Skip to main content
main-content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Erschienen in: Notfall + Rettungsmedizin 1/2021

13.12.2021 | Originalien

Performance of bedside lung ultrasound in emergency (BLUE) protocol in the diagnosis of pneumonia

verfasst von: Doğan Karademir, Serkan Yılmaz, İbrahim Ulaş Özturan, Nurettin Özgür Doğan, Elif Yaka, Murat Pekdemir

Erschienen in: Notfall + Rettungsmedizin | Sonderheft 1/2021

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Although the diagnostic performance of the bedside lung ultrasound emergency (BLUE) protocol has been well-studied in patients with undifferentiated dyspnea, the data on performance of the BLUE protocol and associated ultrasound artifacts for the diagnosis of pneumonia are limited. This study aimed to determine the performance of the BLUE protocol and each of the BLUE protocol profiles in the diagnosis of pneumonia in the emergency department (ED).

Methods

Patients admitted to the ED with the symptoms suggesting pneumonia were included. The BLUE protocol was performed by an operator who was blinded to clinical information. Primary outcome was the diagnostic performance of the BLUE protocol for pneumonia. Secondary outcome was the diagnostic contribution of each BLUE protocol profile supporting pneumonia.

Results

Of the 154 patients included in the study, 112 (72.7%) were diagnosed with pneumonia. The BLUE protocol was able to detect pneumonia in 97 (86.6%) patients with a sensitivity of 86.6%, specificity of 71.4%, and LR+ of 3.03. Among the BLUE protocol profiles, the A/B profile had the highest diagnostic performance with a sensitivity, specificity and LR+ of 48.2, 97.6, and 20.3, respectively.

