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The following is a summary of “Diagnostic accuracy of lung ultrasound in diagnosis of ARDS and identification of focal or non-focal ARDS subphenotypes: a systematic review and meta-analysis,” published in the July 2024 issue of Critical Care by Boumans et al.

With Acute respiratory distress syndrome (ARDS) posing a serious threat in ICUs, lung ultrasound’s (LUS) growing role in diagnosing warrants investigation as a reliable ARDS diagnostic tool.

Researchers conducted a retrospective study determining the precision of LUS in diagnosing ARDS and differentiating between focal and non-focal ARDS subtypes.

They employed a systematic search strategy across PubMed, EMBASE, and Cochrane databases to identify relevant studies. The studies assessed the accuracy of LUS for diagnosing adults with ARDS, compared to chest X-ray (CXR) or thoracic CT scans. Additionally, the ability of LUS to distinguish between focal and non-focal ARDS subtypes was also evaluated. The quality of each study was assessed using the QUADAS-2 tool, and statistical analysis was conducted using “Mada” software within Rstudio version 4.0.3 to summarize the sensitivity and specificity with 95% CI for each included study. The similar approach allowed for a visual representation of the diagnostic accuracy across different studies.

The result showed 2,648 studies with a rigorous selection process in which 11 studies were selected, including 2,075 patients, but only 598 (29%) were diagnosed with ARDS. About 9 studies examined the diagnostic accuracy of LUS for ARDS, while 2 investigated the ability to differentiate between focal and non-focal ARDS subtypes. The meta-analysis revealed a moderate sensitivity of 0.631 (ranging from 0.450 to 0.782) for LUS in diagnosing ARDS but a high specificity of 0.942 (ranging from 0.856 to 0.978). Insufficient data was available of meta-analysis on the ability of LUS to distinguish between focal and non-focal ARDS subphenotypes, although both studies included showed promising results for the application.

Investigators concluded that LUS as a dependable method for diagnosing adults with ARDS and shows potential for classifying focal versus non-focal subphenotypes, though further studies are required.

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-04985-1