Role of Chest Ultrasound in Early Prediction of Volume Overload in Trauma Patients with Pulmonary Contusions (Cohort Study)

Document Type : Original Article

Authors

1 Department of Emergency Medicine, Faculty of Medicine - Alexandria University, Alexandria-Egypt.

2 Department of Anaesthesia and Intensive Care Unit, Faculty of Medicine - Assiut University, Assiut-Egypt.

Abstract

Background: The lungs are frequently injured in blasts, with the edematous phase causing worsening interstitial edema and infiltration within the first 1-2 hours after injury. Point-of-care ultrasound (POCUS) and B-lines can detect fluid accumulation. The study evaluated the effectiveness of POCUS in monitoring fluid resuscitation in chest trauma patients with lung contusions to prevent volume overload.
Aim of the Study: The study aimed to assess the efficacy of ultrasound in predicting volume overload in trauma patients with lung contusions.
Patients and Methods: A cohort study included a total of 100 patients with chest trauma with a lung contusion. It was conducted at Assiut and Alexandria Main University Hospitals. After a thorough clinical evaluation and resuscitation, all patients were subjected to POCUS.
Results: 80 (80%) patients improved without manifestations of volume overload (improved group), and 20 (20%) patients showed manifestations of volume overload (non-improved group). The mean B-line score among all patients was 24.16 ± 7.65, with a significantly higher score among the non-improved group (34.50 ± 6.24 vs. 21.58 ± 5.49). Based on volume overload severity, 12 (12%), 67 (67%), and 21 (21%) patients had mild, moderate, and severe volume overload, respectively. At a cut-off point > 27, B-line scoring has 90% sensitivity, 87.5% specificity, and 88% overall accuracy in predicting volume overload in patients with chest trauma, with an area under the curve of 0.928.
Conclusion: Lung ultrasound plays a crucial role in monitoring patients with chest trauma and lung contusions. A B-line score could be utilized to predict volume overload in these patients.

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