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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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Open Access 01-12-2016 | Original research

Prehospital lung ultrasound for the diagnosis of cardiogenic pulmonary oedema: a pilot study

Authors: Christian B. Laursen, Anja Hänselmann, Stefan Posth, Søren Mikkelsen, Lars Videbæk, Henrik Berg

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2016

Abstract

Background

An improved prehospital diagnostic accuracy of cardiogenic pulmonary oedema could potentially improve initial treatment, triage, and outcome. A pilot study was conducted to assess the feasibility, time-use, and diagnostic accuracy of prehospital lung ultrasound (PLUS) for the diagnosis of cardiogenic pulmonary oedema.

Methods

A prospective observational study was conducted in a prehospital setting. Patients were included if the physician based prehospital mobile emergency care unit was activated and one or more of the following two were present: respiratory rate >30/min., oxygen saturation <90 %. Exclusion criteria were: age <18 years, permanent mental disability or PLUS causing a delay in life-saving treatment or transportation. Following clinical assessment PLUS was performed and presence or absence of interstitial syndrome was registered. Audit by three physicians using predefined diagnostic criteria for cardiogenic pulmonary oedema was used as gold standard.

Results

A total of 40 patients were included in the study. Feasibility of PLUS was 100 % and median time used was 3 min. The gold standard diagnosed 18 (45.0 %) patients with cardiogenic pulmonary oedema. The diagnostic accuracy of PLUS for the diagnosis of cardiogenic pulmonary oedema was: sensitivity 94.4 % (95 % confidence interval (CI) 72.7–99.9 %), specificity 77.3 % (95 % CI 54.6–92.2 %), positive predictive value 77.3 % (95 % CI 54.6–92.2 %), negative predictive value 94.4 % (95 % CI 72.7–99.9 %).

Discussion

The sensitivity of PLUS is high, making it a potential tool for ruling-out cardiogenic pulmonary. The observed specificity was lower than what has been described in previous studies.

Conclusions

Performed, as part of a physician based prehospital emergency service, PLUS seems fast and highly feasible in patients with respiratory failure. Due to its diagnostic accuracy, PLUS may have potential as a prehospital tool, especially to rule out cardiogenic pulmonary oedema.

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Title: Prehospital lung ultrasound for the diagnosis of cardiogenic pulmonary oedema: a pilot study
Authors: Christian B. Laursen
Anja Hänselmann
Stefan Posth
Søren Mikkelsen
Lars Videbæk
Henrik Berg
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine / Issue 1/2016
Electronic ISSN: 1757-7241
DOI: https://doi.org/10.1186/s13049-016-0288-2

ACC 2024 Congress

Springer Medicine

Prehospital lung ultrasound for the diagnosis of cardiogenic pulmonary oedema: a pilot study

Abstract

Background

Methods

Results

Discussion

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Discussion

Conclusions

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