An interventional study of POCUS protocol group and Control group in Point of Care Ultrasound, sponsored by Asociacion Española Primera en Salud. Completed at 1 site in Uruguay. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-04-19.
Sponsored by Asociacion Española Primera en Salud · Not applicable, Interventional, and Diagnostic
Ultrasound is a widely used tool for clinicians to manage severe acute patients, seeking to improve the limitations of traditional physical examination and special studies that require patient transfers and can be harmful. This study aims to determine that a pre-established protocol of multiorganic point-of-care ultrasound can be beneficial performed systematically in a critical care patient, improving the diagnosis, detecting hidden anomalies, generating changes in therapy and guiding interventions. A multicenter, randomized controlled clinical trial, against a conventional therapy group is designed. The study group underwent an ultrasound protocol at the entrance of an ICU, of optic, pulmonary, cardiac, abdominal and guide of interventions.
Exclusion Criteria:
POCUS protocol group It will be submitted to an ultrasound protocol which consists in performing the following ultrasound studies in each patient: Measurement of the diameter of the optic nerve. Neck. Pulmonary ultrasound (LUS score). Echocardiogram (function and volemia). Abdomen. Femoral vascular package. Eco-guided interventionism. Central venous accesses (controlling positioning with saline injection under ultrasound), arterial, pleural or abdominal drainage and percutaneous tracheotomy will be performed under ultrasound.
Behavioral: POCUS protocol group
The usual handling will be followed. The studies will only be performed if the medical team-treating team considers it, requesting a radiologist specialist the same, as is done routinely.
Other: Control group
The findings of multiorgan ultrasound can modify diagnoses and treatments and immediate interventions (eg volume loading with saline solution, pleural or pericardial drainage, initiation of diuretics, increase in positive end expiratory pressure, etc.). This protocol is performed in the first 24 h of admission to the Intensive Care Unit (ICU) and is repeated at 24 h.
Routine protocol of the treating team is followed
Changes in diagnosis and treatment by point of care ultrasound
REGISTER OF (In terms of frequency): IN DIAGNOSIS: * Does not modify the initial diagnosis but confirms it * Induces a change in initial diagnosis * Discover an unknown initial diagnosis * Does not modify the initial diagnosis, does not discard or confirm anything and does not change the treatment that is done. * Induces a wrong diagnosis and leads to an error. IN TREATMENT: * Determines the performance of an urgent interventional diagnostic maneuver * Determines the performance of an urgent medical or pharmacological therapeutic maneuver of the ICU. * Determines the performance of an urgent interventional or surgical therapeutic maneuver
Time frame: Up to 7 days
Definitive diagnosis
Delay in performing definitive diagnosis (hours)
Time frame: Up to 7 days
ICU extra requirements
Requests for imaging studies (Number per patient)
Time frame: Up to 7 days
Interventions
Number and type of procedures or interventions performed on the patient (Number per patient)
Time frame: Up to 7 days
Delay times
Delay between the treatment decision and its actual completion (eg pleural drainage) (in hours)
Time frame: Up to 7 days
Duration of mechanical ventilation
Time of invasive mechanical ventilation (days)
Time frame: Up to 30 days
ICU stay
Internment time in ICU (days)
Time frame: Up to 30 days
Mortality
Death rate (percentage)
Time frame: Up to 30 days
Plan to share: Yes — Clinical and variable data of multiorganic focal ultrasonography
This study is completed, as verified in Apr 2022. You cannot join it, but the record below documents what was studied.
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