The diagnostic value of bedside lung ultrasound in emergency for patients with postoperative hypoxemia in intensive care unit
10.3969/j.issn.1008-9691.2019.03.009
- VernacularTitle:急诊床旁肺部超声在诊断ICU术后低氧血症中的价值
- Author:
Haiyun ZHU
1
;
Jun DUAN
;
Yanwen SUN
;
Chen LI
;
Shupeng WANG
;
Jianying KAN
Author Information
1. 天津市中医药研究院附属医院重症医学科
- Keywords:
Bedside lung ultrasound;
Surgery;
Hypoxemia;
Diagnosis
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2019;26(3):293-295
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical diagnostic value of bedside lung ultrasound in emergency (BLUE) for patients with postoperative hypoxemia in intensive care unit (ICU). Methods Fifty patients with hypoxemia after ICU surgery postoperation were enrolled in Beijing China-Japan Friendship Hospital from April 2017 to October 2018, the chest X-ray, BLUE and chest CT examinations were performed at the same time, and the diagnostic result of chest CT was the gold standard. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate of the 3 methods in the diagnosis of hypoxemia were statistically analyzed, and the results of diagnostic consistency of 3 methods were compared. Results The chest CT findings showed there were 40 cases with different degrees of pneumothorax, pleural effusion, pulmonary consolidation and atelectasis in 50 patients. When the chest X ray was used to diagnose hypoxemia as the pathogenesis, the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy rate were 32.5%, 60.0%, 76.47%, 18.18% and 38.0% respectively; the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy rate of BLUE were 80.0%, 70.0%, 91.43%, 46.67% and 78.0% respectively. The consistency test showed that the chest X-ray diagnosis rate of postoperation hypoxemia as the cause was significantly lower than that of chest CT (Kappa = 0.091, P = 0.047) and BLUE (Kappa =0.107, P = 0.031). The consistancy was relatively good when the diagnosis rate of postoperation hypoxemia obtained from BLUE regimen was compared with that obtained from chest CT (Kappa = 0.634, P = 0.000). Conclusion The use of BLUE for diagnosis of hypoxemia being the pathogenesis of the postoperative patients in ICU is superior to the use of routine chest X ray, and compared with applying chest CT, BLUE is faster, more convenient and worthy to be clinically applied widely.
