Ultrassonografia Pulmonar e Radiografia de Tórax: Existe uma Razão para um Líder entre os Dois?

Autores

  • Costantino Caroselli INRCA IRCCS Ancona
  • Beatrice Ortensi 1Specialization School in Geriatrics, University Politecnica delle Marche, Ancona, Italy

DOI:

https://doi.org/10.24950/rspmi.2177

Palavras-chave:

Dispneia/diagnóstico por imagem, Radiografia Torácica, Sistemas Point-of-Care, Ultrassonografia, Exame Físico, Ascite, Confiabilidade dos Dados

Resumo

A radiografia de tórax (RX) é atualmente a primeira imagem
diagnóstica tradicional usada em pacientes com sintomas respiratórios agudos, mas nos últimos anos a ultrassonografia pulmonar clínica (LUS) ganhou importância crescente.

O LUS clínico é definido como um ultrassom realizado no
ponto de atendimento pelo médico integrado ao exame físico do paciente.

O uso de um LUS integrado no ponto de atendimento é
seguro, barato, rápido e pode reduzir o tempo até o diagnóstico, melhorando o diagnóstico diferencial. Reduz o tempo até o tratamento, diminuindo o tempo de permanência na UTI em comparação com as abordagens convencionais e minimizando o número de exames radiológicos evitando a exposição à radiação ionizante; também reduzir os exames laboratoriais, otimizando o uso de recursos financeiros.

Downloads

Não há dados estatísticos.

Referências

Sørensen SF, Ovesen SH, Lisby M, Mandau MH, Thomsen IK, Kirkegaard H. Predicting mortality and readmission based on chief complaint in emergency department patients: a cohort study. Trauma Surg Acute Care Open. 2021;6:e000604. doi: 10.1136/tsaco-2020-000604.

Lindskou TA, Pilgaard L, Søvsø MB, Kløjgård TA, Larsen TM, Jensen FB, et al. Symptom, diagnosis and mortality among respiratory emergency medical service patients. PLoS One. 2019;14:e0213145. doi: 10.1371/journal. pone.0213145.

Cid-Serra X, Royse A, Canty D, Johnson DF, Maier AB, Fazio T, et al. Effect of a Multiorgan Focused Clinical Ultrasonography on Length of Stay in Patients Admitted With a Cardiopulmonary Diagnosis: A Randomized Clinical Trial. JAMA Netw Open. 2021;4:e2138228. doi: 10.1001/jamanetworkopen. 2021.38228. Erratum in: JAMA Netw Open. 2022;5:e2211248.

Perrone T, Maggi A, Sgarlata C, Palumbo I, Mossolani E, Ferrari S, et al. Lung ultrasound in internal medicine: A bedside help to increase accuracy in the diagnosis of dyspnea. Eur J Intern Med. 2017;46:61-5. doi: 10.1016/j.ejim.2017.07.034.

Narula J, Chandrashekhar Y, Braunwald E. Time to add a fifth pillar to bedside physical examination: inspection, palpation, percussion, auscultation, and insonation. JAMA Cardiol. 2018;3:346-350. doi:10.1001/jamacardio. 2018.0001

Ultrasound Guidelines: Emergency, Point-of-Care and Clinical Ultrasound Guidelines in Medicine. Ann Emerg Med. 2017;69:e27-e54. doi: 10.1016/j. annemergmed.2016.08.457.

Smallwood N, Dachsel M. Point-of-care ultrasound (POCUS): unnecessary gadgetry or evidence-based medicine? Clin Med. 2018;18:219-24. doi: 10.7861/clinmedicine.18-3-219.

Raheja R, Brahmavar M, Joshi D, Raman D. Application of Lung Ultrasound in Critical Care Setting: A Review. Cureus. 2019 Jul 25;11(7):e5233. doi: 10.7759/cureus.5233.

Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein DA, Mathis G, Kirkpatrick AW, et al. International Liaison Committee on Lung Ultrasound (ILC-LUS) for International Consensus Conference on Lung Ultrasound (ICC-LUS). International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012; 38:577-91. doi: 10.1007/s00134-012-2513-4.

