Ultrasound Literature Studies
Ultrasound Studies
Welcome to the Ultrasound Fanatic literature page, your comprehensive resource for ultrasound studies and literature! If you’re in search of the latest and most relevant ultrasound literature, you’re in the right place. Our collection is provides you with access to the most significant studies and research in the field of ultrasound.
Our expert team has compiled an extensive range of ultrasound studies, covering various topics from diagnostic techniques to advancements in handheld ultrasound devices. By exploring our ultrasound literature, you’ll gain valuable insights that can enhance your practice, keep you updated on cutting-edge ultrasound research, and help you make informed decisions about the best tools and methodologies.
Join our community of ultrasound professionals and enthusiasts, and dive into the wealth of knowledge available on our ultrasound literature page. Stay informed and ahead of the curve with Ultrasound Fanatic’s expertly curated ultrasound literature. Don’t miss out on the latest research and findings in the world of ultrasound!
Point of care ultrasound improves clinical outcomes in patients with acute onset dyspnea: a systematic review and meta-analysis
Published: 2022.
Authors: Gergő Vilmos Szabó Szabó, et al.
Enrolled: 5,393 patients / 14 studies.
Overview: The study investigates the effectiveness of Point-of-Care Ultrasound (POCUS) compared to conventional management in patients with acute onset dyspnea.
Findings: Using Point-of-Care Ultrasound (POCUS) in patients with acute onset dyspnea resulted in a significantly shorter time to diagnosis by an average of 63 minutes and time to treatment by an average of 27 minutes compared to conventional diagnostic methods like physical examination, chest radiography, and laboratory tests.
Discussion: These findings are pivotal for POCUS implementation, suggesting that it could be a key tool in improving patient outcomes and streamlining emergency care processes. However, it’s important to note that while POCUS enhanced certain clinical outcomes, the study showed no significant affect in overall hospital stay duration, re-admission rates, or mortality, indicating areas for further research and application.
Diagnosing centrally located pulmonary embolisms in the emergency department using point of care ultrasound
Published: 2018.
Authors: Kritin H Dwyer, et al.
Enrolled: 199 patients.
Overview: The study aimed to investigate the combined accuracy of right heart strain on focused cardiac ultrasound (FOCUS) and deep vein thrombosis (DVT) on compression ultrasound (CUS) for identification of centrally located pulmonary embolism (PE) diag
Findings: In the study, 199 patients were examined, with 23.1% (46 patients) diagnosed with a pulmonary embolism (PE). Almost half of these PEs (43.5%, 20 patients) were centrally located in the lungs. Additionally, 43.5% of patients with a PE also had a DVT detected using bedside ultrasound. For patients with a proximal PE (main or lobar pulmonary arteries), 90% had evidence of right heart strain and the combination of lower extremity compression ultrasound (compression of veins using ultrasound probe to check for blood clots) and focused cardiac ultrasound was 100% sensitive (every patient who actually had a central pulmonary embolism was correctly identified by ultrasound). Diagnostic accuracy was much lower for PEs located in peripheral lung areas.
Discussion: The high sensitivity for detecting central pulmonary embolisms and associated deep vein thrombosis is a significant finding. This shows that POCUS can be a reliable, quick tool for diagnosing serious conditions in emergency settings such as PE, potentially leading to faster treatment and better patient outcomes. Its lower accuracy for peripheral PEs, however, highlights the limitations of ultrasound and the need for ongoing research and training to enhance its effectiveness across various conditions.
Ultrasound for the diagnosis of shoulder dislocation and reduction: A systematic review and meta-analysis
Published: 2022.
Authors: Michael Gottlieb, et al.
Enrolled: 1,836 assessments.
Overview: This systematic review sought to evaluate the diagnostic accuracy of POCUS for diagnosing shoulder dislocations.
Findings: This study analyzed ten different studies involving 1,836 assessments, finding that 34.6% of these assessments showed shoulder dislocations. Ultrasound was found to be extremely accurate (100% sensitive and specific) in diagnosing shoulder dislocations (it correctly identified all cases of dislocation and correctly confirmed all non-dislocation cases). The likelihood ratios (LR+ and LR-) indicate a high probability of accurate diagnosis (they tell us how much a test result changes the odds of having a disease – a high ratio means it’s much more likely, and a low ratio means it’s less likely). The study also found that ultrasound was highly accurate in identifying associated fractures with shoulder dislocations. Different techniques and transducer types showed similar accuracy.
Discussion: The high accuracy demonstrated by ultrasound can significantly aid in rapid, non-invasive diagnosis, leading to quicker and more effective patient care. However, the study’s reliance on data from various sources without uniform methodology could affect the precision of its conclusions. Nonetheless, these findings support the bro
The “lung point”: an ultrasound sign specific to pneumothorax
Published: 2000.
Authors: Daniel A Lichtenstein, et al.
Enrolled: 66 patients.