Conclusion

The BLUE protocol had a good diagnostic performance for pneumonia. Among the BLUE protocol profiles, the A/B profile had the highest performance for confirming pneumonia in the ED.
Literatur
1.
Zurück zum Zitat Moran GJ, Rothman RE, Volturo GA (2013) Emergency management of community-acquired bacterial pneumonia: what is new since the 2007 infectious diseases society of America/American thoracic society guidelines. Am J Emerg Med 31(3):602–612 CrossRef Moran GJ, Rothman RE, Volturo GA (2013) Emergency management of community-acquired bacterial pneumonia: what is new since the 2007 infectious diseases society of America/American thoracic society guidelines. Am J Emerg Med 31(3):602–612 CrossRef
2.
Zurück zum Zitat Metlay JP, Fine MJ (2003) Testing strategies in the initial management of patients with community-acquired pneumonia. Ann Intern Med 138:109–118 CrossRef Metlay JP, Fine MJ (2003) Testing strategies in the initial management of patients with community-acquired pneumonia. Ann Intern Med 138:109–118 CrossRef
3.
Zurück zum Zitat Self WH, Courtney DM, McNaughton CD (2013) High discordance of chest X‑ray and computed tomography for detection of pulmonary opacities in ED patients: implications for diagnosing pneumonia. Am J Emerg Med 31(2):401–405 CrossRef Self WH, Courtney DM, McNaughton CD (2013) High discordance of chest X‑ray and computed tomography for detection of pulmonary opacities in ED patients: implications for diagnosing pneumonia. Am J Emerg Med 31(2):401–405 CrossRef
4.
Zurück zum Zitat Brenner DJ, Hall EJ (2007) Computed tomography—an increasing source of radiation exposure. N Engl J Med 357:2277–2284 CrossRef Brenner DJ, Hall EJ (2007) Computed tomography—an increasing source of radiation exposure. N Engl J Med 357:2277–2284 CrossRef
5.
Zurück zum Zitat Ding W, Shen Y, Yang J et al (2011) Diagnosis of pneumothorax by radiography and ultrasonography: a meta-analysis. Chest 140:859–866 CrossRef Ding W, Shen Y, Yang J et al (2011) Diagnosis of pneumothorax by radiography and ultrasonography: a meta-analysis. Chest 140:859–866 CrossRef
6.
Zurück zum Zitat Volpicelli G, Elbarbary M, Blaivas M et al (2012) International liaison committee on lung ultrasound (ILC-LUS) for international consensus conference on lung ultrasound (ICC-LUS): international evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 38:577–591 CrossRef Volpicelli G, Elbarbary M, Blaivas M et al (2012) International liaison committee on lung ultrasound (ILC-LUS) for international consensus conference on lung ultrasound (ICC-LUS): international evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 38:577–591 CrossRef
7.
Zurück zum Zitat Zanobetti M, Scorpiniti M, Gigli C et al (2017) Point-of-care ultrasonography for evaluation of acute dyspnea in the ED. Chest 151:1295–1301 CrossRef Zanobetti M, Scorpiniti M, Gigli C et al (2017) Point-of-care ultrasonography for evaluation of acute dyspnea in the ED. Chest 151:1295–1301 CrossRef
8.
Zurück zum Zitat Laursen CB, Sloth E, Lassen AT et al (2014) Point-of-care ultrasonography in patients admitted with respiratory symptoms: a single-blind, randomised controlled trial. Lancet Respir Med 2:638–646 CrossRef Laursen CB, Sloth E, Lassen AT et al (2014) Point-of-care ultrasonography in patients admitted with respiratory symptoms: a single-blind, randomised controlled trial. Lancet Respir Med 2:638–646 CrossRef
9.
Zurück zum Zitat Lichtenstein DA, Meziere GA (2008) Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest 134:117–125 CrossRef Lichtenstein DA, Meziere GA (2008) Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest 134:117–125 CrossRef
10.
Zurück zum Zitat Duyan M, Ünal AY, Ozturan IU et al (2020) Contribution of caval index and ejection fraction estimated by e‑point septal separation measured by emergency physicians in the clinical diagnosis of acute heart failure. Turk J Emerg Med 20(3):105–110 CrossRef Duyan M, Ünal AY, Ozturan IU et al (2020) Contribution of caval index and ejection fraction estimated by e‑point septal separation measured by emergency physicians in the clinical diagnosis of acute heart failure. Turk J Emerg Med 20(3):105–110 CrossRef
13.
Zurück zum Zitat Bourcier JE, Paquet J, Seinger M et al (2014) Performance comparison of lung ultrasound and chest x‑ray for the diagnosis of pneumonia in the ED. Am J Emerg Med 32:115–118 CrossRef Bourcier JE, Paquet J, Seinger M et al (2014) Performance comparison of lung ultrasound and chest x‑ray for the diagnosis of pneumonia in the ED. Am J Emerg Med 32:115–118 CrossRef
14.
Zurück zum Zitat Pagano A, Numis FG, Visone G et al (2015) Lung ultrasound for diagnosis of pneumonia in emergency department. Intern Emerg Med 10(7):851–854 CrossRef Pagano A, Numis FG, Visone G et al (2015) Lung ultrasound for diagnosis of pneumonia in emergency department. Intern Emerg Med 10(7):851–854 CrossRef
15.
Zurück zum Zitat Waterer GW (2015) The diagnosis of community-acquired pneumonia. Do we need to take a big step backward? Am J Respir Crit Care Med 192(8):912–913 CrossRef Waterer GW (2015) The diagnosis of community-acquired pneumonia. Do we need to take a big step backward? Am J Respir Crit Care Med 192(8):912–913 CrossRef
16.
Zurück zum Zitat Llamas-Álvarez AM, Tenza-Lozano EM, Latour-Pérez J (2017) Accuracy of lung ultrasonography in the diagnosis of pneumonia in adults: systematic review and meta-analysis. Chest 151(2):374–382 CrossRef Llamas-Álvarez AM, Tenza-Lozano EM, Latour-Pérez J (2017) Accuracy of lung ultrasonography in the diagnosis of pneumonia in adults: systematic review and meta-analysis. Chest 151(2):374–382 CrossRef
17.
Zurück zum Zitat Alzahrani SA, Al-Salamah MA, Al-Madani WH et al (2017) Systematic review and meta-analysis for the use of ultrasound versus radiology in diagnosing of pneumonia. Crit Ultrasound J 9(1):6 CrossRef Alzahrani SA, Al-Salamah MA, Al-Madani WH et al (2017) Systematic review and meta-analysis for the use of ultrasound versus radiology in diagnosing of pneumonia. Crit Ultrasound J 9(1):6 CrossRef
18.
Zurück zum Zitat Bekgoz B, Kilicaslan I, Bildik F et al (2019) BLUE protocol ultrasonography in emergency department patients presenting with acute dyspnea. Am J Emerg Med 37(11):2020–2027 CrossRef Bekgoz B, Kilicaslan I, Bildik F et al (2019) BLUE protocol ultrasonography in emergency department patients presenting with acute dyspnea. Am J Emerg Med 37(11):2020–2027 CrossRef
19.
Zurück zum Zitat Liu XL, Lian R, Tao YK et al (2015) Lung ultrasonography: an effective way to diagnose community-acquired pneumonia. Emerg Med J 32:433–438 CrossRef Liu XL, Lian R, Tao YK et al (2015) Lung ultrasonography: an effective way to diagnose community-acquired pneumonia. Emerg Med J 32:433–438 CrossRef
20.
Zurück zum Zitat Daabis R, Banawan L, Rabea A et al (2014) Relevance of chest sonography in the diagnosis of acute respiratory failure: comparison with current diagnostic tools in intensive care units. Egypt J Chest Dis Tuberc 63:979–985 CrossRef Daabis R, Banawan L, Rabea A et al (2014) Relevance of chest sonography in the diagnosis of acute respiratory failure: comparison with current diagnostic tools in intensive care units. Egypt J Chest Dis Tuberc 63:979–985 CrossRef
Metadaten
Titel
Performance of bedside lung ultrasound in emergency (BLUE) protocol in the diagnosis of pneumonia
verfasst von
Doğan Karademir
Serkan Yılmaz
İbrahim Ulaş Özturan
Nurettin Özgür Doğan
Elif Yaka
Murat Pekdemir
Publikationsdatum
13.12.2021
Verlag
Springer Medizin
Erschienen in
Notfall + Rettungsmedizin / Ausgabe Sonderheft 1/2021
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI
https://doi.org/10.1007/s10049-021-00967-w