LUNG ULTRASOUND AS AN ASSESSMENT TOOL IN ICU FOR CRITICALLY ILL PATIENTS AT A TERTIARY CARE CENTER IN SRINAGAR: A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Background: Lung ultrasound (LUS) has emerged as a rapid, bedside, non-invasive imaging modality for the evaluation of pulmonary pathologies in critically ill patients. Its increasing use in intensive care units (ICUs) is driven by its high diagnostic accuracy, repeatability, and real-time applicability. Objectives: To assess the utility of lung ultrasound in identifying and differentiating various pulmonary pathologies in critically ill ICU patients and to evaluate the association between sonographic findings and final clinical diagnoses. Methods: This prospective observational study included 50 adult patients (>18 years) admitted to the ICU of a tertiary care center. Lung ultrasound was performed using a standardized zonal scanning protocol. Sonographic findings were correlated with clinical diagnoses. Statistical analysis was performed using SPSS version 23. Categorical variables were expressed as frequencies and percentages, and associations were analyzed using the Chi-square test, with a p-value <0.05 considered statistically significant. Results: The majority of patients were in the 60–69 years age group (32%), with a male predominance (58%). Common comorbidities included multiple comorbid conditions (26%), hypertension (20%), and chronic obstructive pulmonary disease (14%). On lung ultrasound, B-lines were observed in 18% of patients, A-lines in 10%, lung sliding in 8%, and the barcode sign in 10%. The most common diagnoses were lung consolidation (34%), followed by pleural effusion (24%), pulmonary edema (18%), acute respiratory distress syndrome (14%), and pneumothorax (10%). A highly significant association was observed between B-lines and pulmonary edema (100% vs 0%, p < 0.001). A-lines showed a strong association with pneumothorax (80% vs 6.7%, p < 0.001) and were absent in cases of consolidation (p < 0.01). No significant association was found between pleural effusion and pneumothorax (p = 0.785). Conclusion: Lung ultrasound is a reliable and effective bedside diagnostic tool for evaluating pulmonary pathologies in critically ill patients. Specific sonographic patterns, particularly B-lines and A-lines, demonstrate strong correlations with pulmonary edema and pneumothorax, respectively, underscoring the diagnostic accuracy and clinical utility of LUS in ICU settings.