Evidence : ICU Resources
Article Citation
Pontet, J., Yic, C., Díaz-Gómez, J.L. et al. Impact of an ultrasound-driven diagnostic protocol at early intensive-care stay: a randomized-controlled trial. Ultrasound J 11, 24 (2019)
Study Hypothesis
Routine use of methodic, multisystemic ultrasound protocol in critically ill patients at admission to the intensive-care unit (ICU) reduces utilization of diagnostic resources and consultation and time to definitive diagnosis and tracheal extubation.
Methods
Multi-center prospective randomized controlled study
Participants recruited in 2017
Inclusion: Patients > 18years requiring mechanical ventilation
Block randomization to POCUS group vs conventional group
Results
Patient demographics were similar between 2 groups
Lower utilization of resources in the POCUS group – less radiological, formal ultrasound & CT scan requests.
Delay to performing first ultrasound was significantly reduced in the POCUS group.
Fluid balance was much lower in POCUS group compared to cobentional.
Lower duration of mechanical ventilation in POCUS group, however no difference in mortality between groups. Tendency for decreases length of ICU stay in POCUS group.
Study Conclusions
POCUS use in ICU leads to significantly reduced utilisation of radiological investigations. The direct clinical implications of the study findings were associated with lower radiation exposure, less intra-hospital transportation of unstable patients, and inherent economic savings with more sophisticated evaluations, including in improved imaging suites workflow and reduced necessity for personnel to transport patient
Limitations
- Small sample size of 80 patients
- Only the first 5 days of ICU stay analyzed
Reference
Pontet, J., Yic, C., Díaz-Gómez, J.L. et al. Impact of an ultrasound-driven diagnostic protocol at early intensive-care stay: a randomized-controlled trial. Ultrasound J 11, 24 (2019)