Evaluation of patient presenting with acute respiratory distress at emergency department in a tertiary care hospital with special reference to bed side thoracic ultrasound
Keywords:
Acute respiratory distress, acute hemodynamic pulmonary edema (AHPE), dyspnea, emergency department, thoracic ultrasound, pulse oximetry, echocardiographyAbstract
Introduction: Heterogeneous group of patients present with shortness of breath at emergency department. Initial and rapid diagnosis may be lifesaving. Bilateral diffuse anterior B-lines (3 or more) along with lung sliding (B-Profile) have been demonstrated to predict acute hemodynamic pulmonary edema (AHPE) in the BLUE (Bedside Lung Ultrasound in Emergency) protocol. Objectives: The objectives of this study are to find out causes of acute onset of dyspnea with special reference to bedside lung ultra sound. Methodology: In this study total number of the cases (N=438) were divided in acute hemodynamic pulmonary edema (AHPE Group, n=194) [i.e. B-Profile or (B/L) interstitial syndrome (3 & 3+ B-Line in all six BLUE points with lung sliding bilaterally)] and in the other – Group (n=244)[A/C/A-B profile]. Results: This AHPE-Group has significant low ejection fraction (44.28±10.92 with P value = 0.0001); significant low saturation at presentation (82.82±13.91 with P value = 0.0001) and significant high blood lactate level (2.41±1.91 with P value =0.0049).Total numbers of consolidation (pneumonia) found by bedside ultrasound in “Other” group was significantly higher than AHPE group (P value = 0.02426). Conclusion: Bedside lung ultrasound is a very useful tool to evaluate acute onset of dyspnea and to initiate prompt management.
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Copyright (c) 2021 Abhradip Das, Amit Dey, Ershad Ali, Saptaparni Gupta, Apurba Panja, Nibedita Chatterjee, Bodhisatwa Biswas
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