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 ...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),and 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%,χ^(2)=0.003,P=0.956).In the multivariable analysis,admission for respiratory failure was an independent variable 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.展开更多
文摘目的 评估在新疆生产建设兵团基层团场医院对急性呼吸困难患者开展床旁肺超声检查的可行性及有效性.方法 选择急性呼吸困难患者90例,按2:1随机分成床旁肺超声指导诊疗组(肺超声组,n=60)和常规诊疗组(对照组,n=30).记录2组患者入院确诊时间、症状缓解时间、床旁超声或胸片检查时间、总住院时间及费用,绘制ROC曲线对比分析汉族维族肺超声诊断心源性呼吸困难敏感度和特异度的差异.结果 与对照组相比,肺超声组患者平均入院确诊时间(33.50 min vs.65.73 min)、平均入院-床旁超声或胸片检查时间(0.45 h vs.15.64 h)、平均入院-症状缓解时间(11.48 h vs.14.73 h)均显著降低,差异有统计学意义(P<0.01);总住院时间(7.28 d vs.8.32 d)及费用(6129.93元vs.6144.35元)差异无统计学意义(P>0.05);床旁肺超声用于汉族与维族患者诊断心源性呼吸困难均有较高的敏感度(93.75% vs.95.00%)与特异度(84.62% vs.81.82%).结论 床旁肺超声检查便捷有效,能改善新疆基层团场医院急性呼吸困难患者的诊疗效率,适宜临床推广应用.
文摘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),and 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%,χ^(2)=0.003,P=0.956).In the multivariable analysis,admission for respiratory failure was an independent variable 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.
