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Open Access 31-10-2022 | Ultrasound | CE-Systematic reviews and meta-analysis

Point-of-care ultrasound improves clinical outcomes in patients with acute onset dyspnea: a systematic review and meta-analysis

Authors: Gergő Vilmos Szabó, Csenge Szigetváry, László Szabó, Fanni Dembrovszky, Máté Rottler, Klemetina Ocskay, Stefanie Madzsar, Péter Hegyi, Zsolt Molnár

Published in: Internal and Emergency Medicine | Issue 2/2023

Abstract

The early, appropriate management of acute onset dyspnea is important but often challenging. The aim of this study was to investigate the effects of the use of Point-of-Care Ultrasound (PoCUS) versus conventional management on clinical outcomes in patients with acute onset dyspnea. The Cochrane Library, MEDLINE, EMBASE and reference lists were searched to identify eligible trials (inception to October 14, 2021). There were no language restrictions. Randomized controlled trials (RCTs), and prospective and retrospective cohort studies that compared PoCUS with conventional diagnostic modalities (controls) in patients with acute onset dyspnea were included. Two independent reviewers extracted data and assessed the risk of bias. Disagreements were resolved by consensus. The primary study outcomes were time to diagnosis, time to treatment, and length of stay (LOS). Secondary outcomes included rate of appropriate treatment, 30-day re-admission rate, and mortality. We included eight RCTs and six observational studies with a total of 5393 participants. Heterogeneity across studies was variable (from low to considerable), with overall low or moderate study quality and low or moderate risk of bias (except one article with serious risk of bias). Time to diagnosis (mean difference [MD], − 63 min; 95% CI, − 115 to − 11 min] and time to treatment (MD, − 27 min; 95% CI − 43 to − 11 min) were significantly shorter in the PoCUS group. In-hospital LOS showed no differences between the two groups, but LOS in the Intensive Care Unit (MD, − 1.27 days; − 1.94 to − 0.61 days) was significantly shorter in the PoCUS group. Patients in the PoCUS group showed significantly higher odds of receiving appropriate therapy compared to controls (odds ratio [OR], 2.31; 95% CI, 1.61–3.32), but there was no significant effect on 30-day re-admission rate and in-hospital or 30-day mortality. Our results indicate that PoCUS use contributes to early diagnosis and better outcomes compared to conventional methods in patients admitted with acute onset dyspnea.

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Title: Point-of-care ultrasound improves clinical outcomes in patients with acute onset dyspnea: a systematic review and meta-analysis
Authors: Gergő Vilmos Szabó
Csenge Szigetváry
László Szabó
Fanni Dembrovszky
Máté Rottler
Klemetina Ocskay
Stefanie Madzsar
Péter Hegyi
Zsolt Molnár
Publication date: 31-10-2022
Publisher: Springer International Publishing
Keywords: Ultrasound
Dyspnea
Care
Dyspnea
Ultrasound
Published in: Internal and Emergency Medicine / Issue 2/2023
Print ISSN: 1828-0447
Electronic ISSN: 1970-9366
DOI: https://doi.org/10.1007/s11739-022-03126-2

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