Gynecologic Cancer, Lung Diseases, Obstetric Complication, Ultrasound
Conditions
Keywords
lung ultrasound, critically ill peripartum, critically ill gynecological cases
Brief summary
Pulmonary dysfunction aggravates the illness of critically ill obstetrics and gynecological patients. Early identification with bedside technique and prompt management may improve the outcome of critical care in this vulnerable population
Detailed description
Hormonal changes in a woman's menstrual cycle and changes during pregnancy affect the respiratory system. These changes especially during pregnancy and peripartum complicate the critical care management of the female patients. In addition to the effect of different pregnancy-related as sepsis, and preeclampsia which directly or indirectly predispose to pulmonary complications. The presence of difficulty in the transfer of critically ill patients mandates point of care modality. Avoidance of fetal exposure to hazardous radiation demands safe technology. Ultrasound arises as a screening method that can be performed rapidly and enables healthcare providers to make timely decisions with no radiation exposure. Thus it facilitates the management of critically ill obstetric and gynecological patients. When compared to other imaging techniques; X-ray imaging is preferably restricted in parturient because of the ionizing risk on the fetus, and CT is not feasible in critically ill if there is a risk of transfer. Thus ultrasound emerged as a bedside imaging technique. Yet, the prevalence of the specific ultrasound signatures in that population is not clearly defined and its relation to poor outcome was not tested, This trial is the first trial to determine frequency, timing concerning admission, type of pulmonary abnormalities detectable by LUS, and their associations with poor outcome in patients whether obstetrics or gynecology admitted to the ICU specialized in women's intensive care
Interventions
DIAGNOSTIC_TESTultrasound detection of any abnormal ultrasonographical findings.
ultrasound assessment within 24 hours. Then reassessment every 48 hours or when the patient develops respiratory distress. While the patient is in a supine or semi-recumbent position, and the probe is in a short axis. The 8-region technique will be used. The areas are four on each side of the chest. The examiner will assess 8 regions -Anterior chest wall ( ACW), Anterior axillary line (AAXL), costo-phrenic angle (COSTO), Postero-lateral alveolar \&/ or pleural syndrome (PLAPS) right and left . Each region will be scored using the LUS aeration score. as follows: "0," A-pattern with 0-2 B-lines; "1," more than 2 separated B-lines; "2," multiple coalescent B-lines; or "3," lung consolidation, . A global LUS score will be calculated at each time point and range from 0 to 24. posterior region will be assessed if needed and if feasible. The venous status will be assessed through a subcostal view for inferior vena cava diameter.
Sponsors
Ain Shams University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
No
Inclusion criteria
* Any patient admitted to the obstetrics and gynecology intensive care unit
Exclusion criteria
* Patient's refusal * inability to do a lung ultrasound examination during the first 24 hours of admission
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the Prevalence of different ultrasonographical abnormal lung signatures | From date of admission untill Death from any cause or discharge from ICU, whichever comes first. assessed up to 20 days | presence or absence of us abnormalities as: abnormal sliding, interstitial syndrome, consolidation, cavitation, pleural effusion, or collapse |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| correlation of ultrasonographic finding with mortality or poor outcome | from the appearance of abnormal ultrasonographic signature to death or disharge from ICU which comes first , assessed up to 20 days from the day of admission | frequency of occurrence of poor outcomes -mortality or ventilatory support- for every abnormal lung ultrasonographic signature. |
| timing of appearance of abnormal ultrasonography lung signatures | on admission, after every 48 hours during ICU stay till death or dischrage from ICU which comes first, assessed up to 20 days from admission | the time of detection of the abnormal lung ultrasonographic finding |
Countries
Egypt
Contacts
PRINCIPAL_INVESTIGATORwessam selima, MD
Ain Shams University
Outcome results
None listed