Please use this identifier to cite or link to this item: https://doi.org/10.1186/s13054-018-2105-y
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dc.titleChest radiography versus lung ultrasound for identification of acute respiratory distress syndrome: A retrospective observational study
dc.contributor.authorSee, K.C
dc.contributor.authorOng, V
dc.contributor.authorTan, Y.L
dc.contributor.authorSahagun, J
dc.contributor.authorTaculod, J
dc.date.accessioned2020-09-09T03:45:40Z
dc.date.available2020-09-09T03:45:40Z
dc.date.issued2018
dc.identifier.citationSee, K.C, Ong, V, Tan, Y.L, Sahagun, J, Taculod, J (2018). Chest radiography versus lung ultrasound for identification of acute respiratory distress syndrome: A retrospective observational study. Critical Care 22 (1) : 203. ScholarBank@NUS Repository. https://doi.org/10.1186/s13054-018-2105-y
dc.identifier.issn1364-8535
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/175106
dc.description.abstractBackground: Lung ultrasound may be a reasonable alternative to chest radiography for the identification of acute respiratory distress syndrome (ARDS), but the diagnostic performance of lung ultrasound for ARDS is uncertain. We therefore analyzed the clinical outcomes of ARDS diagnosed according to the Berlin Definition, using either chest radiography (Berlin-CXR) or lung ultrasound (Berlin-LUS) as an alternative imaging method. Methods: This was a retrospective observational study in a 20-bed medical intensive care unit (ICU). Patients who required noninvasive ventilation or invasive ventilation for hypoxemic respiratory failure on ICU admission from August 2014 to March 2017 were included. Both chest radiography and lung ultrasound were performed routinely upon ICU admission. Comparisons were made using either the Berlin-CXR or Berlin-LUS definitions to diagnose ARDS with respect to the patient characteristics and clinical outcomes for each definition. ICU and hospital mortality were the main outcome measures for both definitions. Results: The first admissions of 456 distinct patients were analyzed. Compared with the 216 patients who met the Berlin-CXR definition (ICU mortality 19.4%, hospital mortality 36.1%), 229 patients who met the Berlin-LUS definition (ICU mortality 22.7%, hospital mortality 34.5%) and 79 patients who met the Berlin-LUS but not the Berlin-CXR definition (ICU mortality 21.5%, hospital mortality 29.1%) had similar outcomes. In contrast, the 295 patients who met either definition had higher mortality than the 161 patients who did not meet either definition (ICU mortality 20.0% versus 12.4%, P=0.041; hospital mortality 34.2% versus 24.2%, P=0.027). Compared with Berlin-CXR, Berlin-LUS had a positive predictive value of 0.66 (95% confidence interval 0.59-0.72) and a negative predictive value of 0.71 (0.65-0.77). Among the 216 Berlin-CXR ARDS patients, 150 patients (69.4%) also fulfilled Berlin-LUS definition. Conclusions: For the identification of ARDS using the Berlin definition, both chest radiography and lung ultrasound were equally related to mortality. The Berlin definition using lung ultrasound helped identify patients at higher risk of death, even if these patients did not fulfill the conventional Berlin definition using chest radiography. However, the moderate overlap of patients when chest imaging modalities differed suggests that chest radiography and lung ultrasound should be complementary rather than used interchangeably. © 2018 The Author(s).
dc.publisherBioMed Central Ltd.
dc.sourceUnpaywall 20200831
dc.subjectadult
dc.subjectadult respiratory distress syndrome
dc.subjectArticle
dc.subjectcontrolled study
dc.subjectdiagnostic test accuracy study
dc.subjectechography
dc.subjectfemale
dc.subjecthospital admission
dc.subjecthospital mortality
dc.subjecthuman
dc.subjectintensive care unit
dc.subjectintermethod comparison
dc.subjectlung ultrasound
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectnoninvasive ventilation
dc.subjectobservational study
dc.subjectpredictive value
dc.subjectpriority journal
dc.subjectrespiratory failure
dc.subjectretrospective study
dc.subjectthorax radiography
dc.subjectadult respiratory distress syndrome
dc.subjectdiagnostic imaging
dc.subjectechography
dc.subjectorganization and management
dc.subjectprocedures
dc.subjectradiography
dc.subjectstandards
dc.subjectthorax
dc.subjectAdult
dc.subjectFemale
dc.subjectHumans
dc.subjectIntensive Care Units
dc.subjectMale
dc.subjectRadiography
dc.subjectRespiratory Distress Syndrome, Adult
dc.subjectRetrospective Studies
dc.subjectThorax
dc.subjectUltrasonography
dc.typeArticle
dc.contributor.departmentMEDICINE
dc.description.doi10.1186/s13054-018-2105-y
dc.description.sourcetitleCritical Care
dc.description.volume22
dc.description.issue1
dc.description.page203
dc.published.statePublished
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