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6. Utility of Point-of-Care Lung Ultrasonography for Evaluating Acute Chest Syndrome in Young Patients With Sickle Cell Disease

Author

Janet Figueroa, Harold K. Simon, Reshika D. Mendis, Claudia R. Morris, Adina Alazraki, Robert Hagbom, Sam Friedman, Shaminy Manoranjithan, Courtney McCracken, Stephen M. Russell, Stephanie G. Cohen, Olufolake Adisa, and Zayir M Malik

Subjects
Male, medicine.medical_specialty, Adolescent, Lung ultrasonography, Radiography, Anemia, Sickle Cell, Disease, Chest pain, 03 medical and health sciences, 0302 clinical medicine, Acute Chest Syndrome, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Child, Ultrasonography, Point of care, Lung, business.industry, Reproducibility of Results, 030208 emergency & critical care medicine, Gold standard (test), Prognosis, medicine.disease, Acute chest syndrome, medicine.anatomical_structure, Point-of-Care Testing, Child, Preschool, Emergency Medicine, Female, Radiography, Thoracic, Radiology, medicine.symptom, business
Abstract

Study objective Acute chest syndrome is a leading cause of mortality in patients with sickle cell disease (SCD). Because early detection of acute chest syndrome is directly tied to prognosis, young patients with SCD undergo countless chest radiography screenings throughout their lifetime for commonly occurring acute chest syndrome risk factors such as fever, chest pain, or cough. Chest radiography is not an ideal screening method because it is associated with radiation exposure, which accumulates with repeated imaging. Point-of-care lung ultrasonography is a nonradiating imaging modality that has been used to identify other lung pathology and may have a role in SCD. The goal of this study was to determine the accuracy of point-of-care lung ultrasound to identify an infiltrate suggestive of acute chest syndrome in patients with SCD compared to chest radiography as the gold standard. Methods This was a prospective observational study in 2 urban pediatric emergency departments to evaluate the accuracy of point-of-care lung ultrasonography in identifying patients with SCD who were aged 0 to 21 years and had an infiltrate suggestive of acute chest syndrome compared with chest radiography. Clinicians and trainees with point-of-care lung ultrasonographic training obtained informed consent and performed investigational point-of-care lung ultrasonography to evaluate for lung consolidation. A blinded point-of-care lung ultrasonographic expert reviewed results for quality assurance and agreement. Accuracy, sensitivity, specificity, likelihood ratios, and positive and negative predictive value were calculated for point-of-care lung ultrasonography test performance characteristics, with chest radiography as a reference standard. Results Point-of-care lung ultrasonography was performed on 191 SCD patients with a mean age of 8 years; 41% were female patients, and there was a 17% prevalence of acute chest syndrome. Accuracy of point-of-care lung ultrasonography to detected acute chest syndrome was 92%, sensitivity was 88%, and specificity was 93% compared with that for chest radiography. Conclusion Point-of-care lung ultrasonography is a feasible alternative to chest radiography for screening for acute chest syndrome in young patients with SCD. Further studies are needed to determine how this test performs within clinical practice.

Published
2020
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9. Neurosurgery Case Review: Questions and Answers

