Diagnostic Accuracy of Point-of-Care Ultrasound Performed by Pulmonary Critical Care Physicians for Right Ventricle Assessment in Patients With Acute Pulmonary Embolism*

Abstract

This is the first study to evaluate pulmonary critical care fellows' and intensivists' use of goal-directed echocardiography in diagnosing right ventricular dysfunction in acute pulmonary embolism. Pulmonary Critical Care Medicine Fellows and intensivists made a timely and accurate assessment. Screening for right ventricular dysfunction using goal-directed echocardiography can and should be performed by pulmonary critical care physicians in patients with acute pulmonary embolism.

COUNTERPOINT: Should the Use of Diagnostic Point-of-Care Ultrasound in Patient Care Require Hospital Privileging/Credentialing? No

“…However, multiple published studies have demonstrated that intensivists can acquire and interpret POCUS images with a high degree of accuracy after a limited amount of formal training. [1][2][3][4] In fact, in a review of malpractice cases related to POCUS, all cases stemmed from an alleged failure to perform POCUS or timely POCUS; there were no reported cases of failure to interpret or misdiagnosis. 5 Moreover, selfassessment and regulation is an integral professional responsibility of physicians.…”

A 54-Year-Old Woman With Chest Pain and Shortness of Breath

“…Intensivists and pulmonary critical care fellows have been shown to be effective at timely RV dysfunction assessments using goal-directed ultrasound. 9 We chose one-half dose systemic tissue plasminogen activator to address both the DVT and the PE. Postthrombolysis echocardiogram showed improved RV strain, RV function, and RVSP (Discussion Video).…”

Lungenarterienembolie

“…Bei hämodynamisch instabilen Patienten ist eine Echokardiografie indiziert, falls eine CT-A nicht unmittelbar verfügbar ist [11]. Diese kann durch entsprechend erfahrene Untersucher und bei Verfügbarkeit geeigneter Geräte auch präklinisch bereits durchgeführt werden.…”