Publication

Should the ultrasound probe replace your stethoscope? A SICS-I sub-study comparing lung ultrasound and pulmonary auscultation in the critically ill

SICS Study Group, Cox, E. G. M., Koster, G., Baron, A., Kaufmann, T., Eck, R. J., Veenstra, T. C., Hiemstra, B., Wong, A., Kwee, T. C., Tulleken, J. E., Keus, F., Wiersema, R. & van der Horst, I. C. C., 13-Jan-2020, In : Critical care (London, England). 24, 1, 7 p., 14.

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APA

SICS Study Group, Cox, E. G. M., Koster, G., Baron, A., Kaufmann, T., Eck, R. J., ... van der Horst, I. C. C. (2020). Should the ultrasound probe replace your stethoscope? A SICS-I sub-study comparing lung ultrasound and pulmonary auscultation in the critically ill. Critical care (London, England), 24(1), [14]. https://doi.org/10.1186/s13054-019-2719-8

Author

SICS Study Group ; Cox, Eline G M ; Koster, Geert ; Baron, Aidan ; Kaufmann, Thomas ; Eck, Ruben J ; Veenstra, T Corien ; Hiemstra, Bart ; Wong, Adrian ; Kwee, Thomas C ; Tulleken, Jaap E ; Keus, Frederik ; Wiersema, Renske ; van der Horst, Iwan C C. / Should the ultrasound probe replace your stethoscope? A SICS-I sub-study comparing lung ultrasound and pulmonary auscultation in the critically ill. In: Critical care (London, England). 2020 ; Vol. 24, No. 1.

Harvard

SICS Study Group, Cox, EGM, Koster, G, Baron, A, Kaufmann, T, Eck, RJ, Veenstra, TC, Hiemstra, B, Wong, A, Kwee, TC, Tulleken, JE, Keus, F, Wiersema, R & van der Horst, ICC 2020, 'Should the ultrasound probe replace your stethoscope? A SICS-I sub-study comparing lung ultrasound and pulmonary auscultation in the critically ill', Critical care (London, England), vol. 24, no. 1, 14. https://doi.org/10.1186/s13054-019-2719-8

Standard

Should the ultrasound probe replace your stethoscope? A SICS-I sub-study comparing lung ultrasound and pulmonary auscultation in the critically ill. / SICS Study Group; Cox, Eline G M; Koster, Geert; Baron, Aidan; Kaufmann, Thomas; Eck, Ruben J; Veenstra, T Corien; Hiemstra, Bart; Wong, Adrian; Kwee, Thomas C; Tulleken, Jaap E; Keus, Frederik; Wiersema, Renske; van der Horst, Iwan C C.

In: Critical care (London, England), Vol. 24, No. 1, 14, 13.01.2020.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

SICS Study Group, Cox EGM, Koster G, Baron A, Kaufmann T, Eck RJ et al. Should the ultrasound probe replace your stethoscope? A SICS-I sub-study comparing lung ultrasound and pulmonary auscultation in the critically ill. Critical care (London, England). 2020 Jan 13;24(1). 14. https://doi.org/10.1186/s13054-019-2719-8


