Ali S. Raja, MD, MBA, MPH, FACEP reviewing Al Deeb M et al. Acad Emerg Med 2014 Aug.
A meta-analysis demonstrates that ultrasound performs as well or better than other tests for the diagnosis of pulmonary edema in patients with acute dyspnea.
Rapidly diagnosing or excluding pulmonary edema in patients with acute dyspnea is essential in determining emergency department treatment, but is often difficult, particularly in older patients and those with comorbidities, especially chronic obstructive pulmonary disease. Several studies have suggested a benefit of point-of-care ultrasound in the diagnosis of pulmonary edema. These authors performed a systematic review and meta-analysis to determine the accuracy of detection of B-lines on point-of-care ultrasound, with diagnosis at clinical follow-up as the reference standard.
Seven prospective cohort and case-control studies, including a total of 1075 patients, were included. The overall sensitivity and specificity of point-of-care ultrasound for pulmonary edema were 94.1% and 92.4%, respectively. Chest x-ray has a reported sensitivity of 14% to 68% and specificity of 53% to 96%
Al Deeb M et al. Point-of-care ultrasonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: A systematic review and meta-analysis. Acad Emerg Med 2014 Aug; 21:843. Link.