Deep Impact of Ultrasound in the Intensive Care Unit
| Autor: | Luciana Faccio, Marco Pesce, Mauro Navarra, Mohsen Motevallian, Emilpaolo Manno, Abdou Mfochivè, Luca Bertolaccini, Andrea Evangelista |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Thorax medicine.medical_specialty Critical Care Heart Diseases law.invention Clinical Protocols law Abdomen Health care Odds Ratio medicine Humans Hospital Mortality Prospective Studies Intensive care medicine APACHE Aged Ultrasonography Aged 80 and over Protocol (science) Septic shock business.industry Ultrasound Optic Nerve Middle Aged medicine.disease Shock Septic Occult Intensive care unit Intensive Care Units Logistic Models medicine.anatomical_structure Echocardiography Blood Vessels Female Radiology Nervous System Diseases business |
| Zdroj: | Survey of Anesthesiology. 57:108-109 |
| ISSN: | 0039-6206 |
| DOI: | 10.1097/01.sa.0000428772.86661.bc |
| Popis: | Background Ultrasound can influence the diagnosis and impact the treatment plan in critical patients. The aim of this study was to determine whether, without encountering major environment- or patient-related limitations, ultrasound examination under a critical care ultrasonography protocol can be performed to detect occult anomalies, to prompt urgent changes in therapy or induce further testing or interventions, and to confirm or modify diagnosis. Methods One hundred and twenty-five consecutive patients admitted to a general intensive care unit were assessed under a critical care ultrasonography protocol, and the data were analyzed prospectively. Systematic ultrasound examination of the optic nerve, thorax, heart, abdomen, and venous system was performed at the bedside. Results Environmental conditions hampered the examination slightly in 101/125 patients (80.8%), moderately in 20/125 patients (16%), and strongly in 4/125 patients (3.2%). Ultrasonographic findings modified the admitting diagnosis in 32/125 patients (25.6%), confirmed it in 73/125 patients (58.4%), were not effective in confirming or modifying it in 17/125 patients (13.6%), and missed it in 3/125 patients (2.4%). Ultrasonographic findings prompted further testing in 23/125 patients (18.4%), led to changes in medical therapy in 22/125 patients (17.6%), and to invasive procedures in 27/125 patients (21.6%). Conclusions In this series of patients consecutively admitted to an intensive care unit, ultrasound examination revealed a high prevalence of unsuspected clinical abnormalities, with the highest number of new ultrasound abnormalities detected in patients with septic shock. As part of rapid global assessment of the patient on admission, our ultrasound protocol holds potential for improving healthcare quality. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|