Integrated use of lung ultrasound and thoracic bioimpedance to predict outcome in patients with acute coronary syndrome

Background Acute Coronary Syndrome (ACS) refers to any group of clinical symptoms compatible with acute myocardial ischemia. Lung ultrasound (LUS) is an emerging tool for the diagnosis and quantification of pulmonary congestion. B-lines on LUS are vertical reverberation artifacts that indicate extravascular fluid. On other hand, the bioimpedance is useful technology to measure thoracic fluid content (TFC), cardiac output (CO) and other parameters. It is viable for clinical practice and epidemiological studies since it is a noninvasive, portable, easy to handle and has good reproducibility. Impedance cardiography has been increasingly used as a prognostic indicator in acute myocardial infarction. Methods We conducted an observational prospective study, was carried out in critical care department, Cairo University. A sample size of 60 patients with acute coronary syndrome was included in the study. LUS and thoracic bioimpedence were performed on all patients on admission and after 48 h and were correlated to outcomes. Results In the present study, 8-zone LUS on admission and after 48 h were significantly correlated with outcome with p value of less than 0.001, length of hospital stay with p value of less than 0.001 and complications such as need for vasopressors, NIV, IMV and need for urgent PCI. Also, the present study showed that TFC on admission and after 48 h were significantly correlated with outcome with p values of less than 0.001 and 0.027 respectively, length of hospital stay with p value of less than 0.001 and complications such as need for vasopressors, NIV, IMV and need for urgent PCI. Conclusion The present study showed that 8-zone LUS score and Bio impedance were strongly correlated with outcomes as mortality, hospital stay and complications.