Dyspnea
Conditions
Keywords
Vscan, portable ultrasound, emergency care, emergency room
Brief summary
The main objective of our study is to compare the effects of two care strategies for dyspneic patients on the length of hospital stay: (1) standard care (=contextual analysis + conventional clinical chest radiography) versus (2) standard care + pleuropulmonary ultrasound.
Detailed description
The secondary objectives of this study are to assess the following for both arms: A-fatality rate, B-degree of concordance between the diagnosis orientation in the emergency department and final diagnosis determined by an expert committee using patient records one month later (blind evaluation by a panel of experts) C-clinical improvement between early emergency care and later care outside the emergency department (clinical parameters = blood gases and other biological parameters) D-imaging parameters.
Interventions
OTHERStandard care
Standard care for dyspneic patients including contextual analysis, conventional clinical exam and a chest X-Ray.
DEVICEVscan portable ultrasound device (GE Healthcare, Wauwatosa, WI)
Standard care (as described for the other intervention) + pleuropulmonary ultrasound using the Vscan portable ultrasound device (GE Healthcare, Wauwatosa, WI).
Sponsors
Centre Hospitalier Universitaire de Nīmes
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* The patient must have given his/her informed and signed consent * The patient must be insured or beneficiary of a health insurance plan * Patient consulting in the emergency department for dyspnea
Exclusion criteria
* The patient is participating in another study * The patient is in an exclusion period determined by a previous study * The patient is under judicial protection, under tutorship or curatorship * The patient refuses to sign the consent * It is impossible to correctly inform the patient * The patient cannot read French * The patient is pregnant, parturient, or breastfeeding
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Length of hospital stay in days | 1 month |
Secondary
| Measure | Time frame |
|---|---|
| Diagnosis in the emergency room | upon discharge from the emergency department (max 1 month) |
| Diagnosis given by expert committee based on patient file | 1 month |
| Glasgow scale | Baseline, day 0 |
| Heart rate | baseline, day 0 |
| Respiratory rate | baseline, day 0 |
| Systolic blood pressure | baseline, day 0 |
| Diastolic blood pressure | baseline, day 0 |
| Temperature | baseline, day 0 |
| blood pH | baseline, day 0 |
| CO2 arterial pressure | baseline, day 0 |
| O2 arterial pressure | baseline, day 0 |
| O2 saturation | baseline, day 0 |
| Alkaline reserve | baseline, day 0 |
| white blood cell count | baseline, day 0 |
| C-reactive protein | baseline, day 0 |
| Brain Natriuretic Peptide | baseline, day 0 |
| Patient deceased? yes/no | 1 month |
| Pulmonary x-ray, yes/no | baseline, day 0 |
| right alveolar opacities on x-ray, yes/no | baseline, day 0 |
| left alveolar opacities on x-ray, yes/no | baseline, day 0 |
| right parenchymal origin on x-ray, yes/no | baseline, day 0 |
| left parenchymal origin on x-ray, yes/no | baseline, day 0 |
| right pleural effusion on x-ray, yes/no | baseline, day 0 |
| left pleural effusion on x-ray, yes/no | baseline, day 0 |
| pleuropulmonary ultrasound, yes/no | baseline, day 0 |
| right alveolar-interstitial syndrome on ultrasound, yes/no | baseline, day 0 |
| left alveolar-interstitial syndrome on ultrasound, yes/no | baseline, day 0 |
| right lung consolidation on ultrasound, yes/no | baseline, day 0 |
| left lung consolidation on ultrasound, yes/no | baseline, day 0 |
| right pleural effusion on ultrasound, yes/no | baseline, day 0 |
| left pleural effusion on ultrasound, yes/no | baseline, day 0 |
| right pneumothorax on ultrasound, yes/no | baseline, day 0 |
| left pneumothorax on ultrasound, yes/no | baseline, day 0 |
| hemoglobin | baseline, day 0 |
Countries
France
Outcome results
None listed