Malerba Paolo, Kaminstein Daniel, Brunetti Enrico, Manciulli Tommaso
Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 74, 27100, Pavia, PV, Italy.
Department of Emergency Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia.
J Ultrasound. 2020 Mar;23(1):13-21. doi: 10.1007/s40477-019-00371-8. Epub 2019 Mar 9.
Point-of-care ultrasound (POCUS) has proven utility in the evaluation and treatment of many tropical diseases. Its role in malaria has been studied, but its value for the clinician at the bedside is unclear. Our review aimed at summarizing the existing studies to assess the usefulness, if any, of POCUS in treating malaria.
We used Boolean operators using keywords "malaria", "acoustic", "ultrasound", "echography", and "ultrasonography" to search PubMed, Scopus, and Science Direct in three languages (Italian, French, and English).
We found 22 eligible references. Organs explored include the liver, spleen, heart, optic nerve sheath diameter (ONSD), kidney, lungs, and cerebral vasculature. Multiple pathologic findings by ultrasound are reported, but few demonstrate clinical utility. Current studies involve small numbers of patients, and a few trends emerge when studies are compared. The ability to combine study results is limited due to the significant heterogeneity that exists between studies in regards to both methods of evaluation and the reporting of organ pathology and malaria severity.
A review of the current literature indicates that the use of ultrasound by clinicians adds little to the diagnostic evaluation of patients with malaria. Our review did find that measurements of the spleen, lungs, optic nerve sheath diameter, and cerebral blood flow have potential utility in specific patient populations. Further studies are needed to evaluate whether this utility persists when a larger sample size is used.
即时超声检查（POCUS）已被证明在多种热带疾病的评估和治疗中具有实用价值。其在疟疾方面的作用已得到研究，但其对床边临床医生的价值尚不清楚。我们的综述旨在总结现有研究，以评估POCUS在治疗疟疾方面的有用性（如果有的话）。
我们使用布尔运算符，以“疟疾”“声学”“超声”“回波描记术”和“超声检查”为关键词，用三种语言（意大利语、法语和英语）检索了PubMed、Scopus和科学Direct数据库。
我们找到了22篇符合条件的参考文献。所探查的器官包括肝脏、脾脏、心脏、视神经鞘直径（ONSD）、肾脏、肺和脑血管系统。报告了超声检查的多种病理结果，但很少有显示出临床实用性的。目前的研究涉及的患者数量较少，在比较研究时出现了一些趋势。由于研究在评估方法以及器官病理和疟疾严重程度报告方面存在显著异质性，合并研究结果的能力有限。
对当前文献的综述表明，临床医生使用超声对疟疾患者的诊断评估作用不大。我们的综述确实发现，脾脏、肺、视神经鞘直径和脑血流的测量在特定患者群体中具有潜在用途。需要进一步研究以评估当样本量更大时这种用途是否仍然存在。