BibTeX

@article{d32d06377bda45f986393173f044b131,
title = "Should the ultrasound probe replace your stethoscope?: A SICS-I sub-study comparing lung ultrasound and pulmonary auscultation in the critically ill",
abstract = "BACKGROUND: In critically ill patients, auscultation might be challenging as dorsal lung fields are difficult to reach in supine-positioned patients, and the environment is often noisy. In recent years, clinicians have started to consider lung ultrasound as a useful diagnostic tool for a variety of pulmonary pathologies, including pulmonary edema. The aim of this study was to compare lung ultrasound and pulmonary auscultation for detecting pulmonary edema in critically ill patients.METHODS: This study was a planned sub-study of the Simple Intensive Care Studies-I, a single-center, prospective observational study. All acutely admitted patients who were 18 years and older with an expected ICU stay of at least 24 h were eligible for inclusion. All patients underwent clinical examination combined with lung ultrasound, conducted by researchers not involved in patient care. Clinical examination included auscultation of the bilateral regions for crepitations and rhonchi. Lung ultrasound was conducted according to the Bedside Lung Ultrasound in Emergency protocol. Pulmonary edema was defined as three or more B lines in at least two (bilateral) scan sites. An agreement was described by using the Cohen κ coefficient, sensitivity, specificity, negative predictive value, positive predictive value, and overall accuracy. Subgroup analysis were performed in patients who were not mechanically ventilated.RESULTS: The Simple Intensive Care Studies-I cohort included 1075 patients, of whom 926 (86{\%}) were eligible for inclusion in this analysis. Three hundred seven of the 926 patients (33{\%}) fulfilled the criteria for pulmonary edema on lung ultrasound. In 156 (51{\%}) of these patients, auscultation was normal. A total of 302 patients (32{\%}) had audible crepitations or rhonchi upon auscultation. From 130 patients with crepitations, 86 patients (66{\%}) had pulmonary edema on lung ultrasound, and from 209 patients with rhonchi, 96 patients (46{\%}) had pulmonary edema on lung ultrasound. The agreement between auscultation findings and lung ultrasound diagnosis was poor (κ statistic 0.25). Subgroup analysis showed that the diagnostic accuracy of auscultation was better in non-ventilated than in ventilated patients.CONCLUSION: The agreement between lung ultrasound and auscultation is poor.TRIAL REGISTRATION: NCT02912624. Registered on September 23, 2016.",
keywords = "Prospective study, Lung ultrasound, Auscultation, Pulmonary edema, Clinical examination, Critical care, Diagnostic accuracy, CHEST RADIOGRAPHY, HEART-FAILURE, SONOGRAPHY",
author = "{SICS Study Group} and Cox, {Eline G M} and Geert Koster and Aidan Baron and Thomas Kaufmann and Eck, {Ruben J} and Veenstra, {T Corien} and Bart Hiemstra and Adrian Wong and Kwee, {Thomas C} and Tulleken, {Jaap E} and Frederik Keus and Renske Wiersema and {van der Horst}, {Iwan C C}",
year = "2020",
month = "1",
day = "13",
doi = "10.1186/s13054-019-2719-8",
language = "English",
volume = "24",
journal = "Critical Care",
issn = "1466-609X",
publisher = "BMC",
number = "1",

}

RIS

TY - JOUR

T1 - Should the ultrasound probe replace your stethoscope?

T2 - A SICS-I sub-study comparing lung ultrasound and pulmonary auscultation in the critically ill

