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Critical Care
Published in: Critical Care 1/2021

Open Access 01-12-2021 | Ultrasound | Research

Bedside POCUS during ward emergencies is associated with improved diagnosis and outcome: an observational, prospective, controlled study

Authors: Laurent Zieleskiewicz, Alexandre Lopez, Sami Hraiech, Karine Baumstarck, Bruno Pastene, Mathieu Di Bisceglie, Benjamin Coiffard, Gary Duclos, Alain Boussuges, Xavier Bobbia, Sharon Einav, Laurent Papazian, Marc Leone

Published in: Critical Care | Issue 1/2021

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Abstract

Background

Rapid response teams are intended to improve early diagnosis and intervention in ward patients who develop acute respiratory or circulatory failure. A management protocol including the use of a handheld ultrasound device for immediate point-of-care ultrasound (POCUS) examination at the bedside may improve team performance. The main objective of the study was to assess the impact of implementing such a POCUS-guided management on the proportion of adequate immediate diagnoses in two groups. Secondary endpoints included time to treatment and patient outcomes.

Methods

A prospective, observational, controlled study was conducted in a single university hospital. Two teams alternated every other day for managing in-hospital ward patients developing acute respiratory and/or circulatory failures. Only one of the team used an ultrasound device (POCUS group).

Results

We included 165 patients (POCUS group 83, control group 82). Proportion of adequate immediate diagnoses was 94% in the POCUS group and 80% in the control group (p = 0.009). Time to first treatment/intervention was shorter in the POCUS group (15 [10–25] min vs. 34 [15–40] min, p < 0.001). In-hospital mortality rates were 17% in the POCUS group and 35% in the control group (p = 0.007), but this difference was not confirmed in the propensity score sample (29% vs. 34%, p = 0.53).

Conclusion

Our study suggests that protocolized use of a handheld POCUS device at the bedside in the ward may improve the proportion of adequate diagnosis, the time to initial treatment and perhaps also survival of ward patients developing acute respiratory or circulatory failure.
Clinical Trial Registration NCT02967809. Registered 18 November 2016, https://​clinicaltrials.​gov/​ct2/​show/​NCT02967809.
Appendix
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Metadata
Title
Bedside POCUS during ward emergencies is associated with improved diagnosis and outcome: an observational, prospective, controlled study
Authors
Laurent Zieleskiewicz
Alexandre Lopez
Sami Hraiech
Karine Baumstarck
Bruno Pastene
Mathieu Di Bisceglie
Benjamin Coiffard
Gary Duclos
Alain Boussuges
Xavier Bobbia
Sharon Einav
Laurent Papazian
Marc Leone
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2021
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-021-03466-z

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