Point-of-care ultrasound modalities in terms of diagnosing acute decompensated heart failure in emergency department; a diagnostic accuracy study

2019 ◽  
Vol 15 (3) ◽  
pp. 491-499 ◽  
Author(s):  
Shervin Farahmand ◽  
Ali Abdolhoseini ◽  
Ehsan Aliniagerdroudbari ◽  
Sepideh Babaniamansour ◽  
Alireza Baratloo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Diagnostic Accuracy ◽  
Acute Decompensated Heart Failure ◽  
Point Of Care ◽  
Decompensated Heart Failure ◽  
Point Of Care Ultrasound ◽  
Diagnostic Accuracy Study ◽  
Accuracy Study

scholarly journals LO074: Point of care ultrasound for lung B-lines in the early diagnosis of acute decompensated heart failure in the emergency department: a systematic review

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S55-S55
Author(s):  
K. McGivery ◽  
P.R. Atkinson ◽  
D. Lewis ◽  
L. Taylor ◽  
K. Gadd
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Emergency Department ◽  
Likelihood Ratio ◽  
Lung Ultrasound ◽  
Acute Decompensated Heart Failure ◽  
Point Of Care ◽  
Decompensated Heart Failure ◽  
Point Of Care Ultrasound ◽  
B Lines

Introduction: Dyspnea is a common presenting problem in the emergency department (ED) that frequently creates a diagnostic challenge for physicians. Acute decompensated heart failure (ADHF) represents a common cause that requires prompt diagnosis and management. Recent studies on dyspneic patients have suggested a potential role for point-of-care ultrasound (PoCUS). The objective of this systematic review was to assess the sensitivity and specificity of early bedside lung ultrasound in patients presenting to the ED with dyspnea. Methods: A search of the literature was conducted using PubMed, EMBASE, the Cochrane Library, bibliographies of previous systematic reviews, and abstracts from major emergency medicine conferences. We included prospective studies that assessed the diagnostic accuracy of B-lines from bedside lung ultrasound in the ED patients compared to a clinical diagnosis of ADHF at hospital discharge. The final diagnosis included at least one of CXR, computed tomography, or BNP. Two reviewers independently screened all titles and abstracts for possible inclusions. Two separate content experts full text-reviewed selected studies and performed quality analysis using a modified Critical Appraisal Skills Program (CASP) questionnaire. Extracted data was assessed with summary receiver operator characteristics curve (SROC) analysis with pooled sensitivity and specificity. Heterogenity was tested. Results: The electronic search yielded 3674 articles of which six met the inclusion criteria and fulfilled CASP requirements for methodological quality. The total number of patients in these studies was 1911. Heterogeneity was noted; due to poorer performance by novice users. Meta-analysis of the data showed that in detecting ADHF, bedside lung ultrasound had a pooled sensitivity of 89.6% (95% CI 69.5 to 97.0%) and a pooled specificity of 88.4% (95% CI 75.0 to 95.1%). The positive likelihood ratio was 6.01 (95% CI 2.93 to 12.32) and negative likelihood ratio was 0.13 (95% CI 0.06 to 0.30). Conclusion: This study suggests that in patients presenting to the ED with undifferentiated dyspnea, early point of care lung ultrasound may be used to confirm the diagnosis of ADHF, which may facilitate earlier appropriate management. Test performance may vary according to experience.

scholarly journals Point-of-Care Ultrasound Identifies Decompensated Heart Failure in a Young Male with Methamphetamine-Associated Cardiomyopathy Presenting in Severe Sepsis to the Emergency Department

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
David Kinas ◽  
Michael Dalley ◽  
Kayla Guidry ◽  
Mark A. Newberry ◽  
David A. Farcy
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Severe Sepsis ◽  
Point Of Care ◽  
Disease Process ◽  
Young Male ◽  
Decompensated Heart Failure ◽  
The United States ◽  
Point Of Care Ultrasound ◽  
Methamphetamine Abuse

We describe a case of a young male who presents to the emergency department with severe sepsis and decompensated heart failure with underlying Methamphetamine-Associated Cardiomyopathy that was previously undiagnosed. This presentation is unique because Methamphetamine-Associated Cardiomyopathy is an uncommonly reported condition that presented in a complex clinical scenario of severe sepsis and decompensated congestive heart failure. We discuss how we used point-of-care ultrasound (POCUS) in this case to identify an unsuspected disease process and how it changed our initial resuscitation strategy and management. Emergency physicians can utilize point-of-care ultrasound (POCUS) to help identify these high-risk patients in the emergency department and guide appropriate resuscitation. Methamphetamine-Associated Cardiomyopathy (MAC) is an infrequently described complication of methamphetamine abuse, most commonly presented as a nonischemic dilated cardiomyopathy. With the rise in methamphetamine abuse in the United States, complications from methamphetamine use are more commonly presenting to the emergency department. Proper education and rehabilitation, with a goal of abstinence from amphetamine use, may allow patients to potentially regain normal cardiac function. Since the majority of patients present late with severe cardiac dysfunction, early detection is essential amongst critically ill patients since recognition may significantly influence ED management.

