PDF(Pubmed)
Abstract：
UNASSIGNED: Non-fatal drownings confer significant morbidity and mortality in the United States. Chest radiograph (CXR) is typically used as a screening modality for interstitial edema but lacks sensitivity early after submersion. No study has evaluated lung ultrasound in assessing for pulmonary edema after submersion events and we hypothesized that lung point-of-care (POC) ultrasound can identify interstitial edema in patients presenting after non-fatal drownings.
UNASSIGNED: Patients presenting to the emergency department after a submersion event were eligible if a CXR was obtained as part of their care. Emergency medicine residents performed a lung POC ultrasound and provided a \"novice\" interpretation of \"normal\" or \"abnormal,\" which was independently reviewed by a blinded expert sonographer. Patients were contacted 2 weeks after presentation to assess for late sequela.
UNASSIGNED: A prospective convenience sample of 59 patients included 21 adults (36%) and 38 children (64%) enrolled over 17 months with a median age of 6. Twenty-four (41%) patients had abnormalities on CXR. Of these, 20 patients had a positive ultrasound per novice interpretation. Compared to CXR, ultrasound had an overall sensitivity of 83% and a specificity of 66% for detecting pulmonary edema in non-fatal drownings. Notably, out of 35 subjects with a negative CXR, there were 12 (34%) cases with a positive lung ultrasound, 10 of which required hospital admission.
UNASSIGNED: Lung POC ultrasound has a moderate sensitivity and specificity when performed by novice sonographers to detect pulmonary edema presenting to an ED setting after a non-fatal drowning event.
UNASSIGNED: Patients presenting to the emergency department after a submersion event were eligible if a CXR was obtained as part of their care. Emergency medicine residents performed a lung POC ultrasound and provided a \"novice\" interpretation of \"normal\" or \"abnormal,\" which was independently reviewed by a blinded expert sonographer. Patients were contacted 2 weeks after presentation to assess for late sequela.
UNASSIGNED: A prospective convenience sample of 59 patients included 21 adults (36%) and 38 children (64%) enrolled over 17 months with a median age of 6. Twenty-four (41%) patients had abnormalities on CXR. Of these, 20 patients had a positive ultrasound per novice interpretation. Compared to CXR, ultrasound had an overall sensitivity of 83% and a specificity of 66% for detecting pulmonary edema in non-fatal drownings. Notably, out of 35 subjects with a negative CXR, there were 12 (34%) cases with a positive lung ultrasound, 10 of which required hospital admission.
UNASSIGNED: Lung POC ultrasound has a moderate sensitivity and specificity when performed by novice sonographers to detect pulmonary edema presenting to an ED setting after a non-fatal drowning event.
摘要：
■非致命性溺水在美国具有显著的发病率和死亡率。胸部X光片（CXR）通常用作间质性水肿的筛查方式，但浸没后早期缺乏敏感性。没有研究评估肺部超声在评估浸没事件后的肺水肿，我们假设肺部护理点（POC）超声可以识别非致命性溺水后出现的患者的间质性水肿。
■如果作为护理的一部分获得了CXR，则在浸没事件后到急诊科就诊的患者符合资格。急诊医师进行了肺部POC超声检查，并提供了“新手”解释“正常”或“异常”，“这是由一名失明的超声专家独立审查的。就诊后2周联系患者以评估晚期后遗症。
■59名患者的前瞻性便利样本包括21名成人（36％）和38名儿童（64％），年龄超过17个月，中位年龄为6岁。24（41％）患者的CXR异常。其中,每个新手解释20例患者的超声检查结果为阳性。与CXR相比，在非致命性溺水中,超声检测肺水肿的总体敏感性为83%,特异性为66%.值得注意的是,在35名CXR阴性的受试者中，有12例（34%）肺部超声阳性，其中10人需要住院。
■在非致命性溺水事件发生后，由新手超声医师进行肺POC超声检查以检测ED设置的肺水肿时，肺POC超声具有中等的敏感性和特异性。
■如果作为护理的一部分获得了CXR，则在浸没事件后到急诊科就诊的患者符合资格。急诊医师进行了肺部POC超声检查，并提供了“新手”解释“正常”或“异常”，“这是由一名失明的超声专家独立审查的。就诊后2周联系患者以评估晚期后遗症。
■59名患者的前瞻性便利样本包括21名成人（36％）和38名儿童（64％），年龄超过17个月，中位年龄为6岁。24（41％）患者的CXR异常。其中,每个新手解释20例患者的超声检查结果为阳性。与CXR相比，在非致命性溺水中,超声检测肺水肿的总体敏感性为83%,特异性为66%.值得注意的是,在35名CXR阴性的受试者中，有12例（34%）肺部超声阳性，其中10人需要住院。
■在非致命性溺水事件发生后，由新手超声医师进行肺POC超声检查以检测ED设置的肺水肿时，肺POC超声具有中等的敏感性和特异性。
