The Severity Of Cardiogenic Pulmonary Edema Was Evaluated By The Optimization Scheme Of Point-of-care Lung Ultrasound

Object:The application value of the optimization scheme of point-of-care lung ultrasound(PoCLUS)was evaluated in the diagnosis of cardiogenic pulmonary edema(CPE).Methods:A total of 170 patients suspected with cardiogenic dyspnea in our hospital were randomly selected.After admission,they immediately underwent the pulmonary point –of-care ultrasound and the detection of blood concentration of N-terminal pro-brain natriuretic peptide precursor(NT-proBNP).The PoCLUS optimization scheme was taken on patients with a linear array probe at 28 intervals in supine position,and the number of B-line and B-line conditions and the amount of pleural effusion in each area were recorded as the scoring standard to score the CPE.The sensitivity and specificity of the PoCLUS optimization scheme were analyzed.The PoCLUS optimization scheme,B-line and the 8-interval method(ETUDES)were used to compare the severity of pulmonary edema,and the correlation with NT-proBNP concentration among patients with different NYHA classification was compared.The ROC curve of the PoCLUS optimization scheme and diagnosis of NYHA at all levels were analyzed.20 patients were randomly selected.The severity of pulmonary edema was determined by 2 physicians according to the PoCLUS optimization scheme,repeatability and consistency tests were performed.Results:(1)137 patients with the PoCLUS optimization scheme positive and clinically confirmed CPE were graded the cardiac function according to NYHA.There were 12 patients with grade I,57 patients with grade II,61 patients with grade III and 7 patients with grade IV.(2)The sensitivity(90.7%)and specificity(68.4%)of the PoCLUS optimization scheme in the diagnosis of CPE were higher.(3)The PoCLUS optimization scheme,number of B lines,ETUDES scheme and NT-proBNP concentration increased with the increase of NYHA classification(P < 0.05).(4)There was a positive correlation between the PoCLUS optimization scheme,the number of B-line,ETUDES scheme and NT-proBNP concentration(r=0.729?0.645?0.587),and the PoCLUS optimization scheme was more relevant than that of B-lines and ETUDES to guide CPE grading.(5)Compared with the number of B-line and ETUDES scheme,the PoCLUS optimization scheme had the highest area value under the ROC curve(AUC=0.926?0.845?0.766)in diagnosing patients with different NYHA grades.(6)Repeatability and consistency test: The same physician and different physicians used the PoCLUS optimization scheme to evaluate CPE,and both correlation and repeatability were good.Conclutions:The PoCLUS optimization scheme was positively correlated with NT-proBNP level,which had a better diagnostic efficacy and could be used to evaluate cardiogenic pulmonary edema.The PoCLUS optimization scheme was a relatively accurate method for evaluating cardiogenic pulmonary edema.The PoCLUS optimization scheme was simple to operate,comprehensive to evaluate and highly operable.