The application of BLUE (Bedside Lung Ultrasound in Emergency) protocol in the emergency department

Eylem Ersan; Güçlü Kıyan; Murat Ersel; Funda Karbek Akarca; Selen Bayraktaroğlu; Bahar Boydak

doi:10.19161/etd.1518590

TR EN

Acil Serviste BLUE (Acil Durumda Yatakbaşı Akciğer Ultrasonu) protokolünün uygulanması

Öz

Giriş: Bu çalışmada acil serviste akut solunum sıkıntısının nedeninin saptanmasında akciğer ultrasonografisinin (US) etkinliğinin değerlendirilmesi amaçlandı. Yöntemler: Bu kesitsel analitik çalışma, bir Üniversite Hastanesi Acil Servisi'ne 6 aylık sürede akut solunum yetmezliği nedeniyle başvuran 195 yetişkin hasta üzerinde gerçekleştirildi. US teşhislerinin geçerliliği, araştırmacıların BLUE protokol sınıflandırmasına göre verdiği kararlar ile primer doktorların kılavuzların önerdiği altın standart teşhis tekniklerini kullanarak verdikleri nihai kararların karşılaştırılması yoluyla değerlendirildi. Bulgular: Akciğer US'un tanısal doğruluğu %89,7 idi. US ile yüksek duyarlık ve özgüllükle; Konjestif Kalp Yetmezliği (KKY) (n=91), Kronik Obstrüktif Akciğer Hastalığı (KOAH) (n=53), pnömoni (n=69) ve Pnömotoraks (PTX) (n=5) tanıları konulabilmektedir. Pulmoner Tromboembolizm (PTE)(n=18) tanısında duyarlılığı ve özgüllüğü düşük (%67) idi. Ultrasonografi aynı zamanda KKY ile ilişkili pnömoni veya KOAH ile ilişkili pnömoni gibi kombine patolojileri de yüksek duyarlılık ve özgüllükle teşhis edebilir. Acil serviste yatak başı solunum sıkıntısını değerlendirmek için kullanılan rutin fizik muayene ve akciğer grafisinin tanısal doğruluğunun ultrasonografiye göre daha düşük olduğu belirlendi. Tartışma: Bu çalışmada akciğer US'un KKY, KOAH, pnömoni, PTE ve PTX tanısında etkili olduğunu bulduk. Altın standart testlerle karşılaştırıldığında tanı süresini kısalttı. Son olarak US, ileri tanı olanaklarının bulunmadığı merkezlerde de güvenle uygulanabilir.

Anahtar Kelimeler

The application of BLUE (Bedside Lung Ultrasound in Emergency) protocol in the emergency department

Abstract

Introduction: This study aimed to evaluate the effectiveness of lung ultrasonography (US) in detecting the cause of acute respiratory distress in the emergency department. Methods: This cross-sectional analytical study was carried out on 195 adult patients who were admitted to the Emergency Department of a University Hospital with acute respiratory failure in 6months period. The validity of the US diagnoses was assessed by comparing the decisions made by researchers according to the BLUE protocol classification with the final judgments made by the primary doctors using gold-standard diagnostic techniques suggested by the guidelines. Results: The diagnostic accuracy of lung US was 89.7%. While Congestive Heart Failure (CHF) (n=91), Chronic Obstructive Pulmonary Disease (COPD) (n=53), pneumonia (n=69), and Pneumothorax (PTX) (n=5) could be diagnosed by ultrasound with high sensitivity and specificity, its specificity in the diagnosis of Pulmonary Thromboembolism (PTE)(n=18) was low (67%). Ultrasonography could also diagnose combined pathologies such as pneumonia associated with CHF, or pneumonia associated with COPD, with high sensitivity and specificity. It has been determined that the diagnostic accuracy of the routine physical examination and lung radiography used in the emergency room to assess bedside respiratory distress is lower than that of ultrasonography. Discussion: In this study, we found that lung US was effective in the diagnosis of CHF, COPD, pneumonia, PTE, and PTX. Compared to the gold standard tests, it shortened the duration of the diagnosis. Finally, US can also be applied safely in centers where advanced diagnostic facilities are not available.

Keywords

References

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Details

Primary Language

English

Subjects

Emergency Medicine

Journal Section

Research Article

Authors

Eylem Ersan ^*
0000-0002-1756-0261
Türkiye

Güçlü Kıyan
0000-0001-8431-7387
Türkiye

Murat Ersel
0000-0003-2282-5559
Türkiye

Funda Karbek Akarca
0000-0003-2455-8044
Türkiye

Selen Bayraktaroğlu
0000-0001-9167-9474
Türkiye

Bahar Boydak
0000-0003-3239-3139
Türkiye

Publication Date

December 9, 2024

Submission Date

July 19, 2024

Acceptance Date

August 17, 2024

Published in Issue

Year 2024 Volume: 63 Number: 4

DOI

https://doi.org/10.19161/etd.1518590

IZ

https://izlik.org/JA64UT84SX

Cite

RIS / Bibtex

Vancouver

1.Eylem Ersan, Güçlü Kıyan, Murat Ersel, Funda Karbek Akarca, Selen Bayraktaroğlu, Bahar Boydak. The application of BLUE (Bedside Lung Ultrasound in Emergency) protocol in the emergency department. EJM. 2024 Dec. 1;63(4):572-9. doi:10.19161/etd.1518590

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