EVALUATION OF NEW ULTRASOUND METHODS FOR QUANTIFYING THE FLUID IN THE PLEURAL CAVITY

Purpose: to determine accuracy of applying the new quantitative assessment methodology for liquid in the pleural cavity.

Materials and methods. The research encompassed 296 patients who underwent surgeries at Federal Center of Cardiovascular Surgery (Penza, Russia) with assisted blood circulation from 2015 to 2017. All the patients had ultrasonic examinations of the pleural cavities that identified the full volume of the liquid component in the pleural cavity, shaped elliptically, with further calculation of the volume with the disk test EDV (Dmax × Lmax × 3.42) – 6.44. The research data was processed with the demo software SPSS Statistics (Statistical Package for the Social Sciences). In order to compare the two methods of assessing the pleural effusionvolume resulting from the pleural puncture, we applied the Bland-Altman comparison method and Pearson correlation coefficient. A difference and a mean difference (M difference) were calculated for each pair of measurements; a standard difference deviation (SD difference) was specified with further verification of the assumption that M difference differed from 0. For this purpose, the sampling mean was compared with the speculative general mean, as tested with Student’s t – distribution.

Results. While determining potential connection between the findings of liquidquantity ultrasonic measurement and the actual volume after pleural cavity puncture, the equation of linear regression found a strong linear connection between them with R2 equal to 0.85 p < 0.001). Comparison of the liquid volume by the Bland-Altman method did not find difference in the liquid volume either: all the measurements are within 2SD difference of those parameters, which proves congruity of those methods. When the sampling mean was compared with the speculative general mean, as tested with Student’s t – distribution, no reliable differences (p = 0.52) were identified.

Conclusion. Development of this methodology proves to be justified by the fact that there are often cases in the postsurgery cardiosurgical and thoracic practice when the pleural effusion volume should be measured quickly and rather accurately and assessed in dynamics.

1. Kirkpatrick A.W., Sirois M., Laupland K.B, Liu D., Rowan K., Ball C.G., Hameed S.M., Brown R., Simons R., Dulc havsky S.A., Hamiilton D.R., Nicolaou S. Hand-held thoracic sonography for detecting post-traumatic pneumot horaces: the Extended Focused Assessment with Sonography for Trauma (EFAST). J. Trauma. 2004; 57: 288–295. DOI: 10.1097/01.TA.0000133565.88871.E4.

2. Alexandre G., David Carlos S., Álvaro Nagib A., Sergio A., Wagner I. Diagnostic accuracy of sonography for pleural effusion: systematic review. Sao Paulo Med. J. 2010; 128 (2): 90–95. DOI: 10.1590/S1516-31802010000200009.

3. Kataoka H., Takada S. The role of thoracic ultrasonography for evaluation of patients with decompensated chronic heart failure. J. Am. Coll. Cardiol. 2000; 35 (6): 1638–1646. DOI: 10.1016/S0735-1097(00)00602-1.

4. Reissig A., Kroegel C. Accuracy of transthoracic sonography in excluding post-interventional pneumothorax and hydropneumothorax. Comparison to chest radio graphy. Eur. J. Radiol. 2005; 53 (3): 463–470. DOI: 10.1016/j.ejrad.2004.04.014.

5. Rocco M., Carbone I., Morelli A., Bertoletti L., Rossi S., Vitale M., Montini L., Passariello R., Pietropaoli P. Diagnostic accuracy of bedside ultrasonography in the ICU: feasibility of detecting pulmonary effusion and lung contusion in patients on respiratory support. Acta Anaesthesiol. Scand. 2008; 52 (6): 776–784. DOI: 10.1111/j.1399-6576.2008.01647.x.

6. Rybakova M.K., Alekhin M.N., Mitkov V.V. Practical Guidance to Ultra-Sound Diagnostics. Echo-cardiography. Ver. 2, amended and supplemented. Moscow: Publishing House Vidar-M, 2008: 282–284. (In Russian)

7. Sikora K., Perera P., Mailhot T., Mandavia D. Ultrasound for the Detection of Pleural Effusions and Guidance of the Thoracentesis Procedure. ISRN Emergency Med. 2012; 2012: 10. DOI: 10.5402/2012/676524.

8. Engin U., Migdat M., Gerhard Z. Ultrasound estimation of volume of postoperative pleural effusion in cardiac surgery patients. Interactive CardioVasc. Thoracic Surg. 2010; 10 (2): 204–207. DOI: 10.1510/icvts.2009.222273.

9. Reardon R., Moscati R. Beyond the FAST Exam: Additional Applications of Sonography in Trauma. Ultrasonongraphy in Trauma: The FAST Exam, American College of Emergency Physicians: Dallas, TX, 2003: 107–126.