Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha 410013, China.
Chin Med Sci J. 2021 Dec 31;36(4):257-264. doi: 10.24920/003874.
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% . 49.0%, =0.003, =0.956). In the multivariable analysis, admission for respiratory failure was an independent variable associated with treatment change, with an odds ratio () of 2.357 [95% confidence interval (): 1.284-4.326, =0.006]; the timing of examination was not associated with treatment change (=0.725, 95%: 0.407-1.291, =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.
目的 聚焦式心脏超声(FCU)和肺部超声(LU)在危重症患者中应用日益广泛。本研究旨在探讨 FCU 联合 LU 对这些患者的影响,并确定超声检查时机与治疗改变是否相关。
方法 这是一项多中心横断面观察性研究。连续筛选收入重症监护病房(ICU)的患者以进行入组。FCU 和 LU 在入 ICU 后 24 h 内进行,根据超声结果和其他临床情况,由操作者提出治疗改变建议。
结果 在纳入的 992 例患者中,502 例在 ICU 入科后 6 h 内进行检查(早期组),490 例在入科 6 h 后进行检查(晚期组)。早期组和晚期组的治疗改变比例相似(48.8%比 49.0%,=0.003,=0.956)。多变量分析显示,因呼吸衰竭而入院是与治疗改变相关的独立变量,比值比(OR)为 2.357(95%可信区间:1.284-4.326,=0.006);检查时机与治疗改变无关(=0.725,95%可信区间:0.407-1.291,=0.275)。
结论 无论在早期还是晚期进行 FCU 联合 LU,均对危重症患者的治疗有显著影响。行超声检查后,呼吸衰竭患者更可能发生治疗改变。