Gullett J, Donnelly JP, Sinert R, Hosek B, Fuller D, Hill H, et al. Interobserver agreement in the evaluation of B-lines using bedside ultrasound. J Crit Care. 2015;30:1395-9. doi: 10.1016/j.jcrc.2015.08.021.

Lichtenstein DA, Mezière GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest. 2008;134:117-25. doi: 10.1378/chest.07-2800. Erratum in: Chest. 2013;144:721.

Maw AM, Hassanin A, Ho PM, McInnes MD, Moss A, Juarez-Colunga E, et al. Diagnostic Accuracy of Point-of-Care Lung Ultrasonography and Chest Radiography in Adults With Symptoms Suggestive of Acute Decompensated Heart Failure: A Systematic Review and Meta-analysis. JAMA Netw Open. 2019;2:e190703. doi: 10.1001/jamanetworkopen.2019.0703.

Llamas-Álvarez AM, Tenza-Lozano EM, Latour-Pérez J. Accuracy of Lung Ultrasonography in the Diagnosis of Pneumonia in Adults: Systematic Review and Meta-Analysis. Chest. 2017;151:374-82. doi: 10.1016/j. chest.2016.10.039.

Falster C, Jacobsen N, Coman KE, Højlund M, Gaist TA, Posth S, et al. Diagnostic accuracy of focused deep venous, lung, cardiac and multiorgan ultrasound in suspected pulmonary embolism: a systematic review and meta-analysis. Thorax. 2022;77:679-89. doi: 10.1136/thoraxjnl-2021-216838.

Staub LJ, Mazzali Biscaro RR, Kaszubowski E, Maurici R. Lung Ultrasound for the Emergency Diagnosis of Pneumonia, Acute Heart Failure, and Exacerbations of Chronic Obstructive Pulmonary Disease/Asthma in Adults: A Systematic Review and Meta-analysis. J Emerg Med. 2019;56:53-69. doi: 10.1016/j.jemermed.2018.09.009.

Al Deeb M, Barbic S, Featherstone R, Dankoff J, Barbic D. Point-of-care ultrasonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: a systematic review and meta-analysis. Acad Emerg Med. 2014;21:843-52. doi: 10.1111/acem.12435.

Marini TJ, Rubens DJ, Zhao YT, Weis J, O'Connor TP, Novak WH, et al. Lung Ultrasound: The Essentials. Radiol Cardiothorac Imaging. 2021;3:e200564. doi: 10.1148/ryct.2021200564. P

Yousefifard M, Baikpour M, Ghelichkhani P, Asady H, Shahsavari Nia K, Moghadas Jafari A, et al. Screening Performance Characteristic of Ultrasonography and Radiography in Detection of Pleural Effusion; a Meta-Analysis. Emerg. 2016;4:1-10.

Ding W, Shen Y, Yang J, He X, Zhang M. Diagnosis of pneumothorax by radiography and ultrasonography: a meta-analysis. Chest. 2011;140:859-66. doi: 10.1378/chest.10-2946.

Falster C, Jacobsen N, Coman KE, Højlund M, Gaist TA, Posth S, et al. Diagnostic accuracy of focused deep venous, lung, cardiac and multiorgan ultrasound in suspected pulmonary embolism: a systematic review and meta-analysis. Thorax. 2022;77:679-89. doi: 10.1136/thoraxjnl-2021-216838.

Alzahrani SA, Al-Salamah MA, Al-Madani WH, Elbarbary MA. Systematic review and meta-analysis for the use of ultrasound versus radiology in diagnosing of pneumonia. Crit Ultrasound J. 2017;9:6. doi: 10.1186/s13089-017-0059-y.

Caroselli C, Blaivas M, Marcosignori M, Chen YT, Falzetti S, Mariz J, et al. Early Lung Ultrasound Findingsin Patients With COVID-19 Pneumonia. A Retrospective Multicenter Study of 479 Patients. J Ultrasound Med. 2022; 41:2547–56.

