Predictive value of chest ultrasound in differentiation between cardiogenic and noncardiogenic pulmonary edema

Abstract

Background Adult respiratory distress syndrome (ARDS) and acute cardiogenic pulmonary edema (CPE) are common clinical issues. Based on clinical data, it is a big challenge to differentiate between both. Secondary to many limitations of computed tomography, chest ultrasound (CUS) provides pleuropulmonary signs that help in differentiation. Objective The current work aimed to assess the accuracy of CUS in differentiating CPE from ARDS. Patients and methods This is a cross-sectional study conducted on patients admitted to different ICUs with pulmonary edema, comprising 25 patients with CPE and 35 patients with ARDS. CUS, ECG, echocardiography, and chest radiograph were done for all patients. Results The mean age of patients with ARDS was 48.90±11.23 years, whereas the mean age of patients with CPE was 49.10±10.10 years. The majority of both groups were males. Systolic dysfunction and pneumonia were the most frequent etiology in CPE and ARDS, respectively. All patients in both groups had alveolar-interstitial syndrome. Pleural line, absence of lung sliding, and the spared area were presented in all cases with ARDS and absent in those with CPE. Moreover, none of those with CPE had lung pulse, but this finding was presented in 18 (51.4%) patients with ARDS. Conclusion CUS can help in differentiating ARDS from CPE in clinical practice. Based on CUS findings, absent or reduced lung sliding, pleural line abnormalities, and spared areas are diagnostic of ARDS.