Point-of-care ultrasound diagnoses acute decompensated heart failure in the ED regardless of examination findings

2014 ◽  
Vol 32 (4) ◽  
pp. 385-388 ◽  
Author(s):  
Kenton L. Anderson ◽  
Katherine Y. Jenq ◽  
J. Matthew Fields ◽  
Nova L. Panebianco ◽  
Anthony J. Dean
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Point Of Care ◽  
Decompensated Heart Failure ◽  
Point Of Care Ultrasound

7. Emergency department diuretic dosing in acute decompensated heart failure and its effect on length of stay and re-admission rate

Heart & Lung ◽  
2012 ◽  
Vol 41 (4) ◽  
pp. 414-415 ◽  
Author(s):  
J. Fearon-Clarke ◽  
M. Betty ◽  
B. Vargas ◽  
R. Montesino ◽  
S. Sheris ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Length Of Stay ◽  
Acute Decompensated Heart Failure ◽  
Admission Rate ◽  
Decompensated Heart Failure

scholarly journals A novel training simulator for portable ultrasound identification of incorrect newborn endotracheal tube placement – observational diagnostic accuracy study protocol

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hasan S. Merali ◽  
Mark O. Tessaro ◽  
Khushboo Q. Ali ◽  
Shaun K. Morris ◽  
Sajid B. Soofi ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Endotracheal Tube ◽  
Standard Of Care ◽  
Tube Placement ◽  
Secondary Outcome ◽  
Point Of Care Ultrasound ◽  
Diagnostic Accuracy Study ◽  
Phase 2 ◽  
Portable Ultrasound ◽  
Accuracy Study

Abstract Background Endotracheal tube (ETT) placement is a critical procedure for newborns that are unable to breathe. Inadvertent esophageal intubation can lead to oxygen deprivation and consequent permanent neurological impairment. Current standard-of-care methods to confirm ETT placement in neonates (auscultation, colorimetric capnography, and chest x-ray) are time consuming or unreliable, especially in the stressful resuscitation environment. Point-of-care ultrasound (POCUS) of the neck has recently emerged as a powerful tool for detecting esophageal ETTs. It is accurate and fast, and is also easy to learn and perform, especially on children. Methods This will be an observational diagnostic accuracy study consisting of two phases and conducted at the Aga Khan University Hospital in Karachi, Pakistan. In phase 1, neonatal health care providers that currently perform standard-of-care methods for ETT localization, regardless of experience in portable ultrasound, will undergo a two-hour training session. During this session, providers will learn to detect tracheal vs. esophageal ETTs using POCUS. The session will consist of a didactic component, hands-on training with a novel intubation ultrasound simulator, and practice with stable, ventilated newborns. At the end of the session, the providers will undergo an objective structured assessment of technical skills, as well as an evaluation of their ability to differentiate between tracheal and esophageal endotracheal tubes. In phase 2, newborns requiring intubation will be assessed for ETT location via POCUS, at the same time as standard-of-care methods. The initial 2 months of phase 2 will include a quality assurance component to ensure the POCUS accuracy of trained providers. The primary outcome of the study is to determine the accuracy of neck POCUS for ETT location when performed by neonatal providers with focused POCUS training, and the secondary outcome is to determine whether neck POCUS is faster than standard-of-care methods. Discussion This study represents the first large investigation of the benefits of POCUS for ETT confirmation in the sickest newborns undergoing intubations for respiratory support. Trial registration ClinicalTrials.gov Identifier: NCT03533218. Registered May 2018.

scholarly journals Utility of Biomarkers in the Differential Diagnosis of Heart Failure in Older People: Findings from the Heart Failure in Care Homes (HFinCH) Diagnostic Accuracy Study

PLoS ONE ◽  
2013 ◽  
Vol 8 (1) ◽  
pp. e53560 ◽  
Author(s):  
James M. Mason ◽  
Helen C. Hancock ◽  
Helen Close ◽  
Jerry J. Murphy ◽  
Ahmet Fuat ◽  
...  
Keyword(s):  
Heart Failure ◽  
Differential Diagnosis ◽  
Older People ◽  
Diagnostic Accuracy ◽  
Care Homes ◽  
Diagnostic Accuracy Study ◽  
Accuracy Study
Sign in / Sign up

Export Citation Format

Share Document