Accessibility of Lung Ultrasound for Diagnosis of Pleural Effusion in Comparison with Chest X-Ray in Critically Ill Patient

Abstract

varies according to the diagnostic technique used (from 8% following physical examination to more than 60% after routine imaging). Objectives: The aim of the study is to compare the diagnostic performance of Lung Ultrasound and bedside Chest X-ray for the detection of Pleural effusion in critically ill patients, using thoracic CT as a gold standard. Patients and Methods: This prospective observational study was applied over a period of six months from 1 St. October 2018 to 31 St. March 2019 in which 40 patients were enrolled after taking ethical committee approval and patients consent, our study was done at ICU department in Ain Shams University Teaching Hospital and MISR University for Science and Technology Teaching Hospital .These 40 patients presented to Critical care department with acute dyspnea as the primary complaint or developed acute dyspnea and or tachypnea during their ICU stay; we classified them randomly into two groups aiming for diagnosis of pleural effusion. Group (S) for patients that underwent LUS and group (X) for the patient that underwent CXR as a diagnostic tools for detection of pleural effusion. CT chest was done as a reference in all cases for detecting the sensitivity and specificity of each modality. Results: In comparison between the X-ray and LUS group as regards diagnosis of pleural effusion. Our study showed that 13 patients was misdiagnosed with pleural effusion by using X-ray with diagnostic accuracy 35% while pleural effusion has been ruled out in 11 patients by using LUS with diagnostic accuracy 65%. Conclusion: Our data suggests that both lung Ultrasound and chest radiography have nearly equivalent the same specificity in detection of pleural effusion in ICU patients (81.8% and 90%). However, Lung Ultrasound was more sensitive than chest radiography in detecting Pleural effusion in ICU patients (88.9% vs. 55.6%).