Caroselli C, Blaivas M, Falzetti S. Diagnostic imaging in newborns, children and adolescents infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): is there a realistic alternative to lung high-resolution computed tomography (HRCT) and chest X-rays? a systematic review of the literature. Ultrasound Med Biol.2021; 47: 3034-40.

Volpicelli G, Cardinale L, Fraccalini T, Calandri M, Piatti C, Geninatti C, et al. Descriptive analysis of a comparison between lung ultrasound and chest radiography in patients suspected of COVID‑19. Ultrasound J. 2021; 13:11. doi: 10.1186/s13089-021-00215-9

Shokoohi H, Liteplo AS, Ma IW. Point-of-Care Ultrasonography: Clearly More Than a Pretty Picture. JAMA Intern Med. 2022;182:567. doi: 10.1001/jamainternmed.2022.0067.

Gartlehner G, Wagner G, Affengruber L, Chapman A, Dobrescu A, Klerings I, et al. Point-of-Care Ultrasonography in Patients With Acute Dyspnea: An Evidence Report for a Clinical Practice Guideline by the American College of Physicians. Ann Intern Med. 2021;174:967-76. doi: 10.7326/M20-5504. Erratum in: Ann Intern Med. 2022;175:458-9.

Siwik D, Apanasiewicz W, Zukowska M, Jaczewski G, Dabrowska M. Diagnosing Lung Abnormalities Related to Heart Failure in Chest Radiogram, Lung Ultrasound and Thoracic Computed Tomography. Adv Respir Med. 2023;91:103–22. doi: 10.3390/arm91020010

Cardinale L, Priola AM, Moretti F, Volpicelli G. Effectiveness of chest radiography, lung ultrasound and thoracic computed tomography in the diagnosis of congestive heart failure. World J Radiol. 2014; 6: 230-7.

Zanobetti M, Scorpiniti M, Gigli C, Nazerian P, Vanni S, Innocenti F, et al. Point-of-care ultrasonography for evaluation of acute dyspnea in the ED. Chest. 2017;151:1295-301. doi: 10.1016/j.chest.2017.02.003.

Laursen CB, Sloth E, Lassen AT, Christensen Rd, Lambrechtsen J, Madsen PH, et al. Point-of-care ultrasonography in patients admitted with respiratory symptoms: a single-blind, randomised controlled trial. Lancet Respir Med. 2014;2:638-46. doi: 10.1016/S2213-2600(14)70135-3.

Szabó GV, Szigetváry C, Szabó L, Dembrovszky F, Rottler M, Ocskay K, et al. Point-of-care ultrasound improves clinical outcomes in patients with acute onset dyspnea: a systematic review and meta-analysis. Intern Emerg Med. 2023;18:639-53. doi: 10.1007/s11739-022-03126-2.

Amatya Y, Rupp J, Russell FM, Saunders J, Bales B, House DR. Diagnostic use of lung ultrasound compared to chest radiograph for suspected pneumonia in a resource-limited setting. Int J Emerg Med. 2018;11:8. doi: 10.1186/s12245-018-0170-2.

Kok B, Wolthuis D, Bosch F, van der Hoeven H, Blans M. POCUS in dyspnea, nontraumatic hypotension, and shock; a systematic review of existing evidence. Eur J Intern Med. 2022;106:9-38. doi: 10.1016/j. ejim.2022.07.017.

García-Araquea HF, Aristizábal-Linaresb JP, Ruíz-Ávilac HA. Semiology of lung ultrasonography – Dynamic monitoring available at the patient’s bedside. Rev Colomb Anestesiol. 2015;43:290–8.

Downloads

Publicado

27-10-2023

Como Citar

1.
Caroselli C, Ortensi B. Ultrassonografia Pulmonar e Radiografia de Tórax: Existe uma Razão para um Líder entre os Dois?. RPMI [Internet]. 27 de Outubro de 2023 [citado 17 de Novembro de 2024];30(4):252-5. Disponível em: https://revista.spmi.pt/index.php/rpmi/article/view/2177

Artigos Similares

Também poderá iniciar uma pesquisa avançada de similaridade para este artigo.