Efficacy of bedside ultrasonography in early diagnosis of patients admitted to the emergency department with dyspnea

Introduction

We designed our study to find a useful USG pattern for diagnosis and assessment of dyspnea. We also compared utilities of chest radiograms in a supine position, thorax CT and bedside USG techniques.

Methods

In Selcuk University Meram Medical Faculty, during the year 2009, 60 patients who had acute dyspnea were included in our study (30 patients with chest trauma and 30 patients with nontraumatic causes). We designed our study as prospective. We tried to determine pathologies that have positive and negative Sliding Lung Sign (SLS) in USG examinations. We also investigated its reliability in differential diagnosis of acute dyspnea.

Results

First of all we performed chest radiograms on all patients in a supine position. After that we performed CT scans. All of the results were interpreted by a detached radiologist. Then we performed bedside thoracic USG to find SLS by physicians in the ER. We conceded CT results as the golden standard and compared the results with chest radiograms and USG findings. The SPSS 13.0 program and Χ² test were used for statistical analysis (P < 0.05). According to our findings, SLS in USG examinations has a sensitivity of 84% and a specificity of 97% with a 97% positive predictive value and 83% negative predictive value.

Conclusions

Throughout the years, USG examinations were defined as inappropriate in lung examinations but in our study we reached a conclusion that they are a necessity. Bedside sonographic examination allows impetuous diagnosis. But every respiratory failure has its own sonographic pattern so mistakes are inevitable. Nevertheless we believe that if profound studies like ours keep coming and if more and more clinicians begin to use USG examinations, the SLS diagnostic value will rise and become a routine element in the ER.