Comparison of lung ultrasound findings with chest computed tomography results in patients with acute respiratory failure in the emergency department

Abstract

Background: Bedside chest ultrasound is a non-invasive and simple-to-use imaging modality. This approach is important in reducing radiation exposure and deciding whether to transport a patient to the Radiology Department, as well as allowing for the guidance of life-saving treatment in emergencies. Early detection and rapid clinical decision-making in patients with acute respiratory failure presenting to the emergency department is essential. Therefore, it is necessary to study the method of monitoring these patients with non-risky, non-invasive and bedside lung ultrasound evaluation, which can be performed at the bedside, and to solve the problems of treatment and diagnosis without delay. Aim: To compare the results of lung ultrasound and CT scan in patients with acute respiratory failure in the emergency department. Material and Methods: The research was carried out between June 1, 2023 and January 1, 2024, following people with respiratory failure who attended the Emergency Department of the Mongolia-Japan Hospital (MJH) of MNUMS. Results: 90% (n=36) of study participants had changes in lung ultrasound. Of these, B line alone (37.5%), pleural effusion (20%), consolidation alone (12.5%), consolidation and B line together (12.5%), and no lung sliding + lung point (7.5%) were detected. When comparing chest ultrasound and chest X-ray with chest CT, the sensitivity for diagnosing pulmonary consolidation was 86.7% (p=0.001) and 66.7% (p=0.018), and the specificity was 100%, respectively, while the sensitivity for determining pleural effusion was 50% (p =0.001) and 83.3% (p=0.005), specificity is 100%, respectively. There was a strong positive correlation between lung ultrasound severity score and CT severity score in subjects with pneumonia changes on lung ultrasound (p<0.005 r=0.71). Conclusion: Lung ultrasound has a higher sensitivity than chest X-ray for the diagnosis of pulmonary consolidation and pleural effusion.