title: [A comparative study of different bedside lung ultrasound examination for the location and signs of diaphragmatic points].
abstract: OBJECTIVE
  To investigate the differences of the locations and signs of the phrenic points between the Modified Bedside Lung Ultrasound Examination (M-BLUE) and Bedside Lung Ultrasound Examination (BLUE).
  
  
  METHODS
  A total of 61 consecutive patients who were treated in the Department of Critical Care Medicine at Peking Union Medical College Hospital in January and February of 2015 were enrolled in this study. BLUE and M-BLUE were both performed on each patient. The differences of examination results were compared.
  
  
  RESULTS
  (1) There were 47.5% (58/122) different locations of the phrenic points and 18.0% (22/122) different echo-signs between the BLUE protocol and the M-BLUE protocol. (2) Compared with BLUE protocol, changes of locations [67.9% (19/28) vs 33.3% (11/33)] and signs [42.9% (12/28) vs 12.1% (4/33)] of the phrenic points in the M-BLUE protocol in patients with respiratory failure were significantly higher than those without pulmonary diseases. Among 5 patients with acute respiratory distress syndrome and 6 patients with chronic obstructive pulmonary disease, all presented changes in locations of the phrenic point in the M-BLUE protocol, while 3 and 4 showed changes in signs respectively. (3) Signs of the phrenic point in the M-BLUE protocol were more consistent with the result of the chest CT than those in the BLUE protocol.
  
  
  CONCLUSIONS
  Compared with BLUE protocol, M-BLUE protocol seems more accurate in locating the phrenic point and more specific for the diagnosis of pulmonary disease. Compared with BLUE protocol, M-BLUE is more valuable for critical patients.
authors.forename: Xin
authors.initials: X
authors.lastname: Ding
authors.forename: Xiaoting
authors.initials: X
authors.lastname: Wang
authors.forename: Huan
authors.initials: H
authors.lastname: Chen
authors.forename: Hua
authors.initials: H
authors.lastname: Zhao
authors.forename: Yangong
authors.initials: Y
authors.lastname: Chao
authors.forename: Wanhong
authors.initials: W
authors.lastname: Yin
authors.affiliation: Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China; Email: dwliu98@yahoo.com.
authors.forename: Dawei
authors.initials: D
authors.lastname: Liu
mesh_terms: D000068476:Beijing; D002985:Clinical Protocols; D003422:Critical Care; D016638:Critical Illness; D003964:Diaphragm / Q000000981:diagnostic imaging*; D006801:Humans; D007362:Intensive Care Units; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008171:Lung Diseases; D029424:Pulmonary Disease, Chronic Obstructive; D012128:Respiratory Distress Syndrome; D012131:Respiratory Insufficiency; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography / Q000379:methods*