Chest
Clinical Investigations“Ultrasound Comet-Tail Images”: A Marker Of Pulmonary Edema: A Comparative Study With Wedge Pressure And Extravascular Lung Water
Section snippets
Patients
We enrolled 20 patients (16 men and 4 women; mean age, 62.6 ± 11.5 years) who underwent cardiac surgery with cardiopulmonary bypass (Table 1). Patients with lung diseases were excluded. The patients were assessed with chest ultrasonography, chest radiography, pulmonary artery catheterization, and the PiCCO System at baseline, immediately after surgical operation, and after 24 h. All examinations were performed within a few minutes and were read by independent operators unaware of the results of
Results
The determinations with the different methods were obtained in all patients. No data were rejected. A total of 60 comparative measurements were performed between the methods.
Discussion
The present study shows that the lung comet-tail images are correlated with wedge pressure and EVLW. Thus, their presence and number permit quantification of the excess of EVLW, providing an indirect measurement of wedge pressure. Moreover, it is sufficiently sensitive and accurate to detect pulmonary interstitial edema even before it becomes apparent clinically.
The comet-tail images appear when there is a marked difference in acoustic impedance between an object and its surroundings.4 The
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