A study published in the October issue of Anesthesiology analyzed the effectiveness of ultrasound examination in the diagnosis and treatment of critical care patients. In particular, the study looked at the ability of ultrasound to detect hidden anomalies, prompt urgent changes in therapy, induce further testing or interventions, and confirm or modify diagnoses.
Researchers at Maria Vittoria Hospital, Torino, Italy, evaluated whether ultrasonography under a critical care protocol can be performed to increase diagnostic and therapeutic accuracy. Data were collected from 125 consecutive patients admitted to a general intensive care unit. Patients were assessed under a critical care ultrasonography protocol and received head-to-toe bedside ultrasounds of the optic nerve, thorax, heart, abdomen and venous system.
Findings from the ultrasound examination modified the diagnosis in 26 percent of patients and confirmed the diagnosis in 58 percent of patients. In addition, findings from the ultrasounds prompted:
• Changes in medical therapy in 18 percent of patients
• Further testing in 18 percent of patients
• New invasive procedures in 22 percent of patients
Lung ultrasounds proved to be especially efficient in differentiating acute pulmonary edema from decompensated chronic obstructive pulmonary disease, asthma or pulmonary embolism in 20 percent of patients who displayed acute shortness of breath or signs of respiratory failure.
"The findings support the use of ultrasound in critical care patients," said lead study author Emilpaolo Manno, M.D., Head of Emergency Department and Intensive Care Unit, Maria Vittoria Hospital. "Systematic ultrasound examinations upon admission are beneficial for not only establishing accurate diagnosis, but providing appropriate and effective treatment."
The researchers believe a rapid global assessment of critical care patients under an ultrasonography protocol holds potential for improving the quality of health care.