Detection of lung atelectasis/consolidation by ultrasound in multiple trauma patients with mechanical ventilation

Abstract

Objective To evaluate the efficacy of bedside ultrasound in detecting lung atelectasis/consolidation in multiple trauma patients with mechanical ventilation. Methods This prospective observation study was con-ducted in the emergency intensive care unit (EICU) over an 18-month period from January 2007 to June 2008. Chest ultrasound was performed in 81 multiple trauma patients with mechanical ventilation. Computed tomography (CT) was regarded as the ''golden standard'' to diagnose lung atelectasis/consolidation. Results Computed tomography detected 154 lung atelec-tasis/consolidation in 324 lung regions in 81 patients. Ultra-sound confirmed 126 lung atelectasis/consolidation, 87 with complete and 39 with incomplete atelectasis/consolidation. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ultrasound were 81.8, 100, 100, 85.9 and 91.4%, respectively. A Kappa agreement test showed a very high concordance between ultrasound and CT with a Kappa coefficient of 0.825 (P = 0.031). The effective ratio of ultrasound guiding lung recruitment was 80.2%. Conclusion Ultrasound is a safe, dynamic viewing and accurate method to diagnose and manage lung atelectasis/ consolidation in multiple trauma patients with mechanical ventilation.