الفهرس 
UltrasonographyOnly 14 pages are availabe for public view
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Abstract
Ultrasonography has become an invaluable tool in the management of critically ill patients.
The benefits of Ultrasound, however, include its portability, cost, lack of radiation exposure, and ability to perform dynamic and real-time procedural guidance at the bedside. The use of portable ultrasound machines has greatly enhanced the evaluation and management of patients with pleural disease.
This study aimed to evaluate the role of Ultrasound in diagnosis and treatment of pleural diseases in Respiratory Intensive Care patients in Abbasia Chest Hospital.
This study recruited fifty-five patients presented with suspected clinical and/or radiological evidence of pleural disease in the Respiratory Intensive Care Unit of Abbasia Chest Hospital during the period from 1/1/2011 to 1/1/2013.
All patients were subjected to Full history taking, thorough clinical examination, diagnostic chest Ultrasonography, chest x-ray with/without CT scan whenever possible, Ultrasound assisted intervention whenever needed and laboratory investigations according to disease etiology.
The results of this study showed that pleural effusion was the most common pleural disease encountered.
Ultrasound correctly predicted the nature of most pleural effusions whether transudative or exudative according to the echogenicity of effusions.
Ultrasound had the best sensitivity and specificity and other test parameters in diagnosing pleural effusion as compared to CT scan and X-ray. Ultrasound had a significant better pleural effusion sensitivity, specificity, PPV, NPV, and accuracy than those of X-ray. Ultrasound had significant better sensitivity for unilateral effusions and for septations than those of CT scan.
There was a significant relation between being feverish and obtaining Ultrasound image suggestive of empyema (complex and echoic effusions).
Empyema drainage using Ultrasound guided interventions in ICU patients were significantly correlated with favorable outcome (cure or transfer from ICU) of the patient.
CT scan had the highest sensitivity for pleural thickening, followed by ultrasound and lastly X-ray. Ultrasound had a highly significant better sensitivity, accuracy, and significant higher negative predictive value than X-ray in diagnosing pleural thickening.
Ultrasound and CT scan had equal pneumothorax sensitivity and NPV. Both image modalities had better test parameters than X-ray in diagnosing pneumothorax.
Ultrasound had the lowest pleuropulmonary masses sensitivity among its own sensitivities of other pleural pathologies as well as among other imaging modalities.
One Complication, A partial iatrogenic pneumothorax was encountered during performing all Ultrasound-guided interventions.
Most patients underwent therapeutic ultrasound guided interventions showed some favorable outcomes including fever subsidence, improvement of oxygenation, control of Random Blood Sugar (RBS) and improvement of drainage from thoracostomy tube.
There was a highly significant positive relation between progress of training on ultrasound and the trainee score. This means that as the trainee examined more cases, her score increased.
The learning curve of the traniee showed early steep fluctuations of score then progressed to a more stable higher level. The trainee’s scores improved reaching up to (100%) after (30) examinations.