多学科重症监护病房中肺部超声的应用：对辐射和医疗费用的影响。

Implementation of lung ultrasound in polyvalent intensive care unit: Impact on irradiation and medical cost.

机构信息

Department of anesthesiology and critical care medicine, Nord hospital, AP-HM, Aix Marseille university, Marseille, France.

Department of medical informatics, Nord hospital, AP-HM, Aix Marseille university, Marseille, France.

出版信息

Anaesth Crit Care Pain Med. 2015 Feb;34(1):41-4. doi: 10.1016/j.accpm.2015.01.002. Epub 2015 Mar 5.

DOI:10.1016/j.accpm.2015.01.002

PMID:25829314

Abstract

OBJECTIVE

To determine the effect of implementing a daily lung ultrasound round on the number of chest radiographs and chest computed tomography (CT) scans in a polyvalent intensive care unit (ICU).

STUDY DESIGN

Retrospective study comparing two consecutive periods.

PATIENTS

All patients hospitalized for longer than 48 hours in a polyvalent ICU.

METHODS

Implementation of a daily lung ultrasound round after a short educational program. The number of chest radiographs and chest CT scans and the patient outcome were measured before (group PRE) and after (group POST) the implementation of a daily lung ultrasound round.

RESULTS

No demographic difference was found between the two groups, with the exception of a higher severity score in the group POST. For each ICU stay, the number of chest radiographs was 10.3 ± 12.4 in the group PRE and 7.7 ± 10.3 in the group POST, respectively (P<0.005) The number of chest CT scans was not reduced in the group POST, as compared with the group PRE (0.5 ± 0.7 CT scan/patient/ICU stay versus 0.4 ± 0.6 CT scan/patient/ICU stay, P=0.01). The ICU mortality was similar in both groups (21% versus 22%, P=0.75) CONCLUSION: The implementation of a daily lung ultrasound round was associated with a reduction in radiation exposure and medical cost without altering patient outcome.

摘要

目的

确定在多学科重症监护病房（ICU）中实施每日肺部超声检查对胸部 X 线摄影和胸部计算机断层扫描（CT）检查数量的影响。

研究设计

回顾性研究比较两个连续时期。

患者

所有在多学科 ICU 住院时间超过 48 小时的患者。

方法

在简短的教育计划后实施每日肺部超声检查。在实施每日肺部超声检查之前（PRE 组）和之后（POST 组）测量胸部 X 线摄影和胸部 CT 扫描的数量以及患者的预后。

结果

两组患者在人口统计学方面无差异，除了 POST 组的严重程度评分较高。对于每次 ICU 住院，PRE 组的胸部 X 线摄影次数为 10.3 ± 12.4 张，POST 组为 7.7 ± 10.3 张（P<0.005）。与 PRE 组相比，POST 组的胸部 CT 扫描数量并未减少（0.5 ± 0.7 次 CT 扫描/患者/ICU 住院与 0.4 ± 0.6 次 CT 扫描/患者/ICU 住院，P=0.01）。两组 ICU 死亡率相似（21%与 22%，P=0.75）。