Impact of integrated use of diagnostic ultrasound examinations in respiratory intensive care units

Abstract

Abstract Background Implementing point-of-care multiorgan ultrasound (POCUS) to the initial assessment of ICU patients allows intensivists to immediately integrate ultrasound findings with the patient history, physical, and laboratory results, yielding a powerful clinical synergy, improving diagnostic accuracy, and ameliorating further management plans. The aim of this work was to assess the diagnostic performance and therapeutic effect of POCUS in patients admitted to respiratory ICU (RICU). Patients and methods A prospective study was carried out on patients admitted to the RICU. POCUS examination was performed to the patients within 12 h of admission that included echocardiography, lung ultrasound, abdominal ultrasound including inferior vena cava assessment and lower limb venous duplex. Results A total of 102 patients were included. The total number of sonographic findings was 320, of which 94 (29.3%) were new findings. This resulted in confirmation of the admitting diagnosis, modification of the admitting diagnosis, prompted further testing, change in medical therapy prescribed, and prompted invasive procedures in 35, 51, 11, 41, and 14% of patients, respectively. However, it was ineffective in confirming or modifying diagnosis, provided wrong diagnosis, and missed a diagnosis in 29.4, 2, and 11.7% of patients, respectively. Conclusion Integrating POCUS in the initial assessment of critically ill RICU patients together with standard diagnostic tests lead to diagnostic and therapeutic changes in most of patients which affected the management of these patients. Thus, it seems reasonable to consider the routine use of POCUS as a new respiratory examination option in the armamentarium of the intensivists.

Keywords

• bedside ultrasound
• echocardiography
• point of care
• respiratory intensive care