Utility and diagnostic accuracy of bedside lung ultrasonography during medical emergency team (MET) activations for respiratory deterioration

作者：Sen Soumitra^*; Acash Ghazwan; Sarwar Akmal; Lei Yuxiu; Dargin James M

来源：Journal of Critical Care, 2017, 40: 58-62.

DOI：10.1016/j.jcrc.2017.03.007

Purpose: We investigated the feasibility and diagnostic accuracy of lung ultrasonography during medical emergency team (MET) activations for respiratory deterioration.
Material and methods: We performed a prospective study of inpatients requiring MET evaluation for respiratory decompensation. A blinded investigator recorded videos of lung and lower extremity ultrasonography. The videos were reviewed by blinded investigators to determine a ultrasonography diagnosis. The accuracy of MET diagnosis and ultrasonography diagnosis were compared to the final diagnosis determined by retrospective chart review.
Results: The ultrasound exam was completed in 49/50 (98%) patients enrolled in the study with a mean duration of 13 +/- 4 min. When excluding six cases that were not amenable to diagnosis by our algorithm, we report a lung ultrasonography diagnostic accuracy of 84% (37/44) which is similar to the accuracy of the MET clinical diagnosis of 75% (33/44) (p = 0.29). Furthermore, we report in 28/37 (76%) of cases where the lung ultrasonography diagnosis was correct, patients may have received inappropriate therapies.
Conclusions: Lung ultrasonography can be rapidly performed in the majority of patients with MET activation for respiratory deterioration. As an independent diagnostic test, lung ultrasonography is non-inferior to the MET clinical assessment and may prevent unnecessary treatments if used simultaneously.