Clinical application of lung ultrasound in emergency department patients for the evaluation of pulmonary congestion: a comparison with chest X-ray

Introduction. Lung ultrasound can effec-tively rule out pulmonary edema when there is an absence of multiple B-lines and enables emergency physicians to improve their diagnostic performance, optimize therapeutic strategy, help early diagnosis for the patient and reduced hospital stay. The primary endpoint of this pilot study was to evaluate the effectiveness of lung ultrasound for diagnosing acute heart fail-ure, even when used by emergency medi-cine residents, and assess the accuracy of B-line lung ultrasound in comparison to chest X-ray in emergency department pa-tients.

Materials and methods. We enrolled 18 patients consecutively as they arrived at the Emergency Department of Clinical Hospital „Sveti Duh“, Croatia, presenting with undifferentiated acute dyspnea. Posi-tive ultrasound confirmation of acute heart failure was defined as the bilateral exist-ence of 2 or more positive regions with 3 or more B-lines.

Results. We found positive results regard-ing B-lines profile in 6 patients and cardiac decompensation was confirmed by their chest x-ray findings. The remaining 12 patients did not have B-lines by the LUS examination, neither signs of pulmonary congestion by their chest x-ray examina-tion.

Conclusion. Lung ultrasound, given its practicability, simplicity and reproduc-ibility, used by non-experts in emergency ultrasound, is a reliable tool for clinical examination of patients with acute heart failure.

emergency department, ultra-sonography, heart failure, extravascular lung water

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