Evaluation of ultrasound lung comets by hand-held echocardiography

被引:165
作者
Bedetti G. [1 ]
Gargani L. [2 ]
Corbisiero A. [3 ]
Frassi F. [2 ]
Poggianti E. [2 ]
Mottola G. [3 ]
机构
[1] Imola Hospital, Imola
[2] CNR, Institute of Clinical Physiology, Pisa
[3] Montevergine Clinic, Mercogliano
关键词
Extravascular Lung Water; Short Learning Curve; Interlobular Septum; Chest Ultrasound; Bedside Evaluation;
D O I
10.1186/1476-7120-4-34
中图分类号
学科分类号
摘要
Background: Ultrasound lung comets (ULCs) are a clinically useful sign of extravascular lung water. They require very limited technology (2 D-echo), and a short learning curve. The aim of the present study is to compare ULCs information obtained by experienced echocardiologists using a full feature echocardiographic platform and by inexperienced sonographers using a hand-held echocardiography system. Methods: 20 consecutive in-hospital patients underwent, within 15′ and in random order, 2 ultrasound examinations for ULCs by 2 observers with different specific expertise and different technology: 1) "high-tech veteran": ULCs assessment with full feature echocardiographic platform (HP Sonos 7500 Philips Medical Systems, Andover, MA, USA) by a trained echocardiologist, with ≥2 years expertise in ULCs assessment and accredited by the European Association of Echocardiography; 2) and a "low-tech beginner": ULCs assessment with hand-held echocardiography (Optigo; Philips, Andover, MA) by an echocardiographer with very limited (30') dedicated training on ULCs assessment. In each patient, ULC score was obtained by summing the number of comets from each of the scanning spaces in the anterior right and left hemithorax, from the second to the fifth intercostal space. Results: There was a significant, tight correlation (r = .958, p < 0.001) between the 2 observations in the same patient by "high-tech veteran" and "low-tech beginner". Conclusion: ULCs are equally reliable in the hands of highly experienced echocardiologists using full feature echocardiographic platforms and in the hands of absolute beginners with miniaturized, compact, and battery-equipped echocardiographic systems. From the technological and expertise viewpoint, ULCs are the "kindergarten" of echocardiography, ideally suited for bedside evaluation of patients with both known or suspected heart failure. © 2006 Bedetti et al; licensee BioMed Central Ltd.
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  • [1] Swedberg K., Cleland J., Dargie H., Drexler H., Follath F., Komajda M., Tavazzi L., Smiseth O.A., Gavazzi A., Haverich A., Hoes A., Jaarsma T., Korewicki J., Levy S., Linde C., Lopez-Sendon J.L., Nieminen M.S., Pierard L., Remme W.J., Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Guidelines for the diagnosis and treatment of chronic heart failure: Executive summary (update 2005): The Task Force for the Diagnosis and Treatment of Chroni
  • [2] Halperin B., Feeley T., Mihm F., Et al., Evaluation of the portable chest roentgenogram for quantitating extravascular lung water in critically ill adults, Chest, 88, pp. 649-652, (1985)
  • [3] Eisenberg P.R., Hansbrough J.R., Anderson D., Et al., A prospective study of lung water measurements during patient management in an intensive care unit, Am Rev Respir Dis, 136, pp. 662-668, (1987)
  • [4] Targhetta R., Chavagneaux R., Bourgeois J.M., Et al., Sonographic approach to diagnosing pulmonary consolidation, J Ultrasound Med, 11, pp. 667-672, (1992)
  • [5] Lichtenstein D., Meziere G., Biderman P., Gepner A., Barre O., The comet-tail artifact. An ultrasound sign of alveolar-interstitial syndrome, Am J Respir Crit Care Med, 156, pp. 1640-1646, (1997)
  • [6] Picano E., Frassi F., Agricola E., Gligorova S., Gargani L., Mottola G., Ultrasound Lung Comets: A Clinically Useful Sign of Extravascular Lung Water, J Am Soc Echocardiogr, 19, pp. 139-146, (2006)
  • [7] Jambrik Z., Monti S., Coppola V., Agricola E., Mottola G., Miniati M., Picano E., Usefulness of ultrasound lung comets as a nonradiologic sign of extravascular lung water, Am J Cardiol, 93, pp. 1265-1270, (2004)
  • [8] Giannotti G., Mondillo S., Galderisi M., Barbati R., Zaca V., Ballo P., Agricola E., Guerrini F., Hand-held echocardiography: Added value in clinical cardiological assessment, Cardiovasc Ultrasound, 3, (2005)
  • [9] Lichtenstein D., Meziere G., A lung ultrasound sign allowing bedside distinction between pulmonary edema and chronic obstructive pulmonary disease: The comet-tail artifact, Intensive Care Med, 24, pp. 1331-1334, (1998)
  • [10] Lange N.R., Schuster D.P., The measurement of lung water, Crit Care, 3, (1999)