RESUMO
Background: To evaluate the value of the pulmonary ultrasound for the diagnosis of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in emergency departments (EDs).Materials and methodsBetween January 2018 and December 2019, patients admitted to the ED of Shanxi Provincial People's Hospital for suspected AECOPD were prospectively included in this study. Pulmonary ultrasound was performed using a linear transducer. The pulmonary ultrasound findings were evaluated for further discrimination for patients with AECOPD. Then, the diagnostic performance of pulmonary ultrasound was estimated and calculated. The clinical characteristics between groups with and without pneumonia were compared.ResultsA total of 53 patients with AECOPD were included in the final analysis. For diagnosis of AECOPD due to pneumonia, ultrasound findings, such as consolidation, slightly rough pleural line, or irregular and interrupted pleural line had a sensitivity of 92.3% and a specificity of 86.7%. For diagnosis of AECOPD complicating pulmonary fibrosis, fringed pleural line had a sensitivity of 100% and a specificity of 97.5%. In addition, patients with pleural effusion (n=19) or pneumothorax (n=1) were correctly identified and wavy or bulging pleural lines were common in patients with AECOPD (58.5%, 31/53).ConclusionUltrasound findings could offer further discrimination for AECOPD complications and other pathological conditions, such as pneumonia, pulmonary fibrosis, pleural effusion, and pneumothorax in EDs. (AU)
Fundamento: Los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) a menudo acuden al servicio de urgencias por una exacerbación de su enfermedad que requiere una actuación inmediata. Por consiguiente, es fundamental llevar a cabo un diagnóstico rápido de su proceso crónico. El objetivo de este estudio fue evaluar el valor de la ecografía pulmonar en el diagnóstico de exacerbación aguda de la EPOC (EAEPOC) en el servicio de urgencias.Materiales y métodosDe enero de 2018 a diciembre de 2019 se incluyeron prospectivamente pacientes sospechosos de EAEPOC en el Servicio de Urgencias del Hospital popular de Shanxi. Se utilizó un transductor lineal para llevar a cabo la ecografía pulmonar. Los resultados de la ecografía pulmonar se utilizaron para diferenciar a los pacientes con EAEPOC y se evaluó el rendimiento diagnóstico de esta técnica. Se compararon las características clínicas del grupo con neumonía con las del grupo sin neumonía.ResultadosUn total de 53 pacientes con EPOC fueron incluidos en el análisis final. Para el diagnóstico de EAEPOC causada por neumonía la sensibilidad y especificidad de la ecografía fueron 92,3% y 86,7%, respectivamente. La sensibilidad y especificidad de la línea pleural marginal en el diagnóstico de EAEPOC con fibrosis pulmonar fueron del 100% y 97,5%. Además, los pacientes con derrame pleural (n=19) o neumotórax (n=1) fueron identificados correctamente, y las líneas pleurales onduladas o elevadas fueron frecuentes en los pacientes con EAEPOC (58,5%; 31/53).ConclusiónLa ecografía puede diferenciar las complicaciones de la EAEPOC de otras condiciones patológicas como neumonía, fibrosis pulmonar, derrame pleural y neumotórax. (AU)
Assuntos
Humanos , Doença Aguda , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/etiologia , Pneumotórax/complicações , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/diagnóstico por imagem , Fibrose Pulmonar/complicaçõesRESUMO
BACKGROUND: To evaluate the value of the pulmonary ultrasound for the diagnosis of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in emergency departments (EDs). MATERIALS AND METHODS: Between January 2018 and December 2019, patients admitted to the ED of Shanxi Provincial People's Hospital for suspected AECOPD were prospectively included in this study. Pulmonary ultrasound was performed using a linear transducer. The pulmonary ultrasound findings were evaluated for further discrimination for patients with AECOPD. Then, the diagnostic performance of pulmonary ultrasound was estimated and calculated. The clinical characteristics between groups with and without pneumonia were compared. RESULTS: A total of 53 patients with AECOPD were included in the final analysis. For diagnosis of AECOPD due to pneumonia, ultrasound findings, such as consolidation, slightly rough pleural line, or irregular and interrupted pleural line had a sensitivity of 92.3% and a specificity of 86.7%. For diagnosis of AECOPD complicating pulmonary fibrosis, fringed pleural line had a sensitivity of 100% and a specificity of 97.5%. In addition, patients with pleural effusion (n=19) or pneumothorax (n=1) were correctly identified and wavy or bulging pleural lines were common in patients with AECOPD (58.5%, 31/53). CONCLUSION: Ultrasound findings could offer further discrimination for AECOPD complications and other pathological conditions, such as pneumonia, pulmonary fibrosis, pleural effusion, and pneumothorax in EDs.
