الفهرس | Only 14 pages are availabe for public view |
Abstract Pulmonary edema can be defined as an increase in lung fluid caused by extravasation of fluid from the pulmonary vasculature into the interstitium and alveoli of the lungs. The buildup of fluid leads to progressive deterioration of alveolar gas exchange and resulting hypoxia. Pulmonary edema is generally classified as non-cardiogenic and cardiogenic. CPE results from leakage of fluid from the pulmonary capillaries and venules into the alveolar space as a result of increased hydrostatic pressure. When the pulmonary capillary hydrostatic pressure exceeds pulmonary interstitial pressure, fluid transudates into the pulmonary alveoli and interstitium. Noncardiogenic pulmonary edema also is called acute respiratory distress syndrome (ARDS). It is characterized by diffuse alveolar damage, marked increased permeability of the alveolar-capillary membrane, and accumulation of protein-rich fluid in the alveolar air sacs. This study included 97 patients admitted to critical care department of AMUH with provisional diagnosis of pulmonary edema In this study, we assess the diagnostic performance of plain X-ray chest, lung ultrasonography in diagnosing cardiogenic and non cardiogenic pulmonary edema in comparison with CT chest (gold standard). Acoording to results of our study, the diagnostic performance of plain chest radiographs in CPE sensitivity was 41.6%, specificity: 90.0%, PPV was 97.0% ,NPV was 16.7%,accuracy was 42.3%. In NCPE plain chest radiographs has sensitivity 60.0%, specificity: 90.9%, PPV 46.2%, NPV:94.6%, accuracy:78.4%. Lung ultrasonography in CPE: the sensitivity was 93.4%, specificity was 93.3%, PPV was 98.6%, NPV was 73.7%, accuracy: 87.6%. Lung ultrasonography in NCPE: sensitivity was 86.7%, specificity: 93.4%%, PPV:72.2%, NPV:97.5%, accuracy :86.6%. So we can conclude that lung US is a bedside, reliable, dynamic, rapid, and noninvasive technique, have a significant value in the diagnosis of pulmonary edema (cardiogenic and non cardiogenic). |