Role of chest ultrasound to differentiate between acute cardiogenic pulmonary edema and non-cardiogenic pulmonary edema (acute respiratory distress syndrome)

Refaat, M.M.; Elassal, M.A.; Essawy, T.S.; Hasaneen, A.B.

doi:10.21608/bjas.2022.243473

	Role of chest ultrasound to differentiate between acute cardiogenic pulmonary edema and non-cardiogenic pulmonary edema (acute respiratory distress syndrome)
Benha Journal of Applied Sciences
Article 3, Volume 7, Issue 5, May 2022, Page 15-20 PDF (427.17 K)
Document Type: Original Research Papers
DOI: 10.21608/bjas.2022.243473
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Authors
M.M. Refaat¹; M.A. Elassal²; T.S. Essawy³; A.B. Hasaneen⁴
¹Radiology Dept., Faculty of Medicine, Benha Univ., Benha, Egypt
²Internal Medicine, Dept., Faculty of Medicine, Benha Univ., Benha, Egypt
³Chest Diseases Dept., Faculty of Medicine, Benha Univ., Benha, Egypt
⁴Critical care medicine Dept., Faculty of Medicine, Benha Univ., Benha, Egypt
Abstract
Introduction Chest Ultrasound can help in rapid treatment of acute respiratory failure in intensive care units when rapid decisions are needed and especially when patients’ transport is a big difficult. Therefore, CUS can be considered an attractive complementary diagnostic tool and one of the most promising techniques for differentiation and management of critically ill patient with either acute cardiogenic pulmonary edema (APE) or acute respiratory distress syndrome (ARDS). Aim :This study was aim to clarify the role of chest ultrasonography to differentiate between ARDS(Acute respiratory distress syndrome) and Acute cardiogenic pulmonary edema in patients admitted to ICU with acute dyspnea. Patients and methods Lung US was applied to respiratory distressed patients In Benha University Hospital ICUs on 60 patients who divided into APE group (23 cases) or ARDS group (37 cases). LUS examination focused on detecting the following pleuropulmonary signs in both groups: alveolar–interstitial syndrome(AIS), absent or reduced lung sliding,spared areas ,subpleural consolidation pleural line abnormalities, and pleural effusion. Result Alveolointerstitial syndrome (AIS )was observed in 100% of APE patients and in100% ofARDS patients . Absent or reduced lung sliding was observed in 0% of APE patients and in 97.3% of ARDS patients(P=0.001). spared areas were found in 0% of APE patients and100% in ARDS patients(=0.001),lungConsolidations were present in 4.3% of APE patients in 94.6% of ARDS patients with (P=0.001). Pleural line abnormalities were observed in 13% of APE patients and in 100% of ARDS patients(P=0.001),and Pleural effusion was present in 100% Of APE patients and in 40.5% of ARDS patients with APE (P=0.001). All these signs, except the AIS sign,presented a statistically significant difference in differentiation between ARDS and APE, resulting in specific ultrasonographic pleuropulmonary signs of ARDS and APE. Conclusion Results of the current study demonastrated that LUS play asignificant role in management of respiratory failure patients especially cases of ARDS and APE in ICU by helping in rapid diagnosis and differentiation between both types in accompanying with EChocardiodraohy and IVC diameter measurement. Absence of reduced lung sliding,spared areas,suppleural consolidation, pleural line abnormalities, on a background of AIS considered specific features for differentiation between ARDS and APE.
Keywords
acute cardiogenic pulmonary edema; acute respiratory distress syndrome; lung ultrasonography; chest ultrasound


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