• Antonella Vezzani, Tullio Manca, Claudia Brusasco, Gregorio Santori, Massimo Valentino, Francesco Nicolini, Alberto Molardi, Tiziano Gherli, and Francesco Corradi.
• Department of Surgery, Cardiac Surgery Intensive Care Unit, University Hospital of Parma, Parma. Electronic address: avezzani@ao.pr.it.
• J. Cardiothorac. Vasc. Anesth.. 2014 Dec 1;28(6):1527-32.

ObjectiveChest 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.DesignDiagnostic accuracy of chest auscultation and chest ultrasound were compared in identifying individual abnormalities detected by chest x-ray, considered the reference method.SettingCardiac surgery intensive care unit.ParticipantsOne hundred fifty-one consecutive adult patients undergoing cardiac surgery.InterventionsAll patients included were studied by chest auscultation, ultrasound, and x-ray upon admission to intensive care after cardiac surgery.Measurements And Main ResultsSix 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).ConclusionsChest 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.Copyright © 2014 Elsevier Inc. All rights reserved.

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