 12-zone LUS. The observed profile consisted of A lines, well-separated B lines, coalescent B lines, and consolidation among patients who were clinically diagnosed as ARDS. These LUS findings may vary depending on the severity of ARDS. The findings were analyzed using IBM SPSS Statistics for Windows, Version 24.0 (IBM Corp., Armonk, NY, USA). Results: Of the 73 study individuals, majority were male 46 (63%). The distributions of study individuals were as follows: 27% - mild ARDS, 37% - moderate ARDS, and 36% - severe ARDS. Coalescent B lines are present in about 70.4% and 92.3% of moderate and severe ARDS patients, respectively. Consolidations are predominantly present in moderate (100%) and severe (92.3%) ARDS. Conclusion: LUS in the initial assessment of patients' with ARDS yielded significant findings in the three clinically designated categories. This study opens up the possibility of using POCUS as an adjunct in the initial assessment of ARDS patient in the ED.

Original languageEnglish
Pages (from-to)248-253
Number of pages6
JournalJournal of Emergencies, Trauma and Shock
Volume12
Issue number4
DOIs
Publication statusPublished - 01-10-2019
Externally publishedYes

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Point-of-Care Systems
Adult Respiratory Distress Syndrome
Hospital Emergency Service
Lung
Severe Acute Respiratory Syndrome
Berlin
Critical Care
Dyspnea

All Science Journal Classification (ASJC) codes

  • Emergency Medicine

Cite this

Sanjan, A. ; Krishnan, S. Vimal ; Abraham, Siju V. ; Palatty, Babu Urumese. / Utility of point-of-care lung ultrasound for initial assessment of acute respiratory distress syndrome patients in the emergency department. In: Journal of Emergencies, Trauma and Shock. 2019 ; Vol. 12, No. 4. pp. 248-253.
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abstract = "Aim: Lung ultrasound (LUS) has been extensively used in the evaluation of acute respiratory distress syndrome (ARDS) in the critical care setting. In our study, we aim to assess the utility of point-of-care ultrasound (POCUS)-LUS in the initial assessment of ARDS patients presenting to the emergency department (ED). Subjects and Methods: We evaluated a prospective convenience sample of 73 adult patients presenting to the ED. The bedside LUS was performed by the trained emergency physician on patients with undifferentiated dyspnea with a clinical diagnosis of ARDS according to the Berlin's criteria. The four major LUS findings were examined on structured 12-zone LUS. The observed profile consisted of A lines, well-separated B lines, coalescent B lines, and consolidation among patients who were clinically diagnosed as ARDS. These LUS findings may vary depending on the severity of ARDS. The findings were analyzed using IBM SPSS Statistics for Windows, Version 24.0 (IBM Corp., Armonk, NY, USA). Results: Of the 73 study individuals, majority were male 46 (63{\%}). The distributions of study individuals were as follows: 27{\%} - mild ARDS, 37{\%} - moderate ARDS, and 36{\%} - severe ARDS. Coalescent B lines are present in about 70.4{\%} and 92.3{\%} of moderate and severe ARDS patients, respectively. Consolidations are predominantly present in moderate (100{\%}) and severe (92.3{\%}) ARDS. Conclusion: LUS in the initial assessment of patients' with ARDS yielded significant findings in the three clinically designated categories. This study opens up the possibility of using POCUS as an adjunct in the initial assessment of ARDS patient in the ED.",
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Utility of point-of-care lung ultrasound for initial assessment of acute respiratory distress syndrome patients in the emergency department. / Sanjan, A.; Krishnan, S. Vimal; Abraham, Siju V.; Palatty, Babu Urumese.

In: Journal of Emergencies, Trauma and Shock, Vol. 12, No. 4, 01.10.2019, p. 248-253.

Research output: Contribution to journalArticle

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N2 - Aim: Lung ultrasound (LUS) has been extensively used in the evaluation of acute respiratory distress syndrome (ARDS) in the critical care setting. In our study, we aim to assess the utility of point-of-care ultrasound (POCUS)-LUS in the initial assessment of ARDS patients presenting to the emergency department (ED). Subjects and Methods: We evaluated a prospective convenience sample of 73 adult patients presenting to the ED. The bedside LUS was performed by the trained emergency physician on patients with undifferentiated dyspnea with a clinical diagnosis of ARDS according to the Berlin's criteria. The four major LUS findings were examined on structured 12-zone LUS. The observed profile consisted of A lines, well-separated B lines, coalescent B lines, and consolidation among patients who were clinically diagnosed as ARDS. These LUS findings may vary depending on the severity of ARDS. The findings were analyzed using IBM SPSS Statistics for Windows, Version 24.0 (IBM Corp., Armonk, NY, USA). Results: Of the 73 study individuals, majority were male 46 (63%). The distributions of study individuals were as follows: 27% - mild ARDS, 37% - moderate ARDS, and 36% - severe ARDS. Coalescent B lines are present in about 70.4% and 92.3% of moderate and severe ARDS patients, respectively. Consolidations are predominantly present in moderate (100%) and severe (92.3%) ARDS. Conclusion: LUS in the initial assessment of patients' with ARDS yielded significant findings in the three clinically designated categories. This study opens up the possibility of using POCUS as an adjunct in the initial assessment of ARDS patient in the ED.

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