Eight versus 28-point lung ultrasonography in moderate acute heart failure: a prospective comparative study

被引：16

作者：

Leidi, Antonio ^{[1
]}

Soret, Guillaume ^{[1
]}

Mann, Tamara ^{[1
]}

Koegler, Flora ^{[1
]}

Coen, Matteo ^{[1
,2
]}

Leszek, Alexandre ^{[1
]}

Dubouchet, Laetitia ^{[1
]}

Guillermin, Alexandre ^{[1
]}

Kaddour, Myriam ^{[1
]}

Rouyer, Frederic ^{[3
]}

Combescure, Christophe ^{[4
,5
,6
]}

Carballo, Sebastian ^{[1
]}

Reny, Jean-Luc ^{[1
]}

Marti, Christophe ^{[1
]}

Stirnemann, Jerome ^{[1
]}

Grosgurin, Olivier ^{[1
,3
]}

机构：

[1] Geneva Univ Hosp, Dept Med, Gen Internal Med, Rue Gabrielle Perret Gentil 4, CH-1205 Geneva, Switzerland

[2] Univ Geneva, Unit Dev & Res Med Educ UDREM, Fac Med, Geneva, Switzerland

[3] Geneva Univ Hosp, Dept Acute Med, Emergency Med, Geneva, Switzerland

[4] Univ Geneva, Dept Hlth & Community Med, Clin Res Ctr, Geneva, Switzerland

[5] Univ Geneva, Dept Hlth & Community Med, Div Clin Epidemiol, Geneva, Switzerland

[6] Geneva Univ Hosp, Geneva, Switzerland

来源：

INTERNAL AND EMERGENCY MEDICINE | 2022年 / 17卷 / 05期

关键词：

Lung ultrasonography; Ultrasound; Heart failure; Congestion; Protocol; Eight; PULMONARY CONGESTION; B-LINES; ULTRASOUND; DIAGNOSIS; ACCURACY;

D O I：

10.1007/s11739-022-02943-9

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Lung ultrasonography (LUS) is an accurate method of estimating lung congestion but there is ongoing debate on the optimal number of scanning points. The aim of the present study was to compare the reproducibility (i.e. interobserver agreement) and the feasibility (i.e. time consumption) of the two most practiced protocols in patients hospitalized for acute heart failure (AHF). This prospective trial compared 8- and 28-point LUS protocols. Both were performed by an expert-novice pair of sonographers at admission and after 4 to 6 days on patients admitted for AHF. A structured bio-clinical evaluation was simultaneously carried out by the treating physician. The primary outcome was expert-novice interobserver agreement estimated by kappa statistics. Secondary outcomes included time spent on image acquisition and interpretation. During the study period, 43 patients underwent a total of 319 LUS exams. Expert-novice interobserver agreement was moderate at admission and substantial at follow-up for 8-point protocol (weighted kappa of 0.54 and 0.62, respectively) with no significant difference for 28-point protocol (weighted kappa of 0.51 and 0.41; P value for comparison 0.74 at admission and 0.13 at follow-up). The 8-point protocol required significantly less time for image acquisition at admission (mean time difference - 3.6 min for experts, - 5.1 min for novices) and interpretation (- 6.0 min for experts and - 6.3 min for novices; P value < 0.001 for all time comparisons). Similar differences were observed at follow-up. In conclusion, an 8-point LUS protocol was shown to be timesaving with similar reproducibility when compared with a 28-point protocol. It should be preferred for evaluating lung congestion in AHF inpatients.

引用

页码：1375 / 1383

页数：9

共 31 条

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