AU - SICS Study Group

AU - Cox, Eline G M

AU - Koster, Geert

AU - Baron, Aidan

AU - Kaufmann, Thomas

AU - Eck, Ruben J

AU - Veenstra, T Corien

AU - Hiemstra, Bart

AU - Wong, Adrian

AU - Kwee, Thomas C

AU - Tulleken, Jaap E

AU - Keus, Frederik

AU - Wiersema, Renske

AU - van der Horst, Iwan C C

PY - 2020/1/13

Y1 - 2020/1/13

N2 - BACKGROUND: In critically ill patients, auscultation might be challenging as dorsal lung fields are difficult to reach in supine-positioned patients, and the environment is often noisy. In recent years, clinicians have started to consider lung ultrasound as a useful diagnostic tool for a variety of pulmonary pathologies, including pulmonary edema. The aim of this study was to compare lung ultrasound and pulmonary auscultation for detecting pulmonary edema in critically ill patients.METHODS: This study was a planned sub-study of the Simple Intensive Care Studies-I, a single-center, prospective observational study. All acutely admitted patients who were 18 years and older with an expected ICU stay of at least 24 h were eligible for inclusion. All patients underwent clinical examination combined with lung ultrasound, conducted by researchers not involved in patient care. Clinical examination included auscultation of the bilateral regions for crepitations and rhonchi. Lung ultrasound was conducted according to the Bedside Lung Ultrasound in Emergency protocol. Pulmonary edema was defined as three or more B lines in at least two (bilateral) scan sites. An agreement was described by using the Cohen κ coefficient, sensitivity, specificity, negative predictive value, positive predictive value, and overall accuracy. Subgroup analysis were performed in patients who were not mechanically ventilated.RESULTS: The Simple Intensive Care Studies-I cohort included 1075 patients, of whom 926 (86%) were eligible for inclusion in this analysis. Three hundred seven of the 926 patients (33%) fulfilled the criteria for pulmonary edema on lung ultrasound. In 156 (51%) of these patients, auscultation was normal. A total of 302 patients (32%) had audible crepitations or rhonchi upon auscultation. From 130 patients with crepitations, 86 patients (66%) had pulmonary edema on lung ultrasound, and from 209 patients with rhonchi, 96 patients (46%) had pulmonary edema on lung ultrasound. The agreement between auscultation findings and lung ultrasound diagnosis was poor (κ statistic 0.25). Subgroup analysis showed that the diagnostic accuracy of auscultation was better in non-ventilated than in ventilated patients.CONCLUSION: The agreement between lung ultrasound and auscultation is poor.TRIAL REGISTRATION: NCT02912624. Registered on September 23, 2016.

AB - BACKGROUND: In critically ill patients, auscultation might be challenging as dorsal lung fields are difficult to reach in supine-positioned patients, and the environment is often noisy. In recent years, clinicians have started to consider lung ultrasound as a useful diagnostic tool for a variety of pulmonary pathologies, including pulmonary edema. The aim of this study was to compare lung ultrasound and pulmonary auscultation for detecting pulmonary edema in critically ill patients.METHODS: This study was a planned sub-study of the Simple Intensive Care Studies-I, a single-center, prospective observational study. All acutely admitted patients who were 18 years and older with an expected ICU stay of at least 24 h were eligible for inclusion. All patients underwent clinical examination combined with lung ultrasound, conducted by researchers not involved in patient care. Clinical examination included auscultation of the bilateral regions for crepitations and rhonchi. Lung ultrasound was conducted according to the Bedside Lung Ultrasound in Emergency protocol. Pulmonary edema was defined as three or more B lines in at least two (bilateral) scan sites. An agreement was described by using the Cohen κ coefficient, sensitivity, specificity, negative predictive value, positive predictive value, and overall accuracy. Subgroup analysis were performed in patients who were not mechanically ventilated.RESULTS: The Simple Intensive Care Studies-I cohort included 1075 patients, of whom 926 (86%) were eligible for inclusion in this analysis. Three hundred seven of the 926 patients (33%) fulfilled the criteria for pulmonary edema on lung ultrasound. In 156 (51%) of these patients, auscultation was normal. A total of 302 patients (32%) had audible crepitations or rhonchi upon auscultation. From 130 patients with crepitations, 86 patients (66%) had pulmonary edema on lung ultrasound, and from 209 patients with rhonchi, 96 patients (46%) had pulmonary edema on lung ultrasound. The agreement between auscultation findings and lung ultrasound diagnosis was poor (κ statistic 0.25). Subgroup analysis showed that the diagnostic accuracy of auscultation was better in non-ventilated than in ventilated patients.CONCLUSION: The agreement between lung ultrasound and auscultation is poor.TRIAL REGISTRATION: NCT02912624. Registered on September 23, 2016.

KW - Prospective study

KW - Lung ultrasound

KW - Auscultation

KW - Pulmonary edema

KW - Clinical examination

KW - Critical care

KW - Diagnostic accuracy

KW - CHEST RADIOGRAPHY

KW - HEART-FAILURE

KW - SONOGRAPHY

U2 - 10.1186/s13054-019-2719-8

DO - 10.1186/s13054-019-2719-8

M3 - Article

C2 - 31931844

VL - 24

JO - Critical Care

JF - Critical Care

SN - 1466-609X

IS - 1

M1 - 14

ER -

ID: 117715380