Overview: In this prospective study, an ultrasound sign was studied, the fleeting appearance of a lung pattern (lung sliding or pathologic comet-tail artifacts) replacing a pneumothorax pattern (absent lung sliding plus exclusive horizontal lines) in a particular location of the chest wall. This sign was called the “lung point”. Simply put, a “lung point” is the edge of the pneumothorax. The “lung point” was sought in 66 consecutive cases of proven pneumothorax analyzable using ultrasound–including 8 radio-occult cases diagnosed by means of CT and in 233 consecutive hemithoraces studied by CT and free of pneumothorax– including 17 cases where pneumothorax was suspected.
Findings: The “lung point” was observed in 44 of 66 cases of pneumothorax (including 6 of 8 radio-occult cases) and in no case in the control group. The location of this sign roughly correlated with the radiological size of the pneumothorax. The “lung point” therefore had an overall sensitivity of 66 % (75 % in the case of radio-occult pneumothorax alone) and a specificity of 100%.
Discussion: The presence of a “lung point” allows positive diagnosis of pneumothorax at the bedside using ultrasound, demonstrating a 100% specificity. These results suggest that while the “lung point” sign is highly specific for pneumothorax, its sensitivity is moderate, indicating it’s superior for confirming the presence of pneumothorax rather than ruling it out.
Meta-Analysis of Point-of-Care Lung Ultrasonography Versus Chest Radiography in Adults With Symptoms of Acute Decompensated Heart Failure
Published: 2022.
Authors: Leonard Chiu, et al.
Enrolled: 7,787 patients / 8 studies.
Overview: This study aimed to illustrate the sensitivity (how well lung ultrasound correctly identifies patients with the condition) and specificity (how well it correctly identifies those without the condition) of lung ultrasound (LUS) in comparison with chest x-ray (CXR) for diagnosing acute decompensated heart failure (ADHF).
Findings: For patients presenting with signs and symptoms of ADHF, LUS was found to be more sensitive than CXR (91.8% vs 76.5%) and more specific than CXR (92.3% vs 87.0%) for the detection of cardiogenic pulmonary edema.
Discussion: In conclusion, LUS is more sensitive and specific than CXR in detecting pulmonary edema. This highlights the importance of sonographic B-lines (B-lines = lung artifact = increase in lung density – either fluid/pneumonia/fibrosis – depending on context), along with the accurate interpretation of clinical data, in the diagnosis of ADHF. In addition to its convenience, portability, reduced costs, and reduced radiation exposure, LUS should be considered an effective alternative to CXR for evaluating patients with dyspnea in the setting of ADHF.
Sensitivity and specificity of ultrasound for the diagnosis of acute pulmonary edema: a systematic review and meta-analysis
Published: 2018.
Authors: Yan Wang, et al.
Enrolled: 1,301 patients / 8 studies.
Overview: This study aimed to determine the sensitivity and specificity of ultrasound for the diagnosis of acute pulmonary edema by meta-analysis.
Findings: The overall sensitivity of ultrasound for the diagnosis of acute pulmonary edema is 97% (95% CI: 96%-98%), meaning it correctly identifies 97% of patients with the condition, and the overall specificity was 98% (95% CI: 97%-99%), meaning it correctly identifies 98% of patients without the condition.
Discussion: Human lungs are mostly air, and ultrasound waves don’t travel well through air (acoustic mismatch). This makes it hard for ultrasounds to show clear images of the lungs, often resulting in a messy pattern called “artifacts” instead of detailed pictures. However, these artifacts can change in specific ways when pathology is present. By understanding these changes, ultrasound can be used to help diagnose lung problems and decide on treatment. This study suggests lung ultrasound, particularly using B-lines (B-lines = lung artifact = increase in lung density and is either fluid/pneumonia/fibrosis depending on context), can be a reliable tool for critically ill patients, possibly improving diagnostic accuracy in emergency settings.
Limitations of the study include biases and incomplete data retrieval, methodological inconsistencies in ultrasonic inspection, and the inclusion of diverse patient populations, which could affect the generalizability of the findings. Another concern was the lack of standardized ultrasound scanning protocols and the need for improved training for sonographers, which contributed to variability in the results.
Point-of-Care Ocular Ultrasound for the Diagnosis of Retinal Detachment: A Systematic Review and Meta-Analysis
Published: 2019.
Authors: Michael Gottlieb, et al.
Enrolled: 844 patients / 11 studies.
Overview: The primary outcome for this review was to determine the test characteristics of point-of-care ocular ultrasound for the diagnosis of retinal detachment.
Findings: Eleven studies (n = 844 patients) were identified. Overall, ultrasound was 94.2% (95% confidence interval [CI] = 78.4% to 98.6%) sensitive and 96.3% (95% CI = 89.2% to 98.8%) specific for the diagnosis of retinal detachment with a positive likelihood ratio of 25.2 (95% CI = 8.1 to 78.0) and a negative likelihood ratio of 0.06 (95% CI = 0.01 to 0.25). Subgroup analysis found that ultrasound was more accurate among ED patients, but was not significantly different when performed by ED or non-ED providers.
