Acil Servise Nefes Darlığı ile Başvuran Hastalarda Bir Ayırıcı Tanı Aracı Olarak Yatakbaşı Ultrasonografik Değerlendirme

Dyspnea is a common complaint among the patients admitted to emergency department. 124 patients who admitted to Hacettepe University, Adult Emergency Department with the complaint of dyspnea within April 2013-October 2013 are included in the prospective, cross-sectional, descriptive study. During the first 24 hours, evaluations of lung ultrasonography appropriate to Bedside Lung Ultrasound in Emergency (BLUE) protocol is done. It is determined that 35.5% (n=43) of patients is A profile, 12.1% (n=15)of patients is B profile, 24.2% (n=30) of patients is C profile, 39.5% (n=47) of patients is A/posterior-lateral alveolar-pleural syndrome (PLAPS), 16.9% (n=21) of patients is A/B profile and 63.7% (n=79) is PLAPS. By using the test of Pearson’s chi-squared for the statistical analyses of lung ultrasonography (p<0.05), diagnoses and profiles were compared. Significant relationship was found between the B profile and congestive heart failure (p=0.002), between the A profile and chronic obstructive pulmonary disease (COPD) acute exacerbation (p=0.003), between being PLAPS (+) and COPD acute exacerbation (p=0.003), between A profile and pneumonia (p=0.017), between C profile and pneumonia (p=0.014). Comparing ultrasonographic evaluations with the discharge from emergency department, hospitalization and 3 month-mortality, it was found that 13.8% of A profile patients (p=0.007), 93.1% of PLAPS (+) patients (p=0.001) died within 3 months, 98% of non-B profile patients (p=0.001) were discharged from emergency department. In conclusion, lung ultrasonography should be used as a diagnostic tool for evaluation of patients suffering from dyspnea.Nefes darlığı (ND) acil servis (AS) başvuruları içinde sık karşılaşılan bir durumdur. Bu prospektif kesitsel tanımlayıcı çalışmaya Nisan 2013-Ekim 2013 tarihleri arasında Hacettepe Üniversitesi Acil Tıp Anabilim Dalı Erişkin Acil servisine ND şikayeti ile başvuran 124 hasta dahil edildi. İlk 24 saatte Bedside Lung Ultrasound in Emergency (BLUE) protokol algoritmasına uygun akciğer ultrasonografik (US) değerlendirmeleri yapıldı. Hastaların %35,5’i (n=43) A profil, %12,1’i (n=15) B profil, %24,2’si (n=30) C profil, %39,5’i (n=47) A/posterior-lateral alveolar-pleural syndrome (PLAPS), %16,9’u (n=21) A/B profil, %63,7’si (n=79) PLAPS saptandı. Akciğer US değerlendirmesinin istatistiksel analizlerinde Pearson’s chi-squared testi kullanılarak tanılar profillere göre karşılaştırıldı (p