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Effect of Focused cardiac ultrasound in Combination with Lung ultrasound on Critically Ill Patients: A Multicenter Observational Study in China

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Chinese Medical Sciences Journal 2021年第4期36卷 257-264页

作者： Hongmin Zhang Lina Zhang Lixia Liu Ying Zhu Wanhong Yin Wei He Xiuling Shang Yangong Chao Liwen Lv Xiaoting Wang Dawei Liu 无 Department of Critical Care Medicine Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Department of Critical Care Medicine Xiangya HospitalCentral South UniversityChangsha 410013China Department of Critical Care Medicine The Fourth Hospital of Hebei Medical UniversityShijiazhuang 050011China Department of Critical Care Medicine Affiliated Hangzhou First People’s HospitalZhejiang University School of MedicineHangzhou 310006China Department of Critical Care Medicine West China HospitalSichuan UniversityChengdu 610041China Department of Critical Care Medicine Beijing Tongren HospitalCapital Medical UniversityBeijing 100730China Department of Critical Care Medicine Fujian Provincial HospitalFuzhou 350001China Department of Critical Care Medicine The First Hospital of Tsinghua UniversityBeijing 100016China Department of Emergency Medicine The People’s Hospital of Guangxi Zhuang Autonomous RegionNanning 530021China Chinese Critical ultrasound Study Group

Objective Focused cardiac ultrasound(FCU)and lung ultrasound(LU)are increasingly being used in critically ill *** study aimed to investigate the effect of FCU in combination with LU on these patients and to determine if the timing of ultrasound examination was associated with treatment *** This is a multicenter cross-sectional observational *** patients admitted to the intensive care unit(ICU)were screened for *** and LU were performed within the first 24 h,and treatment change was proposed by the performer based on the ultrasound results and other clinical *** Among the 992 patients included,502 were examined within 6 h of ICU admission(early phase group),and 490 were examined after 6 h of admission(later phase group).The early phase group and the later phase group had similar proportions of treatment change(48.8%vs.49.0%,χ^(2)=0.003,P=0.956).In the multivariable analysis,admission for respiratory failure was an independent variable associated with treatment change,with an odds ratio(OR)of 2.357[95%confidence interval(CI):1.284-4.326,P=0.006];the timing of examination was not associated with treatment change(OR=0.725,95%CI:0.407-1.291,P=0.275).Conclusions FCU in combination with LU,whether performed during the early phase or later phase,had a significant impact on the treatment of critically ill *** with respiratory failure were more likely to experience treatment change after the ultrasound examination.

关键词： cardiac ultrasound lung ultrasound critically ill point-of-care

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Pre-hospital assessment with ultrasound in emergencies: implementation in the field

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World Journal of Emergency Medicine 2016年第2期7卷 117-123页

作者： Kevin P. Rooney Sari Lahham Shadi Lahham Craig L. Anderson Bryan Bledsoe Bryan Sloane Linda Joseph Megan B. Osborn John C. Fox Department of Emergency Medicine Henry Ford Hospital Detroit Michigan 48202 USA Emergency Medicine University of California Irvine Orange California 92868 USA Emergency Medicine University of Nevada School of Medicine Las Vegas Nevada 89102 USA

BACKGROUND: Point-of-care ultrasound(US) is a proven diagnostic imaging tool in the emergency department(ED). Modern US devices are now more compact, affordable and portable, which has led to increased usage in austere environments. However, studies supporting the use of US in the prehospital setting are limited. The primary outcome of this pilot study was to determine if paramedics could perform cardiac ultrasound in the fi eld and obtain images that were adequate for interpretation. A secondary outcome was whether paramedics could correctly identify cardiac activity or the lack thereof in cardiac arrest ***: We performed a prospective educational study using a convenience sample of professional paramedics without ultrasound experience. Eligible paramedics participated in a 3-hour session on point-of-care US. The paramedics then used US during emergency calls and saved the scans for possible cardiac complaints including: chest pain, dyspnea, loss of consciousness, trauma, or cardiac ***: Four paramedics from two distinct fire stations enrolled a total of 19 unique patients, of whom 17 were deemed adequate for clinical decision making(89%, 95%CI 67%–99%). Paramedics accurately recorded 17 cases of cardiac activity(100%, 95%CI 84%–100%) and 2 cases of cardiac standstill(100%, 95%CI 22%–100%).CONCLUSION: Our pilot study suggests that with minimal training, paramedics can use US to obtain cardiac images that are adequate for interpretation and diagnose cardiac standstill. Further large-scale clinical trials are needed to determine if prehospital US can be used to guide care for patients with cardiac complaints.

关键词： Prehospital ultrasound cardiac ultrasound Emergency ultrasound

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