Discussion: Point-of-care ocular ultrasound is sensitive and specific for the diagnosis of retinal detachment. Future studies should determine the ideal training protocol and the influence of color Doppler and contrast-enhanced ultrasound on diagnostic accuracy.
Auscultation versus Point-of-care Ultrasound to Determine Endotracheal versus Bronchial Intubation: A Diagnostic Accuracy Study
Published: 2016.
Authors: Davinder Ramsingh, et al.
Enrolled: 42 patients.
Overview: The focus of this double-blinded randomized study was to assess the accuracy of point-of-care ultrasound in verifying the correct position of the ETT and to compare it with the accuracy of auscultation. Patients were randomized to right main bronchus, left main bronchus, or tracheal intubation. After randomization, the ETT was placed via fiber-optic visualization. Next, the location of the ETT was assessed using auscultation by a separate blinded anesthesiologist, followed by an ultrasound performed by a third blinded anesthesiologist. Ultrasound examination included assessment of tracheal dilation via cuff inflation with air and evaluation of pleural lung sliding.
Findings: In differentiating tracheal versus bronchial intubations, auscultation showed a sensitivity of 66% (0.39 to 0.87) and a specificity of 59% (0.39 to 0.77), whereas ultrasound showed a sensitivity of 93% (0.66 to 0.99) and specificity of 96% (0.79 to 1). Identification of tracheal versus bronchial intubation was 62% (26 of 42) in the auscultation group and 95% (40 of 42) in the ultrasound group (P = 0.0005) (CI for difference, 0.15 to 0.52), and the McNemar comparison showed statistically significant improvement with ultrasound (P < 0.0001). Interobserver agreement of ultrasound findings was 100%.
Discussion: Assessment of trachea and pleura via point-of-care ultrasound is superior to auscultation in determining the location of ETT. This supports the broader adoption of POCUS for intubation verification. The study’s limited sample size and specific clinical setting might affect its broad application. Future research comparing ultrasound with chest x-ray for ETT placement confirmation could further validate these findings and extend its application in the ICU and ED.
Diagnostic accuracy of point-of-care ultrasonography for intussusception in children: A systematic review and meta-analysis
Published: 2022.
Authors: Margaret Lin-Martore, et al.
Enrolled: 2,400 patients / 11 studies.
Overview: This systematic review and meta-analysis assesses the diagnostic accuracy of POCUS for children with suspected ileocolic intussusception.
Findings: Eleven studies (n = 2400 children) met our inclusion criteria. Overall, 14.4% of children had intussusception. POCUS was 95.1% (95% CI: 90.3% to 97.2%) sensitive and 98.1% (95% CI: 95.8% to 99.2%) specific with a positive likelihood ratio of 50 (95% CI: 23 to 113) and a negative likelihood ratio of 0.05 (95% CI: 0.03 to 0.09).
Discussion: POCUS has excellent diagnostic accuracy for intussusception in children presenting to the emergency department, with a sensitivity of 95.1% and specificity of 98.1%. POCUS can be a reliable, non-invasive diagnostic tool in pediatric emergency cases, potentially leading to quicker and more appropriate treatments. However, the study’s conclusions are based on a meta-analysis, so the results may vary depending on individual study designs and settings.
Comparison of manual pulse palpation, cardiac ultrasonography and Doppler ultrasonography to check the pulse in cardiopulmonary arrest patients
Published: 2018.
Authors: Suat Zengin, et al.
Enrolled: 137 patients.
Overview: This study was prospectively performed in 137 patients older than 16 years of age who underwent cardiopulmonary resuscitation (CPR). The objective was to compare the efficiency of cardiac ultrasonography, doppler ultrasonography, and manual pulse palpation methods to check the pulse in cardiac arrest patients.
Findings: A total of 72.3% (n = 99) of the cardiopulmonary arrest incidents occurred out-of-hospital. The following numerical values represent the average time in seconds taken to detect a pulse in cardiopulmonary arrest patients using each respective method: Cardiac ultrasonography (4.76 ± 2.19, 4.33 ± 2.17, and 3.68 ± 2.14 s), doppler ultrasonography (9.59 ± 2.37, 8.22 ± 2.86, and 7.60 ± 2.83 s), and manual pulse palpation (10.76 ± 1.03, 9.72 ± 3.01, and 9.29 ± 3.36 s) measurements of the first, second, and last inspections were detected, respectively. The false negative rates (100%, 28%, and 0%) and false positive rates (5.3%, 3.5%, and 0%) of manual pulse palpation the first, second, and last inspections were calculated, respectively, as well.
Discussion: The use of cardiac ultrasound during resuscitation provides a substantial contribution to the resuscitation team. It will allow earlier and more accurate detection of pulse than manual pulse palpation and doppler ultrasonography. Incorporating ultrasound in cardiopulmonary resuscitation could enhance accuracy and speed in critical situations. However, the study’s setting and methods may limit its wider applicability.
