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肺超声在基层医疗中对心力衰竭患者管理的预后意义:一项系统评价

Prognostic Significance of Lung Ultrasound for Heart Failure Patient Management in Primary Care: A Systematic Review.

作者信息

Panisello-Tafalla Anna, Haro-Montoya Marcos, Caballol-Angelats Rosa, Montelongo-Sol Maylin, Rodriguez-Carralero Yoenia, Lucas-Noll Jorgina, Clua-Espuny Josep Lluis

机构信息

Institut Català de la Salut (ICS), SAP Terres de l'Ebre, Primary Care Health Tortosa-est, 43500 Tortosa, Spain.

Programa Doctorado Biomedicines, University Rovira-Virgili, Campus Terres de l'Ebre, 43500 Tortosa, Spain.

出版信息

J Clin Med. 2024 Apr 23;13(9):2460. doi: 10.3390/jcm13092460.

Abstract

Heart failure (HF) affects around 60 million individuals worldwide. The primary aim of this study was to evaluate the efficacy of lung ultrasound (LUS) in managing HF with the goal of reducing hospital readmission rates. A systematic search was conducted on PubMed, Embase, Google Scholar, Web of Science, and Scopus, covering clinical trials, meta-analyses, systematic reviews, and original articles published between 1 January 2019 and 31 December 2023, focusing on LUS for HF assessment in out-patient settings. There is a potential for bias as the effectiveness of interventions may vary depending on the individuals administering them. The PRISMA method synthesized the findings. Out of 873 articles identified, 33 were selected: 19 articles focused on prognostic assessment of HF, 11 centred on multimodal diagnostic assessments, and two addressed therapeutic guidance for HF diagnosis. LUS demonstrates advantages in detecting subclinical congestion, which holds prognostic significance for readmission and mortality during out-patient follow-up post-hospital-discharge, especially in complex scenarios, but there is a lack of standardization. there are considerable uncertainties in their interpretation and monitoring changes. The need for an updated international consensus on the use of LUS seems obvious.

摘要

心力衰竭(HF)在全球影响着约6000万人。本研究的主要目的是评估肺部超声(LUS)在管理心力衰竭方面的疗效,目标是降低医院再入院率。对PubMed、Embase、谷歌学术、科学网和Scopus进行了系统检索,涵盖2019年1月1日至2023年12月31日期间发表的临床试验、荟萃分析、系统评价和原创文章,重点关注门诊环境中用于心力衰竭评估的LUS。由于干预措施的有效性可能因实施者不同而有所差异,存在偏倚的可能性。采用PRISMA方法综合研究结果。在识别出的873篇文章中,筛选出33篇:19篇文章聚焦于心力衰竭的预后评估,11篇围绕多模式诊断评估,2篇涉及心力衰竭诊断的治疗指导。LUS在检测亚临床充血方面具有优势,这对出院后门诊随访期间的再入院和死亡率具有预后意义,尤其是在复杂情况下,但缺乏标准化。在其解读和监测变化方面存在相当大的不确定性。显然需要就LUS的使用达成最新的国际共识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81c3/11084515/e4c52bcd7ddd/jcm-13-02460-g001.jpg

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