Could the use of bedside lung ultrasound reduce the number of chest x-rays in the intensive care unit?

Abstract

BackgroundLung ultrasound can be used as an alternative to chest radiography (CXR) for the diagnosis and follow-up of various lung diseases in the intensive care unit (ICU). Our aim was to evaluate the influence that introducing a routine daily use of lung ultrasound in critically ill patients may have on the number of CXRs and as a consequence, on medical costs and radiation exposure.MethodsData were collected by conducting a retrospective evaluation of the medical records of adult patients who needed thoracic imaging and were admitted to our academic polyvalent ICU. We compared the number of CXRs and relative costs before and after the introduction of lung ultrasound in our ICU.ResultsA total of 4134 medical records were collected from January 2010 to December 2014. We divided our population into two groups, before (Group A, 1869 patients) and after (Group B, 2265 patients) the introduction of a routine use of LUS in July 2012. Group A performed a higher number of CXRs compared to Group B (1810 vs 961, P = 0.012), at an average of 0.97 vs 0.42 exams per patient. The estimated reduction of costs between Groups A and B obtained after the introduction of LUS, was 57%. No statistically significant difference between the outcome parameters of the two groups was observed.ConclusionsLung ultrasound was effective in reducing the number of CXRs and relative medical costs and radiation exposure in ICU, without affecting patient outcome.

Lung Ultrasound and the COVID‐19 “Pattern”: Not All That Glitters Today Is Gold Tomorrow

“…We agree with the authors that thoracic ultrasound plays a role in this pandemic and that there could be an opportunity to spread its use even more. 2 In our opinion, the most importance advantages of thoracic ultrasound are closely associated with the following facts. Since Italy was recognized as the second most affected country after China by the 2019 novel coronavirus disease (COVID-19), in many of our hospitals, it was necessary to create 2 separate areas: COVID and non-COVID areas ( Figure 1).…”

Sonographische Bildgebung der Lunge bei COVID-19

“…Die thorakale Bildgebung ist für die weitere Versorgung dieser Patienten essenziell [5]. Neben der hochauflösenden Low-dose-Computertomographie des Thorax (HR-CT) als aktueller Goldstandard der nichtkontrastmittelverstärkten thorakalen Bildgebung kommt dem Point-of-care-Ultraschall (POCUS) der Lunge jedoch insbesondere im Notaufnahme-und Intensivsetting zunehmend eine Schlüsselrolle zu [6].…”

Diagnostic chest ultrasound for acute respiratory failure

“…There are some data showing that use of lung ultrasound in the intensive care unit reduces the number of chest x-rays performed, with associated reductions in cost and radiation, although rates of CT scanning are no different [95,96]. This occurs on a background of general decrease in rates of utilisation of advanced imaging techniques in the ICU, with a significant increase in uptake of US [97].…”