Contribution and Reproducibility of Lung Ultrasound in the Diagnosis of Acute Heart Failure in the ED

Discrimination between cardiac and non-cardiac causes of dyspnea can be challenging, causing excessive delay before adequate therapy. In clinical practice lung ultrasound (LUS) is becoming an easy and reliable noninvasive tool for the evaluation of dyspnea and can shorten the time to diagnosis .However the reproductibility of this test was not extensively studied.

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Key information

Conditions

Dyspnea; Cardiac Cardiovascular Diseases Disease Dyspnea Heart Diseases Heart Failure Pathologic Processes Pathological Conditions, Signs and Symptoms Respiration Disorders Respiratory Tract Diseases Signs and Symptoms Signs and Symptoms, Respiratory

Age range

18 year–90 year

Sex eligibility

All sexes

Study type

Observational

About this study

Dyspnea is one of the most distressing situations for the patient . Emergency cases do not always present in conditions that are ideal for immediate diagnosis, which sometimes compromises outcome. Physical examination, laboratory findings and radiography are imperfect, resulting in a need for sophisticated test results that delay management.

Lung ultrasonography is becoming a standard tool in critical cases in the ED.

the investigators aim to perform ultrasonography on consecutive patients admitted to the ICU with dyspnea, comparing lung ultrasonography results on initial presentation with the final diagnosis by the ICU team.

Three items were assessed: artifacts (horizontal A lines or vertical B lines indicating interstitial syndrome), lung sliding, and alveolar consolidation and/or pleural effusion, these items were grouped to assess ultrasound profiles.

This study assesses the potential of lung ultrasonography to diagnose heart failure.The second aim of this study was to evaluate the inter-observer reproducibility of LUS performed by ED residents in the evaluation of cardiac causes of acute dyspnea.

Patients presenting to the ED with acute dyspnea will be prospectively enrolled in this study. In each patient, LUS was performed by two ED residents blinded to clinical diagnoses.

AHF was determined on the base of clinical exam, chest x-ray , brain natriuretic peptide (BNP) and echocardiographic findings.

A patient lung comet score (LCS) was obtained by summing the number of comets in each of the scanned spaces.

Then the probability of AHF was defined as :

low probability (LCS<15) intermediate probability (15 <LCS<30), and high probability (LCS>30 ).

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

non traumatic dyspnea with the final diagnosis of heart failure

Exclusion criteria

impossibility to give consent to participate in the study
post traumatic dyspnea
pregnant women
need for endotracheal intubation or inotropic drugs
patients who were deemed too unstable for sonography by the treating team

Treatment and study plan

Primary outcomes

the reproductibility of LUS in the diagnosis of heart failure

Time frame: 0 days

the reproductibility of the LUS in the diagnosis of heart failure between two different operators (using the Kappa and the agreement index)
the accuracy of LUS in the diagnosis of heart failure the accuracy of LUS in the diagnosis of heart failure measured by sensitivity ,specificity, and area under the roc curve

Time frame: 0 days

the accuracy of LUS in the diagnosis of heart failure measured by sensitivity ,specificity, and area under the roc curve

Sponsors and collaborators

Lead sponsor

University of Monastir

Other

Registry information

Official study title

Contribution LUS and Reproducibility of Lung Ultrasound in the Diagnosis of Acute Heart Failure in the Emergency Department (ED)

Important dates

Study start: 2016
Primary completion: 2017
Study completion: 2017
First posted: Sep 6, 2018
Registry last updated: Mar 17, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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