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Role of ultrasound in the management of pleural diseases in respiratory intensive care patients

Egyptian Journal of Bronchology volume 9, pages 79–91 (2015)Cite this article

Abstract

Introduction

Ultrasonography (US) has become an invaluable tool in the management of critically ill patients.

Objectives

This study aimed to evaluate the role of US in the diagnosis and treatment of pleural diseases in patients in the respiratory intensive care unit.

Patients and methods

This study recruited 55 patients who presented with suspected clinical and/or radiological evidence of pleural disease in whom US and chest radiography were performed. In addition, US-guided interventions were carried out whenever needed and computed tomography scans of the chest where obtained whenever possible.

Results

Pleural effusion was the most common pleural disease encountered (54.5%). US correctly predicted the nature of most pleural effusions, whether transudative or exudative (84%). US was significantly more sensitive than chest radiography in the diagnosis of pleural effusion and pleural thickening (P = 0.00 and 0.004, respectively) and had significantly better sensitivity for unilateral effusions and for septations compared with computed tomography (P = 0.004). There was almost perfect agreement between US results and the final diagnosis in all pleural diseases, with κ values ranging from 0.9 to 0.98. A total of 67 US-guided interventions were carried out, with a success rate of 94%, and only one (1.5%) complication was encountered in the form of partial pneumothorax. US affected the diagnosis and altered the treatment policy, with recorded favorable outcomes. Short-term training programs enable pulmonologists to acquire US examination skills after 30 examinations.

Conclusion

US is an efficient and suitable method for evaluating pleural disease in the respiratory intensive care unit, especially pleural effusion. US-guided pleural interventions have been successful and have shown favorable outcomes and minimal complications. Short-term training could enable mastering of US use.

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Authors and Affiliations

  1. Department of Chest Diseases, Ain Shams University, Cairo, Egypt

    Leila A. Helala, Ashraf Madkour & Nehad M. Osman MD, PhD

  2. Department of Radiodiagnosis, Ain Shams University, Cairo, Egypt

    Waleed M. Hetta

  3. Abbassia Chest Hospital, Cairo, Egypt

    Inas M. Abdel Hakim

Authors
  1. Leila A. Helala
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  2. Ashraf Madkour
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  3. Nehad M. Osman MD, PhD
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  4. Waleed M. Hetta
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  5. Inas M. Abdel Hakim
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Corresponding author

Correspondence to Nehad M. Osman MD, PhD.

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Helala, L.A., Madkour, A., Osman, N.M. et al. Role of ultrasound in the management of pleural diseases in respiratory intensive care patients. Egypt J Bronchol 9, 79–91 (2015). https://doi.org/10.4103/1687-8426.153658

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  • DOI: https://doi.org/10.4103/1687-8426.153658

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