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Effect of focused cardiac ultrasound in combination with lung ultrasound on critically ill patients: a multicenter observational study in China

Hongmin Zhang1, Lina Zhang2, Lixia Liu3, Ying Zhu4, Wanhong Yin5, Wei He6, Xiuling Shang7, Yangong Chao8, Liwen Lv9, Xiaoting Wang1*, Dawei Liu1; Chinese Critical Ultrasound Study Group   

  1. 1Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

    2Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha 410013, China

    3Department of Critical Care Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China

    4Department of Critical Care Medicine, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China

    5Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China

    6Department of Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China

    7Department of Critical Care Medicine, Fujian Provincial Hospital, Fuzhou 350001, China

    8Department of Critical Care Medicine, The First Hospital of Tsinghua University, Beijing 100016, China 9Department of Emergency Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China

Abstract:

Objective Focused cardiac ultrasound (FCU) and lung ultrasound (LU) are increasingly being used in critically ill patients. This study aimed to investigate the effect of FCU in combination with LU on these patients and to determine if the timing of ultrasound examination was associated with treatment change.

Methods This is a multicenter cross-sectional observational study. Consecutive patients admitted to the intensive care unit (ICU) were screened for enrollment. FCU and LU were performed within the first 24 h, and treatment change was proposed by the performer based on the ultrasound results and other clinical conditions.

Results Among the 992 patients included, 502 were examined within 6 h of ICU admission (early phase group), 490 were examined after 6 h of admission (later phase group). The early phase group and the later phase group had similar proportions of treatment change (48.8% vs. 49.0%, χ2=0.003, P=0.956). In the multivariable analysis, admission for respiratory failure were independent variables associated with treatment change, with an odds ratio (OR) of 2.357 [95% confidence interval (CI): 1.284-4.326, P=0.006]; the timing of examination was not associated with treatment change (OR=0.725, 95%CI: 0.407-1.291, P=0.275).

Conclusions FCU in combination with LU, whether performed during the early phase or later phase, had a significant impact on the treatment of critically ill patients. Patients with respiratory failure were more likely to experience treatment change after the ultrasound examination. 

Key words: cardiac ultrasound;, lung ultrasound, critically ill;, point-of-care

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