Bedside ultrasound of the lung for the monitoring of acute decompensated heart failure

被引:185
作者
Volpicelli, Giovanni [1 ]
Caramello, Vateria [1 ]
Cardinale, Luciano [2 ]
Mussa, Alessandro [1 ]
Bar, Fabrizio [1 ]
Frascisco, Mauro F. [1 ]
机构
[1] Osped San Luigi Gonzaga, Dept Emergency Med, I-10043 Turin, Italy
[2] San Luigi Gonzaga Hosp, Inst Radiol, I-10043 Turin, Italy
关键词
D O I
10.1016/j.ajem.2007.09.014
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Purposes: Multiple artifacts B lines (B+) at transthoracic lung ultrasound have been proposed as a sonographic sign of pulmonary congestion. Our aim is to assess B+ clearance after medical treatment in acute decompensated heart failure (ADHF) and to compare the usefulness of sonography with other traditional tools in monitoring resolution of pulmonary congestion. Methods: Eighty-one patients with a diagnosis of ADHF were submitted to lung ultrasound and chest radiography at admission, and 70 of them under-went the same procedures as control group after 4.2 +/- 1.7 days of medical treatment. The ultrasound examination was performed with 11 scans on as many anterolateral thoracic areas (6 on the right side and 5 on the left side). Then, we calculated a sonographic score Counting the B+ scans and compared it with radiologic score for extravascular lung water, clinical, and plasma brain natriuretic peptide improvement. Main Results: All patients showed B+ pattern at admission and significant clearing after treatment, with median number of 8 positive scans (range, 3-9 scans) vs 0 (range, 0-7 scans) (P <.05). Our sonographic score showed positive linear correlation with radiologic score (r = 0.62; P <.05), clinical score (r = 0.87; P <.01), and brain natriuretic peptide levels (r = 0.44; P <.05). Delta Sonographic score correlated with Delta clinical (r = 0.55; P <.05) and radiologic (r = 0.28; P <.05) scores. Conclusions: B line pattern mostly clears after adequate medical treatment of ADHF and represents an easy-to-use alternative bedside diagnostic tool for clinically monitoring pulmonary congestion in patients with ADHF. (C) 2008 Elsevier Inc. All rights reserved.
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页码:585 / 591
页数:7
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