Ienghong Kamonwon, Cheung Lap Woon, Chanthawatthanarak Sivit, Apiratwarakul Korakot
Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
Accident & Emergency Department, Princess Margaret Hospital, Kowloon, Hong Kong.
Int J Emerg Med. 2024 Dec 2;17(1):183. doi: 10.1186/s12245-024-00776-1.
Effective management of pulmonary edema in the emergency department (ED) is crucial given its significant global impact on health. This study aimed to investigate the hypothesis: "Does the utilization of Automatic B-lines via ultrasonography in patients with pulmonary edema facilitate faster diuretic administration in a developing country?"
This retrospective observational study was conducted at a tertiary academic center in Thailand. Patients with pulmonary edema admitted to the ED between January 2023 and June 2024 were enrolled. Ultrasound documentation and electronic ED medical records were compared to assess the time of diuretic administration between patients who had lung ultrasounds utilizing automatic B-lines and those who had manual B-lines counted by physician eye inspection. Multivariate logistic regression was employed to examine the relationship between the use of automatic B-lines and early diuretic administration.
The study included 134 patients with pulmonary edema. The time to diuretic administration was significantly shorter in the automatic B-lines group (median time [Q1-Q3], 55 min; range, 35-110 min) compared to the non-automatic B-lines group (median time, 100 min; range, 75-145 min). In the multivariable logistic regression analysis, early diuretic administration within 60 min of triage was significantly more likely in the automatic B-lines group (adjusted odds ratio, 1.45; 95% confidence interval, 1.10-2.45) than in the non-automatic B-lines group.
In a developing country, patients with pulmonary edema who had lung ultrasound evaluation with automated B lines experienced a fastest diuresis compared to those who utilized ultrasonography without automatic B lines. Implementing automatic B-lines as an early screening protocol could enhance clinical practice in the ED.
鉴于肺水肿对全球健康有重大影响，急诊科对其进行有效管理至关重要。本研究旨在探讨这一假设：“在发展中国家，对肺水肿患者使用超声自动B线是否有助于更快地给予利尿剂？”
这项回顾性观察研究在泰国的一家三级学术中心进行。纳入了2023年1月至2024年6月期间急诊科收治的肺水肿患者。比较超声记录和电子急诊科病历，以评估使用自动B线进行肺部超声检查的患者与通过医生肉眼检查计数手动B线的患者之间给予利尿剂的时间。采用多变量逻辑回归分析来检验自动B线的使用与早期给予利尿剂之间的关系。
该研究纳入了134例肺水肿患者。与非自动B线组（中位时间，100分钟；范围，75 - 145分钟）相比，自动B线组给予利尿剂的时间显著更短（中位时间[Q1 - Q3]，55分钟；范围，35 - 110分钟）。在多变量逻辑回归分析中，自动B线组在分诊后60分钟内早期给予利尿剂的可能性显著高于非自动B线组（调整后的比值比，1.45；95%置信区间，1.10 - 2.45）。
在一个发展中国家，与未使用自动B线超声检查的肺水肿患者相比，使用自动B线进行肺部超声评估的患者利尿最快。将自动B线作为早期筛查方案实施可改善急诊科的临床实践。
