An interventional study of diagnostic strategy based on lung and cardiac ultrasonography in Dyspnea and Respiratory Distress Syndrome, sponsored by University Hospital, Toulouse. Recruiting at 1 site in France. Open to participants aged 65 Years and older. Per ClinicalTrials.gov, last updated 2025-12-04.
Sponsored by University Hospital, Toulouse · Not applicable, Interventional, and Diagnostic
Prospective trial to evaluate the impact on the initial therapeutic inadequacy of a management strategy for acute dyspnea in the elderly based on the use of lung and cardiac ultrasonography.
Acute dyspnea is a frequent and serious reason of admission in Emergency Department (ED), with a one-month mortality close to 16%. It is difficult to diagnose in the initial assessment phase since the cause of this symptom can vary (cardiological, pulmonary, infectious, etc.) and the symptoms can be misleading. This difficulty in diagnosing delays the implementation of appropriate therapeutic management even as the timeliness of management is associated with a reduction in mortality. These issues are particularly important in the elderly.
Lung and cardiac ultrasonography performed by the emergency physician, immediately available at the patient's bedside, could reduce the diagnostic and therefore therapeutic delay.
However, the impact of a diagnostic strategy based on lung and cardiac ultrasonography in dyspneic elderly subjects has not been evaluated.
Patients will be randomized in two groups : "standard of care" or "clinical ultrasound" group. Treatments initiated in Emergency Department (ED) will be noted to be compared to final diagnosis.
655 studies on the registry are indexed under Dyspnea; 153 are open to participants now.
This study's planned enrollment of 504 is above the median of 48 across 429 interventional studies indexed under Dyspnea.
Browse Dyspnea studies →University Hospital, Toulouse is the lead sponsor of 794 studies on the registry; 214 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Eligible patients will be aged over 65 years, affiliated with the French social security system, and presenting to the ED with acute dyspnea (onset \<14 days) accompanied by severity signs before or at triage (respiratory rate ≥22 and SpO2 \<92% on room air). The enrolling emergency physician (EP) must be the patient's treating physician and must be trained in LuCUS. Written informed consent from the patient or their legal representative is required for inclusion
Exclusion Criteria:
dyspnea secondary to thoracic trauma, dyspnea clearly related to COVID-19, known pulmonary fibrosis or lung cancer, prior administration of specific treatment for dyspnea before inclusion, immediate need for endotracheal intubation, patients identified as being at end-of-life, and individuals under legal guardianship or deprived of liberty.
diagnostic strategy based on the protocolized implementation of clinical lung and cardiac ultrasonography, with a proposed diagnostic and therapeutic focus based on the results.
Diagnostic Test: diagnostic strategy based on lung and cardiac ultrasonography
diagnostic and therapeutic strategy based on the usual practices of the department and the clinician
cardiopulmonary ultrasound performed by the emergency physician, immediately at patient's bed
therapeutic inadequacy
therapeutic inadequacy between initiated emergency treatments and the final diagnosis made by expert opinion
Time frame: Hour 1
correct diagnosis
correct diagnosis at the emergency department discharge (compared with final diagnosis made by expert opinion)
Time frame: emergency department discharge (up to hour 4)
duration of emergency department stay
duration in emergency department (in hours)
Time frame: emergency department discharge (up to hour 4)
Post-emergency hospital stay
duration in Post-emergency hospital department: in medicine/surgery/obstetrics or follow-up and rehabilitation care (in days)
Time frame: Day 30
Number of days alive outside hospital between D0 and D30
Number of days alive outside hospital between D0 and D30
Time frame: Day 30
Care cost
Care cost - Direct and indirect medical cost looking at French social security spendings for patients
Time frame: Day 30
Plan to share: No
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University Hospital, Toulouse