Dyspnea; Cardiac
Conditions
Keywords
Lung ultrasound, heart failure, diagnosis, accuracy, nurses
Brief summary
This study assesses the potential of lung ultrasonography to diagnose heart failure.
Detailed description
Dyspnea is one of the most distressing situations for the patient . Emergency cases do not always present in conditions that are ideal for immediate diagnosis, which sometimes compromises outcome. Physical examination, laboratory findings and radiography are imperfect, resulting in a need for sophisticated test results that delay management. Lung ultrasonography is becoming a standard tool in critical cases in the ED. the investigators aim to perform ultrasonography on consecutive patients admitted to the ICU with dyspnea, comparing lung ultrasonography results on initial presentation with the final diagnosis by the nurses. Three items were assessed: artifacts (horizontal A lines or vertical B lines indicating interstitial syndrome), lung sliding, and alveolar consolidation and/or pleural effusion, these items were grouped to assess ultrasound profiles. the study aimed to evaluate the accuracy and reproducibility of B-lines testing assessed by emergency nurses after 12-h training in the diagnosis of HF in patients admitted to the emergency department with acute dyspnea.
Interventions
DIAGNOSTIC_TESTwe perform a lung ultrasound to all the patients admitted for dyspnea independantly from the final diagnosis
Patients were placed in a semi-recumbent or supine position depending on their respiratory tolerance. For each side of the chest, 4 zones have to be assessed : 2 anterior and 2 lateral. The operator should calculate the number of B-lines when present .
Sponsors
University of Monastir
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* non traumatic dyspnea with the final diagnosis of heart failure
Exclusion criteria
* age less than 18 years * impossibility to give consent to participate in the study * post-traumatic dyspnea * pregnant women * need for endotracheal intubation or inotropic drugs * patients who were deemed too unstable for sonography by the treating team
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the accuracy of LUS performed by nurses in the diagnosis of heart failure | 0 days | the accuracy of LUS in the diagnosis of heart failure measured by sensitivity . |
| the Specificity of LUS by nurses in the diagnosis of heart failure | 0 days | the accuracy of LUS in the diagnosis of heart failure measured by specificity. |
| the reproducibility of LUS in by nurses the diagnosis of heart failure | 0 days | the accuracy of LUS in the diagnosis of heart failure measured by area under the roc curve |
| Agreement between nurses and expert's | 0 days | Agreement between nurses and expert's interpretation was assessed by kappa agreement index for ordinal LUS scale classification |
Countries
Tunisia
Outcome results
None listed