Point-of-Care Ultrasonography for Evaluation of Acute Dyspnea in the ED

Zanobetti, Maurizio; Scorpiniti, Margherita; Gigli, Chiara; Nazerian, Peiman; Vanni, Simone; Innocenti, Francesca; Stefanone, Valerio Teodoro; Savinelli, Caterina; Coppa, Alessandro; Bigiarini, Sofia; Caldi, Francesca; Tassinari, Irene; Conti, Alberto; Grifoni, Stefano; Pini, Riccardo

doi:10.1016/j.chest.2017.02.003

Cited by 230 publications

(179 citation statements)

References 29 publications

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“…Similarly, much of the current data pertains to the critical care population, who are by definition at the most severe end of the pathological spectrum; this may mean that the diagnostic accuracies reported in some of this work are not truly generalisable to those patients seen Point-of-care ultrasound routinely in general internal medicine. It is this factor that may help explain the reduced diagnostic accuracy seen with POCUS in respiratory failure in an Italian ED patient cohort 13 versus a French critical care population 12 . More studies are needed in unselected adult medical patients to clarify these differences.…”

Section: Discussionmentioning

confidence: 99%

“…This compared the performance of POCUS-guided diagnosis versus traditional techniques, for both time to diagnosis and concordance between the diagnoses, in 2683 patients. 13 This study group showed that POCUS significantly reduced the time to diagnosis (24 +/-10 min vs 186 +/-72 min), and performed as well as clinical examination plus chest X-ray (CXR) for diagnosing acute coronary syndrome, pneumonia, pleural effusion, pericardial effusion, pneumothorax and dyspnoea from other causes. POCUS was more sensitive for heart failure, and less for exacerbations of asthma / chronic obstructive pulmonary disease (COPD) and pulmonary embolism.…”

Section: Nicholas Smallwood and Martin Dachselmentioning

confidence: 99%

“…Emergency Department (ED) in Italy has been published, 13 which may be more generalisable to the 'acute take' cohort of patients seen in general internal medicine. This compared the performance of POCUS-guided diagnosis versus traditional techniques, for both time to diagnosis and concordance between the diagnoses, in 2683 patients.…”

Section: Nicholas Smallwood and Martin Dachselmentioning

confidence: 99%

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Point-of-care ultrasound (POCUS): unnecessary gadgetry or evidence-based medicine?

2018

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Over the last decade there has been increasing interest and enthusiasm in point-of-care ultrasound (POCUS) as an aide to traditional examination techniques in assessing acutely unwell adult patients. However, it currently remains the domain of a relatively small handful of physicians within the UK. There are numerous reasons for this, notably a lack of training pathways and supervisors but also a lack of understanding of the evidence base behind this imaging modality. This review article aims to explore some of the evidence base behind POCUS for a number of medical pathologies, and where possible compare it to evidenced traditional examination techniques. We discuss the issues around training in bedside ultrasound and recommend a push to integrate POCUS training into internal medicine curricula and support trainers to comprehensively deliver this.

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Section: Discussionmentioning

confidence: 99%

Section: Nicholas Smallwood and Martin Dachselmentioning

confidence: 99%

Section: Nicholas Smallwood and Martin Dachselmentioning

confidence: 99%

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Point-of-care ultrasound (POCUS): unnecessary gadgetry or evidence-based medicine?

2018

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“…Focused cardiac ultrasonography (FoCUS) is a noninvasive and reproducible examination that has great diagnostic and prognostic value in patients with heart failure, major valve disease, cardiac tamponade, significant reduction in left ventricular function, and massive pulmonary embolism . The concordance between cardiac ultrasonography by pocket ultrasound device (PUD) and standard echocardiography has been recently assessed, and the use of PUD confirmed to be feasible and reliable even by medical resident .…”

Section: Introductionmentioning

confidence: 99%

Assessment of left atrial size in addition to focused cardiopulmonary ultrasound improves diagnostic accuracy of acute heart failure in the Emergency Department

et al. 2018

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“…Thus, PoCUS is emerging as a feasible and reliable diagnostic approach to the patient with dyspnoea, allowing a reduction in time to diagnosis. [34] Sonography of the neck and chest ultrasound should be included in the routine imaging modality for patients with dyspnoea presenting to ED. [33] A brief outline of diagnostic tests may be summarised below (Table 7].…”

Section: Approach To Patients With Primarily Heart Diseasementioning

confidence: 99%

Evaluation and Management of the Dyspnoeic Patient- A Challenge to the Anaesthesiologist

Bagchi¹,

Mandal²,

Saha³

et al. 2018

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BACKGROUNDAnaesthesiologists are not infrequently facing the problematic patient presenting in the pre-anaesthetic clinic with evident dyspnoea, which has not been properly evaluated. Dyspnoea being a presentation of several severe disorders, its evaluation and management remains important even today to modify the risks entailed and to diminish the perioperative complications along with post-operative ventilation. In this perspective, we searched for relevant medical literature in English language using Google Search Engine. A thorough search for articles was done using the following Medical Subject Headings (MeSH) terms such as 'Dyspnoea,' 'Dyspnoea/ aetiology,' 'Dyspnoea/ physiopathology,' 'Dyspnoea/ diagnosis,' 'Dyspnoea/ therapy,' 'Dyspnoea/ psychology,' 'Exercise/ physiology,' 'Respiratory Insufficiency' and 'Sensation.' The full text articles published in last two decades were mainly considered with the exception for some old seminal articles, which dates back to the 50's. Subsequently, the articles are filtered and only the review articles, original investigations, guidelines and editorials were consulted. Framing of this article was envisaged to provide an overview of the varying aetiology of dyspnoea, its work-up and management in the light of recent advances. This may help in the refreshment of knowledge, which can help reducing the perioperative mortality and morbidity of these patients, already living a restricted life-style with a considerable morbidity.

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Point-of-Care Ultrasonography for Evaluation of Acute Dyspnea in the ED

Cited by 230 publications

References 29 publications

Point-of-care ultrasound (POCUS): unnecessary gadgetry or evidence-based medicine?

Point-of-care ultrasound (POCUS): unnecessary gadgetry or evidence-based medicine?

Assessment of left atrial size in addition to focused cardiopulmonary ultrasound improves diagnostic accuracy of acute heart failure in the Emergency Department

Evaluation and Management of the Dyspnoeic Patient- A Challenge to the Anaesthesiologist

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