Author

Christian A. Bowers, Flavio Giordano, Faisal Abdulhamid Farrash, Pascal M. Jabbour, Alan Siu, Ramez Malak, Donald C. Shields, Unwar Ul-Haq, Jared J. Marks, Francisco Sanz, Achal Patel, Edward C. Benzel, Nabeel S. Alshafai, Hasel W. Slone, Jason S. Goldberg, Fahad Eid Alotaibi, Mohammad Almubaslat, Kamlesh B. Patel, Glenn C. Hunter, Anna Zicca, Michel Lacroix, Ibrahim Althubaiti, H. Francis Farhadi, Ahmed Mohyeldin, Robert L. Tiel, Homoud Aldahash, Claude-Edouard Châtillon, Franco DeMonte, Ossama Al-Mefty, Roberto Rafael Herrera, Nicholas J. Erickson, Nazer H. Qureshi, André Beer-Furlan, Judith Marcoux, Abdulrahman Yaqub Alturki, Ahmed Alaqeel, Badih Daou, Turki Elarjani, Sandeep Mittal, Kathleen E. Knudson, Alvin Chan, Amin B. Kassam, Kelsey A. Walsh, Mohammed Alghamd, Alfio Spina, Richard Bucholz, Fred Gentili, Marguerite Harding, Ricardo L. Carrau, Alwin Camacho, Pablo González-López, Faisal Al-Otaibi, Cristian Gragnaniello, Abdulrahman J. Sabbagh, Asem Salma, Stephen J. Hentschel, Joung H. Lee, Fahad AlKherayf, Rory Mayer, Rihaf Algain, John Woulfe, Stephen M. Russell, Han Zhuang Beh, Perry S. Bradford, Andrew Smith, Frederick Boop, Jorge E. Isaza, Vishal Patel, Eddie Perkins, Abdulrahman Albakr, Ibrahim Omeis, Christopher D. Baggott, Kevin Petrecca, Bassem Yousef Sheikh, Shaymaa Al-Umran, Michele Bailo, Jonathon Lebovitz, Pratap Chand, Edgar Gerardo Ordóñez-Rubiano, Aaron S. Gaekwad, Mohammed Almekhlafi, Jonathan Yun, Dimitri Sigounas, Julius July, Joseph A. Shehadi, Gustavo D. Luzardo, Ennio Antonio Chiocca, Shaan M. Raza, Alberto L. Gallotti, Anup Aggarwal, Ali Luqman, Mohammad A. Aziz-Sultan, Isabella Esposito, Eka Julianta Wahjoepramono, Imad N. Kanaan, Abdulrazag Ajlan, Hosam Al-Jehani, Brian Gill, Jaime Gasco, Brian Seaman, William T. Couldwell, José Luis Ledesma, Gary L. Gallia, Ananth K. Vellimana, Mark G. Hamilton, Da’Marcus Baymon, Almunder Algird, Evan S. Marlin, Ahmad I. Lary, Rudiger Von Ritschl, Afnan Uthman Alkhotani, Kevin Phan, Ayman Abdullah Albanyan, Essam A. Al Shail, Joshua Loewenstein, Mohammad Misfer Alshardan, Denis Klironomos, Ehtesham Ghani, Hector P. Rojas, Jeffery Atkinson, Matthew D. Smyth, Eldad J. Hadar, Erol Veznedaroglu, Mark A. Mahan, Qasim Al Hinai, Iván Verdú-Martínez, Peter J. Mews, Mohamed A. Labib, Randy L. Jensen, Rahul Shah, Amal Mokeem, Rolando Del Maestro, Denis Sirhan, Albert M. Isaacs, José Luis Montes, Mariam Alrashid, Jason Tullis, Hussam Abou-Al-Shaar, Justin Reagan, Daniel S. Ikeda, Pietro Mortini, David Sinclair, Hubert Lee, Mazda K. Turel, Michael S. Taccone, Alexander Y. Lin, Stephano Chang, Patrick Kim, Paul Steinbok, Luke G. F. Smith, Sami Obaid, Ashwag Al-Qurashi, Andrew Shaw, Abdul Haseeb Naeem, Exequiel P. Verdier, Ahmed Jaman Alzahrani, Lahbib A. Soualmi, Remi Nader, Ralph J. Mobbs, Soha Abdu M. Alomar, Mohammed Saeed Bafaqeeh, Zachary N. Litvack, Weston T. Northam, Joaquin Hidalgo, Robert F. Keating, Amgad S. Hanna, Jared Fridley, Bassam M. J. Addas, Monish Maharaj, Diana Ghinda, Daniel M. Prevedello, John S. Myseros, Lorenzo Genitori, Layla Batarfi, Khalid N. Almusrea, Samer K. Elbabaa, Adam Sauh Gee Wu, Anthony M. T. Chau, Naif M. Alotaibi, Saleh S. Baeesa, Kimberly Hamilton, Franz L. Ricklefs, Hashem Al Hashemi, Lissa Marie Peeling, Gareth Rutter, Sohum Desai, Philippe Mercier, Daniel Branch, Jorge E. Alvernia, Craig C. Weinkauf, Sunil Kukreja, Michel W. Bojanowski, Paul W. Gidley, Reem Bunyan, Domenic P. Esposito, Salah Baz, Randall C. Edgell, Christopher Evan Stewart, Burak Sade, Frank Gerold, Ali Alwadei, Nancy McLaughlin, Christopher J. Winfree, Terence Verla, Marc-Elie Nader, Andrew Jea, Filippo Gagliardi, Jean-Pierre Farmer, Giuliana Rizzo, Jeffrey P. Mullin, Ahmed T. Abdelmoity, Eric P. Roger, Anish Sen, Ivona Nemeiko, Mahmoud AlYamany, Anthony J. Caputy, Peter Nakaji, Nirmeen Zagzoog, Charles B. Agbi, Khalid Bajunaid, Matthew Pierson, Juan Ortega-Barnett, Justine Pearl, Maqsood Ahmad, Abdulmajeed Alahmari, and Robert A. Moumdjian

Subjects
Questions and answers, medicine.medical_specialty, Medical education, business.industry, medicine, Neurosurgery, business, Neuroscience, Case review
Published
2020
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