Lung ultrasound score versus computed tomography chest score for predicting acute respiratory distress syndrome in adult patients with pulmonary contusion after blunt thoracic trauma

Background Trauma is the primary cause of mortality on a global scale. The most predominant thoracic injury associated with blunt chest trauma is lung contusion, which is associated with increased rates of morbidity and death. Aim This work aimed to compare the sensitivity of chest ultrasound versus computed tomography (CT) chest scores in predicting the acute respiratory distress syndrome (ARDS) in patients with pulmonary contusion following blunt chest trauma. Patients and methods This prospective study involved 40 patients with respiratory-related manifestations examined at the Emergency and Traumatology Department at Tanta University. All patients underwent clinical examination of vital signs, arterial blood gas analysis for 3 days, and radiological investigations, including ultrasound of the chest. Results The lung ultrasound (LUS) findings showed multiple B lines in 21 (52.5%) patients, multiple C lines in three (7.5%) patients, and multiple B and C lines in 11 (27.5%) patients, while five (12.5%) patients showed negative findings. The mean CT chest score was 5.15 ± 3.67 and the mean LUS score was 4.6 ± 3.86. The LUS had 76.7% sensitivity 95% CI (57.1–86.8%), 100.0% specificity 95% CI (80.5–100.0%), 99.6% positive predictive value, 58.8% negative predictive value, and 82.5% diagnostic accuracy in the prediction of ARDS compared with CT chest score (as a gold standard). Conclusion LUS is a reliable and noninvasive tool for diagnosing lung contusion and predicting ARDS, offering advantages over CT in critical care scenarios. Its high specificity, practicality, and correlation with CT scoring highlight its utility in trauma management.