Impact of device selection and clip duration on lung ultrasound assessment in patients with heart failure - 29/06/15

Doi : 10.1016/j.ajem.2015.06.002

Elke Platz, MD, MS ^a,^{^⁎,}^{^{1
These authors contributed equally to this work.}} , Emanuele Pivetta, MD, MSc ^b,^{^{1
These authors contributed equally to this work.}}, Allison A. Merz, BA ^a,^c, Julie Peck, BA ^a,^c, Jose Rivero, MD ^c, Susan Cheng, MD, MSc, MPH ^c
^a Department of Emergency Medicine, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA
^b Department of Medical Sciences, Division of Emergency Medicine and Cancer Epidemiology Unit, “Città della Salute e della Scienza di Torino”, Hospital and the University of Turin, Turin, Italy
^c Cardiovascular Division, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA

^⁎Corresponding author at: Department of Emergency Medicine, Brigham and Women’s Hospital, 75 Francis Street, Neville House, Boston, MA 02115, USA. Tel.: +1 617 525 7932; fax: +1 617 713 3060.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Monday 29 June 2015
Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder

Abstract

Objectives

Pulmonary edema is a common sign of heart failure and can be quantified by counting vertical artifacts (B-lines) on lung ultrasound (LUS). The primary aim of this study was to compare a pocket size ultrasound device to high-end ultrasound systems on the measured number of B-lines. We also compared the impact of different-length ultrasound clips on the measured number of B-lines.

Methods and results

We studied 21 hospitalized patients with heart failure (81% men; median age, 73; 71% Caucasian) who underwent concurrent 8- and 4-zone LUS using both a pocket ultrasound device and a high-end ultrasound system. For the 4-zone scanning method, the median B line number was 2 (interquartile range, 1-4) for the pocket device and 3 (1-5) for the high-end system (P = .67). For the 8-zone method, the median B-line number was 4 (2-7) for the pocket device and 5 (3-7) for the high-end system (P = .18). A higher number of B-lines was identified on the 4- vs 2-second LUS clips (P < .001 for 4 zones, P = .001 for 8 zones), and on the 6- vs 4-second LUS clips (P=0.057 for 4 zones, P=0.018 for 8 zones).

Conclusions

Our findings suggest significant differences based on LUS clip duration rather than the type of ultrasound device used, with respect to the number of B-lines detectable in patients with heart failure. These factors should be considered in the design and reporting of LUS studies and in longitudinal assessments of heart failure patients.

Le texte complet de cet article est disponible en PDF.