A point-of-care thoracic ultrasound protocol for hospital medical emergency teams (METUS) improves diagnostic accuracy.

Autor: Blans MJ; Department of Intensive Care, Rijnstate Hospital, PO box 9555, 6800 TA, Arnhem, The Netherlands. mblans@rijnstate.nl., Bousie E; Department of Intensive Care, Rijnstate Hospital, PO box 9555, 6800 TA, Arnhem, The Netherlands., van der Hoeven JG; Department of Intensive Care, Radboud University Medical Center, PO box 9101, 6500 HB, Nijmegen, The Netherlands., Bosch FH; Department of Internal Medicine, Rijnstate Hospital, PO box 9555, 6800 TA, Arnhem, The Netherlands.
Jazyk: angličtina
Zdroj: The ultrasound journal [Ultrasound J] 2021 Jun 04; Vol. 13 (1), pp. 29. Date of Electronic Publication: 2021 Jun 04.
DOI: 10.1186/s13089-021-00229-3
Abstrakt: Background: Point-of-care ultrasound (POCUS) has proven itself in many clinical situations. Few data on the use of POCUS during Medical Emergency Team (MET) calls exist. In this study, we hypothesized that the use of POCUS would increase the number of correct diagnosis made by the MET and increase MET's certainty.
Methods: Single-center prospective observational study on adult patients in need for MET assistance. Patients were included in blocks (weeks). During even weeks, the MET physician performed a clinical assessment and registered an initial diagnosis. Subsequently, the POCUS protocol was performed and a second diagnosis was registered (US+). During uneven weeks, no POCUS was performed (US-). A blinded expert reviewed the charts for a final diagnosis. The number of correct diagnoses was compared to the final diagnosis between both groups. Physician's certainty, mortality and possible differences in first treatment were also evaluated.
Results: We included 100 patients: 52 in the US + and 48 in the US-  group. There were significantly more correct diagnoses in the US+ group compared to the US- group: 78 vs 51% (P  = 0.006). Certainty improved significantly with POCUS (P  <  0.001). No differences in 28-day mortality and first treatment were found.
Conclusions: The use of thoracic POCUS during MET calls leads to better diagnosis and increases certainty.
Trial Registration: ClinicalTrials.gov. Registered 12 July 2017, NCT03214809 https://www.clinicaltrials.gov/ct2/show/NCT03214809?term=metus&cntry=NL&draw=2&rank=1.
Databáze: MEDLINE
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