| Title: | Combination of lung ultrasound (a comet-tail sign) and N-terminal pro-brain natriuretic peptide in differentiating acute heart failure from chronic obstructive pulmonary disease and asthma as cause of acute dyspnea in prehospital emergency setting |
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| Authors: | ID Prosen, Gregor (Author)
ID Klemen, Petra (Author)
ID Strnad, Matej (Author)
ID Grmec, Štefek (Author) |
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| Files: |  Critical_Care_2011_Prosen_et_al._Combination_of_lung_ultrasound_(a_comet-tail_sign)_and_N-terminal_pro-brain_natriuretic_peptide_in_diff.pdf (420,76 KB)
MD5: A9152657A06A7BF9CB630E7278001024
 http://ccforum.biomedcentral.com/articles/10.1186/cc10140
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| Language: | English |
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| Work type: | Scientific work |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: | MF - Faculty of Medicine
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| Abstract: | Introduction: We studied the diagnostic accuracy of bedside lung ultrasound (the presence of a comet tail sign), N-terminal pro-brain natriuretic peptide (NT-proBNP), and clinical assessment (modified Boston criteria) in differentiating heart failure (HF)- related acute dyspnea from pulmonary (COPD/asthma) related acute dyspnea in the prehospital setting.
Methods: Prospective study was performed at the Center for Emergency Medicine Maribor, Slovenia, between July 2007 and April 2010. Two groups of patients were compared: HF-related acute dyspnea group (n = 129) vs pulmonary-related (asthma/COPD) acute dyspnea group (n = 89). All patients underwent lung ultrasound examination, along with basic laboratory, rapid NT-proBNP testing and chest X-ray.
Results: Ultrasound comet tail sign has 100% sensitivity, 95% specificity, 100% negative predictive value (NPV) and 96% positive predictive value (PPV) for the diagnosis of HF. NT-proBNP (cut-off point 1000 pg/ml) has 92% sensitivity, 89% specificity, 86% NPV and 90% PPV. Boston modified criteria have 85% sensitivity, 86% specificity, 80% NPV and 90% PPV. Comparing the three methods, we found significant differences between ultrasound sign vs NT-proBNP (P<0.05) and Boston modified criteria (P<0.05). Combination of ultrasound sign and NT-proBNP has 100% sensitivity, 100% specificity, 100% NPV and 100% PPV. With ultrasound we can exclude HF in patients with pulmonary related dyspnea who have positive NT-proBNP (> 1000 pg/ml) and previous history of HF.
Conclusions: Ultrasound comet tail sign alone or in combination with NT-proBNP has a high diagnostic accuracy in differentiating between acute HF and COPD/asthma causes of acute dyspnea in prehospital emergency setting. |
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| Keywords: | lungs, ultrasound, N-terminal pro-brain natriuretic peptide, acute heart failure, chronic obstructive pulmonary disease, asthma, acute dyspnea |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Year of publishing: | 2011 |
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| Number of pages: | str. 1-9 |
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| Numbering: | Letn. 15 |
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| PID: | 20.500.12556/DKUM-66511  |
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| ISSN: | 1466-609X |
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| UDC: | 616.24-008.4-083.98 |
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| ISSN on article: | 1466-609X |
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| COBISS.SI-ID: | 3911231 |
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| DOI: | 10.1186/cc10140 |
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| NUK URN: | URN:SI:UM:DK:KXEEWJ6W |
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| Publication date in DKUM: | 29.06.2017 |
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| Views: | 2202 |
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| Downloads: | 423 |
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| Metadata: |    |
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| Categories: | Misc.
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