Diagnostic Value of Chest Ultrasound After Cardiac Surgery: A Comparison With Chest X-ray and Auscultation

被引:34
作者
Vezzani, Antonella [1 ]
Manca, Tullio [1 ]
Brusasco, Claudia [2 ]
Santori, Gregorio [2 ]
Valentino, Massimo [3 ]
Nicolini, Francesco [1 ]
Molardi, Alberto [1 ]
Gherli, Tiziano [1 ]
Corradi, Francesco [1 ,4 ]
机构
[1] Univ Hosp Parma, Dept Surg Cardiac Surg Intens Care, I-43100 Parma, Italy
[2] Univ Genoa, Genoa, Italy
[3] SOC Radiol Azienda Serv Sanit 3, Friuli Venezia Giulia, Italy
[4] EO Osped Galliera, Dept Crit Care, Intens Care Unit, Genoa, Italy
关键词
lung ultrasonography; postoperative complications; critical care; daily on-demand chest radiography; MECHANICALLY VENTILATED PATIENTS; ACUTE RESPIRATORY-FAILURE; INTENSIVE-CARE-UNIT; EMERGENCY-DEPARTMENT; LUNG ULTRASOUND; CRITICALLY-ILL; RADIOGRAPHS; PNEUMOTHORAX; INTUBATION; ACCURACY;
D O I
10.1053/j.jvca.2014.04.012
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Objective: Chest auscultation and chest x-ray commonly are used to detect postoperative abnormalities and complications in patients admitted to intensive care after cardiac surgery. The aim of the study was to evaluate whether chest ultrasound represents an effective alternative to bedside chest x-ray to identify early postoperative abnormalities. Design: Diagnostic accuracy of chest auscultation and chest ultrasound were compared in identifying individual abnormalities detected by chest x-ray, considered the reference method. Setting: Cardiac surgery intensive care unit. Participants: One hundred fifty-one consecutive adult patients undergoing cardiac surgery. Interventions: All patients included were studied by chest auscultation, ultrasound, and x-ray upon admission to intensive care after cardiac surgery. Measurements and Main Results: Six lung pathologic changes and endotracheal tube malposition were found. There was a highly significant correlation between abnormalities detected by chest ultrasound and x-ray (k = 0.90), but a poor correlation between chest auscultation and x-ray abnormalities (k = 0.15). Conclusions: Chest auscultation may help identify endotracheal tube misplacement and tension pneumothorax but it may miss most major abnormalities. Chest ultrasound represents a valid alternative to chest x-ray to detect most postoperative abnormalities and misplacements. (C) 2014 Elsevier Inc. All rights reserved.
引用
收藏
页码:1527 / 1532
页数:6
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