Eight versus 28-point lung ultrasonography in moderate acute heart failure: a prospective comparative study

Article Article scientifique Article Eight versus 28-point lung ultrasonography in moderate acute heart failure: a prospective comparative study eng 2022-02-18 2022-02-18 author Leidi Antonio Siro Gabriele 0000-0002-3934-0104 910614 author Soret Guillaume 669645 author Mann Tamara author Koegler Flora Anaïd 663093 author Coen Matteo 0000-0002-6156-1691 601519 author Leszek Alexandre 584956 author Dubouchet Laetitia 672274 author Guillermin Alexandre 701478 author Kaddour Myriam 749790 author Rouyer Frédéric 885902 author Combescure Christophe 0000-0003-2631-4780 670542 author Carballo Juan Sebastian 84409 author Reny Jean-Luc 0000-0002-7528-7363 704339 author Marti Christophe Alberic 97449 author Stirnemann Jérôme 793435 author Grosgurin Olivier 503200 10.1007/s11739-022-02943-9 35181839 1828-0447 PMC8856869 https://link.springer.com/10.1007/s11739-022-02943-9 Lung ultrasonography (LUS) is an accurate method of estimating lung congestion but there is ongoing debate on the optimal number of scanning points. The aim of the present study was to compare the reproducibility (i.e. interobserver agreement) and the feasibility (i.e. time consumption) of the two most practiced protocols in patients hospitalized for acute heart failure (AHF). This prospective trial compared 8- and 28-point LUS protocols. Both were performed by an expert–novice pair of sonographers at admission and after 4 to 6 days on patients admitted for AHF. A structured bio-clinical evaluation was simultaneously carried out by the treating physician. The primary outcome was expert-novice interobserver agreement estimated by kappa statistics. Secondary outcomes included time spent on image acquisition and interpretation. During the study period, 43 patients underwent a total of 319 LUS exams. Expert–novice interobserver agreement was moderate at admission and substantial at follow-up for 8-point protocol (weighted kappa of 0.54 and 0.62, respectively) with no significant difference for 28-point protocol (weighted kappa of 0.51 and 0.41; P value for comparison 0.74 at admission and 0.13 at follow-up). The 8-point protocol required significantly less time for image acquisition at admission (mean time difference − 3.6 min for experts, − 5.1 min for novices) and interpretation (− 6.0 min for experts and − 6.3 min for novices; P value < 0.001 for all time comparisons). Similar differences were observed at follow-up. In conclusion, an 8-point LUS protocol was shown to be timesaving with similar reproducibility when compared with a 28-point protocol. It should be preferred for evaluating lung congestion in AHF inpatients. Congestion Eight Heart failure Lung ultrasonography Protocol Ultrasound Dewey 613 Dewey 610/370 Dewey 616 Dewey 617 Dewey 618 56 Département de médecine 221 48 Unité de développement et de recherche en éducation médicale 204 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 217 Centre de recherche clinique 201 64 Département de santé et médecine communautaires 22A false 11 Plaquettes et antithrombotiques 13 319 Groupe Perrier Arnaud (Médecine interne générale, de réhabilitation et de gériatrie) 585 88 Epidémiologie clinique et biostatistique 115 Internal and emergency medicine efb98a79-7a91-4af5-a516-bfe3bf9ab41b Article (Published version) Public Article-scientifique-from-crossref.pdf 698080 application/pdf CC BY-4.0 2b53afa2-a68b-466f-a18b-fd50cc0efb13 Appendix Public 11739_2022_2943_MOESM1_ESM.docx 3007333 application/vnd.openxmlformats-officedocument.wordprocessingml.document openAccess Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Unité de développement et de recherche en éducation médicale Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences Faculté de médecine / Centre de recherche clinique Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires

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