Garipoli Andrea, Leone Edoardo, Stefanucci Rita, Beomonte Zobel Bruno, Galluzzo Michele, Trinci Margherita
Department of Radiology, Isola Tiberina-Gemelli Isola Hospital, Via Di Ponte Quattro Capi, 39, 00186, Rome, Italy.
Department of Radiology, San Camillo Forlanini Hospital, Rome, Italy.
J Ultrasound. 2025 Mar;28(1):75-79. doi: 10.1007/s40477-024-00962-0. Epub 2024 Nov 9.
The purpose of this work is to evaluate whether EFAST can also play a role in the hemodynamically stable polytrauma patient, without delaying his arrival in the CT-scan room.
In a period of seven month, 748 polytrauma patients were retrospective valued; we analyzed the findings of the CT exams of 485 haemodynamically stable patients for whom the EFAST investigation was not requested, highlighting the possible presence of findings that, if reported during the EFAST, could have changed the patient management.
52 hemodynamically stable patients with CT examination findings potentially detectable by ultrasound examination directly in the shock room, which represent a percentage of about 11% of all the hemodynamically stable patients analyzed; about 54% of CT findings are represented by the presence of pneumothorax.
Looking to the results and the sensitivity of thoracic ultrasound in identifying even small flaps of pneumothorax, the evaluation by EFAST ultrasound examination could be extended at least to all those patients with chest trauma or who require endotracheal intubation. The risk of generating a hypertensive pneumothorax following positive pressure intubation is widely known, and certainly the presence of a pre-existing layer of pneumothorax, even if of modest entity, further increases this possibility.
本研究旨在评估急诊创伤超声重点评估（EFAST）检查在血流动力学稳定的多发伤患者中是否也能发挥作用，同时不延迟其前往CT扫描室的时间。
在七个月的时间里，对748例多发伤患者进行回顾性评估；我们分析了485例血流动力学稳定且未要求进行EFAST检查的患者的CT检查结果，重点关注那些若在EFAST检查中报告可能会改变患者治疗方案的检查结果。
52例血流动力学稳定的患者，其CT检查结果可在休克室通过超声检查直接发现，约占所有分析的血流动力学稳定患者的11%；约54%的CT检查结果为气胸。
鉴于胸部超声在识别即使是小面积气胸方面的结果和敏感性，EFAST超声检查评估至少可扩展至所有胸部创伤患者或需要气管插管的患者。正压插管后发生高压性气胸的风险是众所周知的，而且即使存在少量的预先存在的气胸层，也肯定会进一步增加这种可能性。
