The role of bedside ultrasound in the diagnosis and outcome of patients with acute respiratory failure

Abstract

The aim of the present study was to evaluate the relationship between a bedside ultrasound evaluation during an episode of acute respiratory failure and the patient’s outcome. A retrospective observational study was conducted in the emergency departments (EDs) of two hospitals in Como (Sant’Anna Hospital and Valduce Hospital) over two years. Two hundred and twenty eight adult patients with acute respiratory failure were recruited for the study. One hundred and eight patients (group A) received immediately a bedside ultrasound diagnostic test by expert investigastors at the time of ED admission, while 120 patients (group B) were evaluated and managed without a preliminary ultrasound diagnostic approach. The concordance between initial and final diagnosis was statistically significant in group A vs group B (P<0.01). In-hospital mortality was significantly lower in group A as compared with group B [3 (2.7%) vs 6 (5%), respectively; P<0.01]; in group A only nine patients (8.3%) compared with seventeen patients (14.1%) in group B (P<0.01) were transferred to the intensive care unit for monitoring and treatment. The study proposed is not able to recommend the procedure because it is a retrospective design. In spite of this, our study supports the routine use of ultrasonography for the evaluation of patients having acute respiratory failure.

Keywords

• ultrasound, emergency, acute respira- tory failure, diagnosis, outcome