Firoozbakhsh Sh, Safavi E, Zahed Poor Anaraki Mr, Derakhshan Deilami Gr ,
Volume 60, Issue 3 (14 2002)
Abstract
Background: Transbronchial lung biopsy (TBLB) is an attractive alternative to open lung biopsy as an initial diagnostic procedure for patients with diffuse parenchymal disease or localized densities beyond direct endoscopic vision. TBLB can be carried out safely without fluoroscopy in patients with diffuse lung disease. Since in our bronchoscopic department fluoroscopy is not available, we planned to evaluate the blind (without fluoroscopic guide) TBLB being performed in our department to determine the success rate in obtaining lung tissue, the sensitivity of the procedure and the risk of complications.
Materials and Methods: Sixty-Four TBLB were done in our department during a 6 month period (March-September 1999).
Results: Lung tissue wasn’t detected in two (3.1 percent) samples. Pathological results were helpful in 46 (71.9 percent) cases. No evidence of hemoptysis was found after the procedure. Three (4.68 percent) cases of pneumothorax was detected. Only one of them required chest tube (1.51 percent).
Conclusion: We concluded that blind TBLB was successful in our department with rates of complications comparable to other approved centers.
Mohammadreza Kasraei , Hamidreza Abtahi, Niloofar Eyoobi Yazdi, Enayat Safavi, Shahram Firoozbakhsh, Mostafa Mohammady,
Volume 72, Issue 7 (October 2014)
Abstract
Pleural effusion (PE) is common among ICU and acutely ill patients. Traditionally plain chest radiography (CXR) has been done for pleural effusion evaluation in ICU. However, better results have been reported by ultrasound for the diagnosis of this condition in ICU. In this study, we compared two methods of ultrasound and CXR in PE detection in ICU patients. Also we studied the percentage of thoracentesis by physician after detection of PE by ultrasonography or CXR.
Methods: Portable supine CXR and chest ultrasound were done in Thirty-nine non-surgical patients who were admitted to the Medical and General ICUs of Imam Khomeini hospital in Tehran from Oct 2013 to Mar 2014. Ultrasound was done and interpreted by radiologist and CXR by patient' physician. Thoracentesis or CT-scan was used as gold standard for PE diagnosis.
Results: Ultrasound in 29 patients (74.3%) showed PE. In 21 patients thoracentesis was done by patient’s physician and all had PE with mean volume of 447.2(417.6). In 13 of 18 patients without thoracentesis chest CT scan was available. It shows PE in 6 cases (all with positive PE in ultrasonography). CXR in 9 patients (23.1%) was positive for PE and in 30 patients (76.9%) was negative. The ability of chest ultrasound and CXR for diagnosis of PE was significantly different (P= 0.0.1). In 68.9 % of cases that ultrasound was positive, the CXR was negative and only in 34.5% of cases both methods had negative results. The sensitivity, specificity, positive and negative predictive values were 100% (87.1-100), 100% (58.9-100), 100% (87.1-100), 100% (58.9-100) respectively for ultrasonography. For CXR there were 33% (16.6-54.0), 100% (58.9-100), 100% (66.2-100), 28% (12.1-49.4) respectively.
Conclusion: Ultrasonography for diagnosis of pleural effusion in ICU patients has better diagnostic performance than portable CXR
