Chest U/S in Differentiating Lung Congestion & Pneumonia in Adult Critically-ill Patients and Its Prognostic Impact

Pneumonia Clinical Trial

Official title:

The Role of Chest Ultrasound in Differentiating Lung Congestion and Pneumonia in Adult Critically-ill Patients and Its Prognostic Impact

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05636631
• Other study ID #: chest US for lung conditions
• Status: Recruiting
• Start date: November 1, 2022
• Est. completion date: July 31, 2025

Study information

• Verified date: December 2022
• Source: Assiut University
• Contact: Nardin Aymn, resident
• Phone: 01285151220
• Email: Nardeen.14223960[@]med.aun.edu.eg
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

This study aim will be to assess the effectiveness of chest ultrasound as a diagnostic and differentiating modality in cases of pneumonia and lung congestion . It also evaluates chests sonography effectiveness in follow-up of patients with pneumonia and lung congestion .

Description:

Lung ultrasound (LUS) is used at the bedside in emergency and critical care settings. It is a rapid and low-cost approach that can direct patient care without the use of harmful radiation. The success of this technique depends on its simplicity to discover the sonographic signs which indicate certain lung pathology. These signs include a hyperechoic and sliding line, moving forward and back with ventilation seen 0.5 cm below the rib line and is called the pleural line. The A-profile associates anterior lung sliding with A lines. A lines are horizontal repetition artifacts of the pleural line. The B-profile associates anterior lung sliding with B lines. B lines appear as shining vertical lines arising from the pleural line and reach the edge of the screen.

Several pathological etiologies can fill the alveolar spaces, with fluid (heart failure), pus (pneumonia which is the commonest), blood (pulmonary hemorrhage), and cells (lung cancer).

Other causes of lung consolidation may include atelectasis, pulmonary edema, infarction, and lung cancer. Chest imaging with CT is regarded as the gold standard modality allowing for the diagnosis of pneumonia in earlier stage and with higher sensitivity and specificity. On the contrary, cardiogenic pulmonary edema (CPE) is defined as alveolar transudation caused by elevated pulmonary capillary hydrostatic pressure secondary to increased pulmonary venous pressure with low-protein content in the interstitial tissue of lung as a result of cardiac dysfunction

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 60
• Est. completion date: July 31, 2025
• Est. primary completion date: November 30, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Adult (above 18 years old)

• Both genders

• Patient with symptoms suggestive of pneumonia

• Patient with symptoms suggestive of acute congestive heart failure

• admitted to Critical care unit

Exclusion Criteria:

• Patients with Renal induced lung congestion

Related Conditions & MeSH terms

• Pneumonia
• Pulmonary Edema

Intervention

Device:
• Chest ultrasound
chest ultrasound as a non invasive, low cost & bedside device for differentiation & follow up of lung congestion & pneumonia

Locations

Country	Name	City	State
Egypt	Nardin Aymn	Assiut	Asyut

Sponsors (1)

Lead Sponsor	Collaborator
Assiut University

Country where clinical trial is conducted

Egypt, 

References & Publications (2)

Lichtenstein DA. BLUE-protocol and FALLS-protocol: two applications of lung ultrasound in the critically ill. Chest. 2015 Jun;147(6):1659-1670. doi: 10.1378/chest.14-1313. — View Citation

Volpicelli G, Cardinale L, Garofalo G, Veltri A. Usefulness of lung ultrasound in the bedside distinction between pulmonary edema and exacerbation of COPD. Emerg Radiol. 2008 May;15(3):145-51. doi: 10.1007/s10140-008-0701-x. Epub 2008 Jan 31. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Diagnostic tool	Diagnosis of pneumonia vs lung congestion by using chest ultrasound examination viewing A-lines, B-lines, pleural effusion presence & its initial amount .	Baseline
Primary	Follow up after initiation of treatment	Follow up of findings of chest U.S on day 1 after initiating therapy using same parameters ( A-lines, B-lines, pleural effusion) on day 3 of hospital admission	Baseline ( day 3 of hospital admission)
Primary	Follow up before assessing final outcome	Follow up of findings of chest U.S on day 1 after initiating therapy using same parameters ( A-lines, B-lines, pleural effusion) on day 7 of hospital admission	Baseline ( day 7 of hospital admission)
Secondary	morbidity & mortality	if patient's symptoms improved or not If patient died or not	baseline