title: Diagnostic value of chest ultrasound after cardiac surgery: a comparison with chest X-ray and auscultation.
abstract: OBJECTIVE
  Chest auscultation and chest x-ray commonly are used to detect postoperative abnormalities and complications in patients admitted to intensive care after cardiac surgery. The aim of the study was to evaluate whether chest ultrasound represents an effective alternative to bedside chest x-ray to identify early postoperative abnormalities.
  
  
  METHODS
  Diagnostic accuracy of chest auscultation and chest ultrasound were compared in identifying individual abnormalities detected by chest x-ray, considered the reference method.
  
  
  METHODS
  Cardiac surgery intensive care unit.
  
  
  METHODS
  One hundred fifty-one consecutive adult patients undergoing cardiac surgery.
  
  
  METHODS
  All patients included were studied by chest auscultation, ultrasound, and x-ray upon admission to intensive care after cardiac surgery.
  
  
  RESULTS
  Six lung pathologic changes and endotracheal tube malposition were found. There was a highly significant correlation between abnormalities detected by chest ultrasound and x-ray (k = 0.90), but a poor correlation between chest auscultation and x-ray abnormalities (k = 0.15).
  
  
  CONCLUSIONS
  Chest auscultation may help identify endotracheal tube misplacement and tension pneumothorax but it may miss most major abnormalities. Chest ultrasound represents a valid alternative to chest x-ray to detect most postoperative abnormalities and misplacements.
authors.affiliation: Department of Surgery, Cardiac Surgery Intensive Care Unit, University Hospital of Parma, Parma. Electronic address: avezzani@ao.pr.it.
authors.forename: Antonella
authors.initials: A
authors.lastname: Vezzani
authors.affiliation: Department of Surgery, Cardiac Surgery Intensive Care Unit, University Hospital of Parma, Parma.
authors.forename: Tullio
authors.initials: T
authors.lastname: Manca
authors.affiliation: University of Genova, Genova.
authors.forename: Claudia
authors.initials: C
authors.lastname: Brusasco
authors.affiliation: University of Genova, Genova.
authors.forename: Gregorio
authors.initials: G
authors.lastname: Santori
authors.affiliation: S.O.C. Radiology Azienda Servizi Sanitari 3 - Friuli Venezia Giulia.
authors.forename: Massimo
authors.initials: M
authors.lastname: Valentino
authors.affiliation: Department of Surgery, Cardiac Surgery Intensive Care Unit, University Hospital of Parma, Parma.
authors.forename: Francesco
authors.initials: F
authors.lastname: Nicolini
authors.affiliation: Department of Surgery, Cardiac Surgery Intensive Care Unit, University Hospital of Parma, Parma.
authors.forename: Alberto
authors.initials: A
authors.lastname: Molardi
authors.affiliation: Department of Surgery, Cardiac Surgery Intensive Care Unit, University Hospital of Parma, Parma.
authors.forename: Tiziano
authors.initials: T
authors.lastname: Gherli
authors.affiliation: Department of Surgery, Cardiac Surgery Intensive Care Unit, University Hospital of Parma, Parma; Department of Critical Care, Intensive Care Unit, E.O. Ospedali Galliera, Genova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Corradi
mesh_terms: D000368:Aged; D001314:Auscultation / Q000379:methods* / Q000592:standards; D006348:Cardiac Surgical Procedures; D003422:Critical Care / Q000379:methods; D019544:Equipment Failure Analysis / Q000379:methods; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D013902:Radiography, Thoracic / Q000379:methods*; D015203:Reproducibility of Results; D014463:Ultrasonography
keywords: critical care; daily on-demand chest radiography; lung ultrasonography; postoperative complications