A Diagnostic Accuracy Study of Multi-Organ Point-of-Care Ultrasound for Detecting Pulmonary Embolism in Critically ill COVID-19 Patients


Severe illness COVID-19 patients were more likely to develop pulmonary embolism (PE). Point-of-care ultrasound (POCUS) diagnosis of PE might reduce the need for computed tomography pulmonary angiography (CTPA) while decreasing time-to-diagnosis. Adult ICU patients with COVID-19 were included in this prospective observational study. Within 24 hours of CTPA, a multi-organ (lungs, deep vein, and cardiac) POCUS was performed to look for subpleural consolidations, deep venous thrombosis (DVT), and right ventricular strain (RVS). Researchers reported the scan time and calculated diagnostic accuracy measures separately and in combination for these signs. There were 70 patients in total. A PE occurred in 23 patients (32.8%). The average scan time was 14 minutes (IQR 11–17). The diagnostic accuracy of subpleural consolidations was 42.9% (95% CI [34.1–52.0]). The diagnostic accuracy of DVT and RVS was 75.6% (95% CI [67.1–82.9]) and 74.4% (95% CI [65.8–81.8]). Their sensitivity was 24.0% (95% CI [9.4–45.1]) and 40.0% (95% CI [21.3–61.3]), respectively, while their specificity was 88.8% (95% CI [80.8–94.3]) and 83.0% (95% CI [74.2–89.8]). The sensitivity of multi-organ POCUS was 87.5% (95% CI [67.6–97.3]), and the specificity was 25% (95% CI [16.9–34.7]). Multi-organ, as opposed to single-organ POCUS, could help rule out PE in critically ill COVID-19 patients and help select patients for CTPA. Furthermore, finding RVS could increase the likelihood of PE, whereas finding DVT eliminates the need for a CTPA.

Source:www.sciencedirect.com/science/article/pii/S0883944122000107



Source link

Leave a Reply

Your email address will not be published.

Back To Top