Lung Ultrasound in Diagnosis of Acute Respiratory Failure: BLUE Protocol Based Evaluation
Journal Title: International Journal of Medical Research Professionals - Year 2017, Vol 3, Issue 2
Abstract
Introduction: Acute respiratory failure is a distressing situation for the patient, demanding dynamic evaluation and interventions. Lung ultrasound is a bedside technique, very promising in this setting. Aims/Objectives: To evaluate the diagnostic accuracy of the lung ultrasound algorithm (BLUE protocol) in ICU patients admitted with acute respiratory failure. Methodology: This study was conducted in the department of respiratory medicine in consensus emergency medicine in Pariyaram Medical College, Kannur over a period of 1 year investigating 111 consecutive adult patients who presented with acute respiratory failure. A double blinded screening lung ultrasonography was performed according to the blue protocol, and was compared with final diagnosis. Uncertain diagnoses and rare causes were excluded. Three items were assessed: artefacts (horizontal A lines or vertical B lines indicating interstitial syndrome), lung sliding, and alveolar consolidation and/or pleural effusion. Results: 111 patients were evaluated (63.2% male), mean age was 62 years (SD ± 12.9). Anterior absent lung sliding plus A lines plus lung point indicated pneumothorax with 68% sensitivity, 100 % specificity and an accuracy of 94.1%. A normal anterior profile plus deep venous thrombosis indicated pulmonary embolism with 50% sensitivity, 96.6% specificity and 97% accuracy. Multiple anterior diffuse B lines with lung sliding indicated pulmonary oedema with 90.5% sensitivity, 97.5% specificity and 96% accuracy. C profile and A/B profile showed > 80% accuracy in pneumonia. Conclusion: Lung ultrasound, as proposed in the BLUE protocol, has good accuracy, and seems reproducible and useful in acute respiratory failure.
Authors and Affiliations
Niyas. K. Naseer, Muhammad Shafeek, Rajani. M, Manoj. D. K
Keywords
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- EP ID EP543811
- DOI 10.21276/ijmrp.2017.3.2.024
- Views 83
- Downloads 0
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