Point-of-care ultrasound improves clinical outcomes in patients with acute onset dyspnea: a systematic review and meta-analysis

Abstract

The early, appropriate management of acute onset dyspnea is important but often challenging. The aim of this study was to investigate the effects of the use of Point-of-Care Ultrasound (PoCUS) versus conventional management on clinical outcomes in patients with acute onset dyspnea. The Cochrane Library, MEDLINE, EMBASE and reference lists were searched to identify eligible trials (inception to October 14, 2021). There were no language restrictions. Randomized controlled trials (RCTs), and prospective and retrospective cohort studies that compared PoCUS with conventional diagnostic modalities (controls) in patients with acute onset dyspnea were included. Two independent reviewers extracted data and assessed the risk of bias. Disagreements were resolved by consensus. The primary study outcomes were time to diagnosis, time to treatment, and length of stay (LOS). Secondary outcomes included rate of appropriate treatment, 30-day re-admission rate, and mortality. We included eight RCTs and six observational studies with a total of 5393 participants. Heterogeneity across studies was variable (from low to considerable), with overall low or moderate study quality and low or moderate risk of bias (except one article with serious risk of bias). Time to diagnosis (mean difference [MD], − 63 min; 95% CI, − 115 to − 11 min] and time to treatment (MD, − 27 min; 95% CI − 43 to − 11 min) were significantly shorter in the PoCUS group. In-hospital LOS showed no differences between the two groups, but LOS in the Intensive Care Unit (MD, − 1.27 days; − 1.94 to − 0.61 days) was significantly shorter in the PoCUS group. Patients in the PoCUS group showed significantly higher odds of receiving appropriate therapy compared to controls (odds ratio [OR], 2.31; 95% CI, 1.61–3.32), but there was no significant effect on 30-day re-admission rate and in-hospital or 30-day mortality. Our results indicate that PoCUS use contributes to early diagnosis and better outcomes compared to conventional methods in patients admitted with acute onset dyspnea. Graphical abstract

Single-sided magnetic resonance-based sensor for point-of-care evaluation of muscle

“…Point-of-care (POC) medical diagnostics are increasingly utilized in both inpatient and outpatient settings 1 , 2 . The ability to rapidly detect aneurysms, fluid pockets, and other clinical findings that can be managed using an interventional procedure can decrease the time to diagnosis and treatment, leading to improved patient outcomes 3 , 4 . The bedside operation of these POC instruments enables measurement of diagnostic information without the need to transport the patient to a centralized-care facility – reducing cost, time to treat, and in some cases, length of stay 5 .…”

Seeing through the myths: Practical aspects of diagnostic point-of-care ultrasound in nephrology

“…Interestingly, patients in the POCUS group had significantly higher odds of receiving appropriate therapy vs controls (odds ratio = 2.31; 95% confidence interval: 1.61-3.32). Further, the length of stay in the intensive care unit was significantly shorter in the group managed using POCUS (mean difference -1.27 d)[ 24 ]. This clinical scenario is pertinent to nephrologists as they are often responsible for managing patients with dyspnea related to fluid overload.…”

Single-sided magnetic resonance-based sensor for point-of-care evaluation of muscle

“…POC medical diagnostics are increasingly utilized in both inpatient and outpatient settings 1 , 2 . The ability to rapidly detect aneurysms, fluid pockets, and other clinical findings that can be managed using an interventional procedure can decrease the time to diagnosis and treatment, leading to improved patient outcomes 3 , 4 . The bedside operation of these POC instruments enables measurement of diagnostic information without the need to transport the patient to a centralized-care facility – reducing cost, time to treat, and in some cases, length of stay 5 .…”