D Lichtenstein1, O Axler. 1. Medical Intensive Care Unit, Hôpital Ambroise-Paré, Boulogne, France.
Abstract
OBJECTIVE: To assess the impact of systematic ultrasound (US) examination in patients admitted to the ICU. DESIGN: An observational study of 150 consecutive patients. SETTING: A medical ICU of a University-affiliated hospital. PATIENTS: All consecutively admitted patients were examined, but patients discharged within < 48 h were excluded from the analysis. INTERVENTIONS: A systematic examination of the abdomen, pleural space, cervical and femoral vein, was performed at the bedside by the same investigator. MEASUREMENTS: Results of US examinations were compared to findings from CT-scan, surgery, endoscopic procedures, autopsy, or other diagnostic tests. The impact of U.S. findings on immediate patients management was evaluated. RESULTS: In 33 of 150 patients (22%), U.S. findings influenced the diagnosis, work up of the patients, and had a direct impact on the therapeutic plan. In 30/33 cases, confirmation of diagnosis was obtained by another diagnostic and/or therapeutic procedure. CONCLUSIONS: Routine US examination may alter therapeutic plans in up to 1/4 of critically ill patients admitted to the ICU. US examination should be liberally performed on such patients.
OBJECTIVE: To assess the impact of systematic ultrasound (US) examination in patients admitted to the ICU. DESIGN: An observational study of 150 consecutive patients. SETTING: A medical ICU of a University-affiliated hospital. PATIENTS: All consecutively admitted patients were examined, but patients discharged within < 48 h were excluded from the analysis. INTERVENTIONS: A systematic examination of the abdomen, pleural space, cervical and femoral vein, was performed at the bedside by the same investigator. MEASUREMENTS: Results of US examinations were compared to findings from CT-scan, surgery, endoscopic procedures, autopsy, or other diagnostic tests. The impact of U.S. findings on immediate patients management was evaluated. RESULTS: In 33 of 150 patients (22%), U.S. findings influenced the diagnosis, work up of the patients, and had a direct impact on the therapeutic plan. In 30/33 cases, confirmation of diagnosis was obtained by another diagnostic and/or therapeutic procedure. CONCLUSIONS: Routine US examination may alter therapeutic plans in up to 1/4 of critically ill patients admitted to the ICU. US examination should be liberally performed on such patients.
Authors: Doris Schacherer; Frank Klebl; Daniela Goetz; Roland Buettner; Stephanie Zierhut; Juergen Schoelmerich; Julia Langgartner Journal: Intensive Care Med Date: 2007-03-16 Impact factor: 17.440