Point of Care Ultrasound
Conditions
Keywords
Intensive Care, Point-of-Care Ultrasound, Thoracic Ultrasound, Diagnostic Techniques and procedures.
Brief summary
Ultrasound is a widely used tool for clinicians to manage severe acute patients, seeking to improve the limitations of traditional physical examination and special studies that require patient transfers and can be harmful. This study aims to determine that a pre-established protocol of multiorganic point-of-care ultrasound can be beneficial performed systematically in a critical care patient, improving the diagnosis, detecting hidden anomalies, generating changes in therapy and guiding interventions. A multicenter, randomized controlled clinical trial, against a conventional therapy group is designed. The study group underwent an ultrasound protocol at the entrance of an ICU, of optic, pulmonary, cardiac, abdominal and guide of interventions.
Interventions
BEHAVIORALPOCUS protocol group
The findings of multiorgan ultrasound can modify diagnoses and treatments and immediate interventions (eg volume loading with saline solution, pleural or pericardial drainage, initiation of diuretics, increase in positive end expiratory pressure, etc.). This protocol is performed in the first 24 h of admission to the Intensive Care Unit (ICU) and is repeated at 24 h.
OTHERControl group
Routine protocol of the treating team is followed
Sponsors
Intensive Care Unit Pasteur Hospital
Asociacion Española Primera en Salud
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Intervention model description
Controlled clinical trial. Prospective, randomized controlled clinical trial. The type of design is with posttest only and control group. Two groups will be compared, a study group (experimental) undergoing a focal ultrasound protocol, versus a control group with conventional conventional management.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Admitted to the ICU with the requirement of Ventilatory Mechanical Assistance, and admitted for trauma, sepsis, shock of any cause, and postoperative major surgery.
Exclusion criteria
* More than 12 hours of previous hospitalization. * Those who refuse to enter the protocol. * Those considered by the treating team to be out of recovery possibilities or to enter to support Organ donation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in diagnosis and treatment by point of care ultrasound | Up to 7 days | REGISTER OF (In terms of frequency): IN DIAGNOSIS: * Does not modify the initial diagnosis but confirms it * Induces a change in initial diagnosis * Discover an unknown initial diagnosis * Does not modify the initial diagnosis, does not discard or confirm anything and does not change the treatment that is done. * Induces a wrong diagnosis and leads to an error. IN TREATMENT: * Determines the performance of an urgent interventional diagnostic maneuver * Determines the performance of an urgent medical or pharmacological therapeutic maneuver of the ICU. * Determines the performance of an urgent interventional or surgical therapeutic maneuver |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ICU extra requirements | Up to 7 days | Requests for imaging studies (Number per patient) |
| Interventions | Up to 7 days | Number and type of procedures or interventions performed on the patient (Number per patient) |
| Delay times | Up to 7 days | Delay between the treatment decision and its actual completion (eg pleural drainage) (in hours) |
| Definitive diagnosis | Up to 7 days | Delay in performing definitive diagnosis (hours) |
| ICU stay | Up to 30 days | Internment time in ICU (days) |
| Mortality | Up to 30 days | Death rate (percentage) |
| Duration of mechanical ventilation | Up to 30 days | Time of invasive mechanical ventilation (days) |
Countries
Uruguay
Outcome results
None listed