Point-of-care lung ultrasound optimization scheme for the assessment of cardiogenic pulmonary edema: A promising tool

To evaluate the Point-of-Care Lung Ultrasound Optimization Scheme (PoCLUS) for assessing cardiogenic pulmonary edema (CPE) and compare it with the B-lines method and ETUDES protocol. Methods 170 patients suspected of CPE were included. Lung Point-of-Care Ultrasound examination and NT-pro BNP measurement were performed. Diagnostic performance and receiver operating characteristic (ROC) analysis were conducted to compare the predictive performance of the PoCLUS protocol, B-lines method, and Emergency thoracic ultrasound in the differentiation of the etiology of shortness of breath (ETUDES) protocol. Correlations with NT-proBNP concentration were analyzed. Results PoCLUS protocol showed a sensitivity of 90.7% and specificity of 31.6% for diagnosing CPE. PoCLUS protocol, B-lines method, ETUDES protocol, and NT-proBNP concentration increased with NYHA classification (all P < 0.05). The AUC for diagnosing different NYHA classifications by PoCLUS protocol, B-lines method, ETUDES protocol, and NT-proBNP concentration were 0.926, 0.854, 0.778, and 0.935, respectively. Positive correlations were found between the PoCLUS protocol, B-lines method, ETUDES protocol and NT-proBNP concentration. Delong's test showed that both the PoCLUS protocol and NT-proBNP concentration were significantly better than the B-lines method and ETUDES protocol in diagnosing CPE (both p<0.05). There was no significant difference in the performance of the PoCLUS protocol versus NT-proBNP concentration and B-lines method versus the ETUDES protocol in the diagnosis of CPE (all p > 0.05). Conclusion PoCLUS protocol is positively correlated with NT-proBNP levels, has high diagnostic performance, and can be used to evaluate cardiogenic pulmonary edema