2018
DOI: 10.1017/cem.2018.27
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Emergency department ultrasound for the detection of B-lines in the early diagnosis of acute decompensated heart failure: a systematic review and meta-analysis

Abstract: CLINICIAN'S CAPSULE What is known about the topic? Current diagnostic tools for heart failure in the emergency department (ED) have limited accuracy and often lead to delays in management. What did this study ask? What is the accuracy of early bedside lung ultrasound in the diagnosis of acute decompensated heart failure? What did this study find? This meta-analysis found that the sensitivity and specificity of bedside lung US in ADHF is 82.5% and 83.6%, respectively. Why does this study matter to clinicians? T… Show more

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Cited by 31 publications
(37 citation statements)
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“…In adult dyspneic patients, approximately 40 % suffer from acute decompensated heart failure (ADHF) [4]. However, the symptoms and signs are non-specific, and the emergency physician often fails to differentiate congestion from pulmonary diseases [1]. Approximately 20 % of dyspneic patients in the ED are initially misdiagnosed and treated inappropriately, thereby negatively affecting both morbidity and mortality [1].…”
Section: Introductionmentioning
confidence: 99%
See 1 more Smart Citation
“…In adult dyspneic patients, approximately 40 % suffer from acute decompensated heart failure (ADHF) [4]. However, the symptoms and signs are non-specific, and the emergency physician often fails to differentiate congestion from pulmonary diseases [1]. Approximately 20 % of dyspneic patients in the ED are initially misdiagnosed and treated inappropriately, thereby negatively affecting both morbidity and mortality [1].…”
Section: Introductionmentioning
confidence: 99%
“…There are a variety of different LUS methods [1,6] but a consistent problem in previous studies was the gold standards used for assessing congestion. Instead of measuring congestion directly, most studies used an integrated diagnosis of ADHF based on medical records, echocardiography, biomarkers and chest X-ray (CXR), which are by nature subjective and indirectly affected by the LUS result [1,7,8]. The CXR is not an acceptable gold standard to detect pulmonary congestion since more than 20 % are false-negative, but CXR can be useful to assess other causes of dyspnea [4].…”
Section: Introductionmentioning
confidence: 99%
“…The LUS+2014 project is not a test of LUS per se, it is a test of the implementation of an LUS protocol. LUS has been proven worthy in other arenas and is already trickling into practice . We asked whether the protocol is ready for wholesale implementation, robust enough to withstand non‐expert sonologists, complex patients and a range of hospitals.…”
Section: Discussionmentioning
confidence: 99%
“…Favourable reports on the utility of LUS are found in meta‐analyses, but most of these are weighted by exclusive populations, with expert sonologists performing multisystem protocols . With two important exceptions, most are prospective observational trials.…”
Section: Introductionmentioning
confidence: 99%
“…3 This systematic review and meta-analysis add to the body of literature surrounding the role of lung POCUS, focusing specifically on the ED, and the diagnosis of acute heart failure by the detection of sonographic B-lines. These results strongly support the utility of lung POCUS in the diagnosis of acute heart failure, despite the test characteristics not being as robust as previously reported in other settings.…”
mentioning
confidence: 99%