Emergency Medical Service of Primary Health Care Center in Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina.
Medical Faculty, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina.
Medicina (Kaunas). 2024 Sep 18;60(9):1521. doi: 10.3390/medicina60091521.
: PoCUS ultrasound applications are widely used in everyday work, especially in the field of emergency medicine. The main goal of this research was to create a diagnostic and therapeutic protocol that will integrate ultrasound examination of the lungs, ultrasound measurements of the inferior vena cava (assessment of central venous pressure) and BREST scores (risk stratification for heart failure), with the aim of establishing a more effective differential diagnostic approach for dyspneic patients. A cross-sectional study was conducted in the emergency medicine department with the educational center of the community health center of Banja Luka. Eighty patients of both sexes were included and divided into experimental and control groups based on the presence or absence of dyspnea as a dominant subjective complaint. Based on the abovementioned variables, the LUSBI protocol (lung ultrasound/BREST score/inferior vena cava) was created, including profiles to determine the nature of the origin of complaints. The biochemical marker of heart failure NT pro-BNP served as a laboratory confirmation of the cardiac origin of the complaints. : The distribution of NT pro BNP values in the experimental group showed statistically significant differences between individual profiles of the LUSBI protocol ( < 0.001). Patients assigned to group B PLAPS 2 had significantly higher average values of NT pro-BNP (20159.00 ± 3114.02 pg/mL) compared to other LUSBI profiles. Patients from the experimental group who had a high risk of heart failure according to their BREST scores also had a significantly higher average maximum expiratory diameter compared to those without heart failure ( = 0.004). A statistically significant difference ( = 0.001) in LUSBI profiles was observed between the groups of patients divided according to CVP categories. : The integration of the LUSBI protocol into the differential diagnosis of dyspnea has been shown to be very effective in confirming or excluding a cardiac cause of the disease in patients.
: 肺部超声、下腔静脉超声测量（中心静脉压评估）和 BREST 评分（心力衰竭风险分层）在日常工作中得到广泛应用，特别是在急诊医学领域。本研究的主要目的是制定一种诊断和治疗方案，将肺部超声检查、下腔静脉超声测量和 BREST 评分整合在一起，旨在为呼吸困难患者建立更有效的鉴别诊断方法。本研究为横断面研究，在巴尼亚卢卡社区卫生中心的急诊医学系和教育中心进行。共纳入 80 例男女患者，根据是否存在呼吸困难这一主要主诉，将其分为实验组和对照组。基于上述变量，制定了 LUSBI 方案（肺部超声/BREST 评分/下腔静脉），包括确定症状起源性质的特征。心力衰竭的生物标志物 NT pro-BNP 作为心脏来源症状的实验室确认。: 实验组 NT pro-BNP 值的分布在 LUSBI 方案的各个特征之间存在统计学差异（ < 0.001）。B 组 PLAPS 2 患者的 NT pro-BNP 平均值显著高于其他 LUSBI 特征（20159.00 ± 3114.02 pg/mL）。根据 BREST 评分，被归类为高危心力衰竭的实验组患者的呼气末最大直径平均值也明显高于无心力衰竭患者（ = 0.004）。根据 CVP 类别分组的患者中，LUSBI 特征的差异具有统计学意义（ = 0.001）。: 将 LUSBI 方案纳入呼吸困难的鉴别诊断中，对于确认或排除患者疾病的心脏病因非常有效。
