Pre-hospital Lung Ultrasound for Cardiac Heart Failure and COPD: is It Worthwhile?

Overview

Journal Crit Ultrasound J

Specialty Critical Care

Date 2018 Sep 11

PMID 30198053

Citations 11

Authors

Mirko Zanatta

Piero Benato

Sigilfredo De Battisti

Concetta Pirozzi

Renato Ippolito

Vito Cianci

Affiliations

Soon will be listed here.

Abstract

Background: Pre-hospital ultrasound is a new challenge and lung ultrasound could be an interesting opportunity in the pre-hospital medical service. The aim of our study was to evaluate the efficacy of lung ultrasound in out-of-hospital non-traumatic respiratory insufficiency.

Methods: We planned a case-controlled study in the ULSS 5 ovest vicentino area (Vicenza-Italy) enrolling subjects with severe dyspnea caused by cardiac heart failure or acute exacerbation of chronic obstructive pulmonary disease. We compared drugs administration, oxygen delivery, and laboratory tests between those patients with ultrasound integrated management and those without ultrasound.

Results: Pre-hospital lung ultrasound had a high specificity (94.4%) and sensitivity (100%) for the correct identification of alveolar interstitial syndrome using B lines, whereas the percentages obtained with pleural effusion were lower (83.3, 53.3%, respectively). The patients with ultrasound integrated management received a more appropriate pharmacological therapy (p 0.01), as well as non-invasive ventilation (CPAP) was used more frequently in those with an acute exacerbation of chronic obstructive pulmonary disease (p 0.011). Laboratory tests and blood gases analysis were not significant different between the two study groups. In a sub-analysis of the patients with an A profile, we observed a significant lower concentration of PCO in those with an ultrasound integrated management (PCO: 42.62 vs 52.23 p 0.049). According with physicians' opinion, pre-hospital lung ultrasound gave important information or changed the therapy in the 42.3% of cases, whereas it just confirmed physical examination in the 67.7% of cases.

Conclusions: Pre-hospital lung ultrasound is easy and feasible, and learning curve is rapid. Our study suggests that cardiac heart failure and acute exacerbation of chronic obstructive pulmonary disease can be considered two indications for pre-hospital ultrasound, and can improve the management of patient with acute respiratory insufficiency.

Citing Articles

Accuracy of Lung Ultrasonography for Diagnosis of Heart Failure; a Systematic Review and Meta-analysis.

Rahmani E, Farrokhi M, Farrokhi M, Nouri S, Moghadam Fard A, Hoorshad B Arch Acad Emerg Med. 2025; 13(1):e33.

PMID: 40027217 PMC: 11868670. DOI: 10.22037/aaemj.v13i1.2555.

Contribution of point-of-care ultrasound in the prehospital management of patients with non-trauma acute dyspnea: a systematic review and meta-analysis.

Taheri O, Samain J, Mauny F, Puyraveau M, Desmettre T, Marx T Eur J Emerg Med. 2024; 32(2):87-99.

PMID: 39630617 PMC: 11855997. DOI: 10.1097/MEJ.0000000000001205.

The LUSBI Protocol (Lung Ultrasound/BREST Score/Inferior Vena Cava)-Its Role in a Differential Diagnostic Approach to Dyspnea of Cardiogenic and Non-Cardiogenic Origin.

Dojcinovic B, Banjac N, Vukmirovic S, Dojcinovic T, Vasovic L, Mihajlovic D Medicina (Kaunas). 2024; 60(9).

PMID: 39336562 PMC: 11433694. DOI: 10.3390/medicina60091521.

Impact of Prehospital Ultrasound Training on Simulated Paramedic Clinical Decision-Making.

Roche A, Watkins E, Pettit A, Slagle J, Zapata I, Seefeld A West J Emerg Med. 2024; 25(5):784-792.

PMID: 39319810 PMC: 11418876. DOI: 10.5811/westjem.18439.

[Prehospital ultrasound in emergency medicine].

Vicent O, Reske A, Nickl R, Heinen R, Spieth P Anaesthesiologie. 2024; 73(8):502-510.

PMID: 39060458 DOI: 10.1007/s00101-024-01437-x.

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