Blans M J, Bousie E, van der Hoeven J G, Bosch F H
Department of Intensive Care, Rijnstate Hospital, PO box 9555, 6800 TA, Arnhem, The Netherlands.
Department of Intensive Care, Radboud University Medical Center, PO box 9101, 6500 HB, Nijmegen, The Netherlands.
Ultrasound J. 2021 Jun 4;13(1):29. doi: 10.1186/s13089-021-00229-3.
Point-of-care ultrasound (POCUS) has proven itself in many clinical situations. Few data on the use of POCUS during Medical Emergency Team (MET) calls exist. In this study, we hypothesized that the use of POCUS would increase the number of correct diagnosis made by the MET and increase MET's certainty.
Single-center prospective observational study on adult patients in need for MET assistance. Patients were included in blocks (weeks). During even weeks, the MET physician performed a clinical assessment and registered an initial diagnosis. Subsequently, the POCUS protocol was performed and a second diagnosis was registered (US+). During uneven weeks, no POCUS was performed (US-). A blinded expert reviewed the charts for a final diagnosis. The number of correct diagnoses was compared to the final diagnosis between both groups. Physician's certainty, mortality and possible differences in first treatment were also evaluated.
We included 100 patients: 52 in the US + and 48 in the US- group. There were significantly more correct diagnoses in the US+ group compared to the US- group: 78 vs 51% (P = 0.006). Certainty improved significantly with POCUS (P < 0.001). No differences in 28-day mortality and first treatment were found.
The use of thoracic POCUS during MET calls leads to better diagnosis and increases certainty.
ClinicalTrials.gov. Registered 12 July 2017, NCT03214809 https://www.clinicaltrials.gov/ct2/show/NCT03214809?term=metus&cntry=NL&draw=2&rank=1.
即时超声检查（POCUS）已在许多临床情况下得到验证。关于在医疗急救团队（MET）呼叫期间使用POCUS的数据很少。在本研究中，我们假设使用POCUS将增加MET做出的正确诊断数量并提高MET的确定性。
对需要MET协助的成年患者进行单中心前瞻性观察研究。患者按组（周）纳入。在偶数周，MET医生进行临床评估并记录初始诊断。随后，执行POCUS方案并记录第二次诊断（US+）。在奇数周，不进行POCUS（US-）。一位盲法专家审查病历以得出最终诊断。比较两组正确诊断数量与最终诊断结果。还评估了医生的确定性、死亡率以及首次治疗的可能差异。
我们纳入了100例患者：US+组52例，US-组48例。与US-组相比，US+组的正确诊断明显更多：分别为78%和51%（P = 0.006）。POCUS使确定性显著提高（P < 0.001）。未发现28天死亡率和首次治疗存在差异。
在MET呼叫期间使用胸部POCUS可实现更好的诊断并提高确定性。
ClinicalTrials.gov。于2017年7月12日注册，NCT03214809 https://www.clinicaltrials.gov/ct2/show/NCT03214809?term=metus&cntry=NL&draw=2&rank=1 。
