الفهرس 
Dyspnea in Emergency RoomOnly 14 pages are availabe for public view
 |  | from | 163 |  |  |
| | | from | 163 | | |
Abstract
A quick, easy, low-cost, noninvasive technique for visualizing various causes of acute dyspnea is thoracic ultrasonography. A growing collection of research is demonstrating how well thoracic ultrasound can diagnose chest cause of acute dyspnea and direct related interventions. In earlier studies that evaluated the accuracy of the thoracic ultrasound in the diagnosis of various chest disorders, it demonstrated high sensitivity and specificity.
This prospective study was carried out on 96 patients referred to us with acute dyspnea at Emergency Department, Faculty of Medicine, Menoufia University Hospitals.
After written consents, all patients submitted to full history taking, clinical examination, laboratory investigation, ABGs, CXR, CT and TUS examination.
Thoracic US chest examination was done by Sonoscape ultrasound machine, model S30. After application of ultrasound gel the selected probe was positioned on the chest wall perpendicular to the skin with the index marker always toward the patient‘s head.
Anterior and posterior axillary lines divided the chest wall into three fields: Anterior, Lateral and Posterior. The fields were further divided into equal quadrants for a total of six areas on each side. The lung was scanned using Brightness (B) and Motion (M) modes.
The image marker on the screen corresponded to the index marker on the probe and was positioned to the right of the screen when cardiology convention was used and on the left with radiology convention. Radiology convention was used. Gain and depth were adjusted to obtain clear distinction of shades of grey and to cover the whole lung depth. Anterior and posterior axillary lines divided the chest wall into three fields: Anterior, Lateral and Posterior. The fields were further divided into equal quadrants for a total of six areas on each side. The lung was scanned longitudinally moving craniocaudally to cover all quadrants. To access the posterior quadrant a lateral rotation of the patient is often necessary.
Interpretation of CXR, CT and TUS have been done and tabulated. SPSS program (version 28.0 for Windows) was used to conduct the statistical analysis. Frequency tables with percentages were used for categorical variables and descriptive statistics (mean and standard deviation) were used for numerical variables. Either Student-t was used to compare quantitative variables, while Pearson‘s Chi-square test was used to analyze categorical variables. The sensitivity, specificity, positive predictive value, and accuracy were calculated for thoracic US in comparison to CT results.
from total 96 patients, 70 of patients were males, 26 were females and mean age was 51.98 ± 14.35years. 52 (54.2%) patients were smokers. Most of patients have systemic comorbidities (54.2%), 16 (16,7 %) patients have history of trauma. Hypertension was the most systemic comorbidities which presented by 18 (18.8%) patients.
Normal arterial blood gases presented by 16 patients (16.7%), 5 patients (5.2%) had metabolic acidosis, 37 patients (38.6%) had respiratory alkalosis, 20 patients (20.9%) had type 1 respiratory failure, 8 patients (8.3%) had type II respiratory failure, 3 patients (3.1%) had type I respiratory failure and respiratory alkalosis, 6 patients (6.2%) had metabolic acidosis and respiratory alkalosis, and only one patient had Combined metabolic and respiratory acidosis.