Point-of-care focused lung ultrasound in emergency medicine: Protocol for a scoping review

Forfattere

  • Stig Holm Ovesen Research Center for Emergency Medicine, Aarhus University Hospital and Aarhus University, Denmark AND Emergency Department, Horsens Regional Hospital, Denmark https://orcid.org/0000-0003-3815-2141
  • Andreas Hvilshøj Clausen Emergency Department, Horsens Regional Hospital, Denmark
  • Hans Kirkegaard Research Center for Emergency Medicine, Emergency Department, Aarhus University Hospital, Denmark AND Research Center for Emergency Medicine, Department of Clinical Medicine Aarhus University, Denmark
  • Bo Løfgren Department of Internal Medicine, Randers Regional Hospital, Denmark AND Research Center for Emergency Medicine, Aarhus University Hospital and Aarhus University, Denmark
  • Rasmus Aagaard Department of Anesthesiology, Randers Regional Hospital, Denmark AND Research Center for Emergency Medicine, Aarhus University Hospital and Aarhus University, Denmark
  • Søren Helbo Skaarup Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Denmark
  • Jesper Weile Department of Emergency Medicine, Aarhus University Hospital, Denmark AND Research Center for Emergency Medicine, Aarhus University Hospital and Aarhus University, Denmark AND Emergency Department, Horsens Regional Hospital, Denmark

DOI:

https://doi.org/10.7146/akut.v5i2.131570

Nøgleord:

Emergency medicine, Point-of-care ultrasound, Lung ultrasound

Resumé

Baggrund

Point-of-care fokuseret lungeultralyd er en central kompetence i akutmedicin. Meta-analyser for diagnostiske studier af point-of-care fokuseret lungeultralyd har vist lovende diagnostiske resultater for pneumothorax, pleura effusion, interstitielt syndrom, lungeemboli og pneumoni. Men manglende evidens på patient-nære endemål og et fåtal af randomiserede kontrollerede studier synes at være begrænsende for den videre implementering af point-of-care ultralyd.

En metodisk kortlægning af eksisterende studier indenfor et forskningsfelt kan vejlede fremtidige forskningsindsatser. Formålet med dette review er at give et overblik over original forskning i point-of-care fokuseret lungeultralyd i akutmedicin med særlig vægt på studiedesign og patient-relevansen af endemål.

Metoder

Reviewet designes som et scoping review og det vil inkludere originale studier i point-of-care fokuseret lungeultralyd til voksne patienter i akutafdelinger. Reviewet vil fokusere på point-of-care fokuseret lungeultralyd; studier i fyldestgørende thorakal ultralyd er uden for denne afgrænsning (f.eks. ultralydsundersøgelser som vurderer mediastinale lymfeknuder, diafragma bevægelse, kontrast- eller procedure lunge ultralyd). Vi vil ekskludere studier uden tilgængeligt engelsk manuskript. Grå litteratur og udelukkende kvalitative studier vil ikke blive inkluderet. Reviews, protokoller, meta-analyser, case artikler, letters, og konference abstrakts vil blive ekskluderet.

Dataudtrækket vil inkludere adskillige metodiske og sonografiske karakteristika (f.eks. sampling metoden [lejlighedsvis/fortløbende], diagnostisk rolle af ultralyd [triage, tillæg, erstatning], antal af sonografører, sonograførernes ekspertise [træning og erfaring] og sonograførernes rolle [behandlende læge eller forsker]. Den narrative syntese af alle inkluderede studier vil blive gennemført med særlig vægt på studie designs og patient-relevans af endemål. Figurer og diagrammer vil opsummere tidsmæssige tendenser, metode karakteristika og endemål.

Diskussion

Dette scoping review vil tilbyde et overblik som systematiske reviews ikke kan sammenfatte eller kortlægge. Kortlægningen af studie designs og patient-relevans af endemål vil vejlede fremtidige studier og systematiske reviews i forsøget på at vejlede klinikere og patienter til den mest hensigtsmæssige brug af point-of-care fokuseret lungeultralyd i akutmedicin. Reviewet vil også biddrage med et overblik over område-specifikke metodiske og sonografiske karakteristika, som gør det muligt for andre forskere at identificere de utilstrækkeligheder, som bør opgives, og de fremskridt som bør dyrkes.

Referencer

Ultrasound guidelines: emergency, point-of-care and clinical ultrasound guidelines in medicine. Ann Emerg Med. 2017;69(5):e27–e54. DOI: 10.1016/j.annemergmed.2016.08.457

Lewis D, Rang L, Kim D, Robichaud L, Kwan C, Pham C, et al. Recommendations for the use of point-of-care ultrasound (POCUS) by emergency physicians in Canada. CJEM. 2019;21(6):721–6. DOI: 10.1017/cem.2019.392

Laursen CB, Nielsen K, Riishede M, Tiwald G, Møllekær A, Aagaard R, et al. A framework for implementation, education, research and clinical use of ultrasound in emergency departments by the Danish Society for Emergency Medicine. Scand J Trauma Resusc Emerg Med. 2014;22(1):25. DOI: 10.1186/1757-7241-22-25

Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein DA, Mathis G, Kirkpatrick AW, et al. International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012;38(4):577–91. DOI: 10.1007/s00134-012-2513-4

Díaz-Gómez JL, Mayo PH, Koenig SJ. Point-of-care ultrasonography. N Engl J Med. 2021;385(17):1593–602. DOI: 10.1056/NEJMra1916062

Weile J, Brix J, Moellekaer AB. Is point-of-care ultrasound disruptive innovation? Formulating why POCUS is different from conventional comprehensive ultrasound. Crit Ultrasound J. 2018;10(1):25. DOI: 10.1186/s13089-018-0106-3

Moore CL, Copel JA. Current concepts: point-of-care ultrasonography. N Engl J Med. 2011;364(8):749–57. DOI: 10.1056/NEJMra0909487

Al Deeb M, Barbic S, Featherstone R, Dankoff J, Barbic D. Point-of-care ultrasonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: a systematic review and meta-analysis. Acad Emerg Med. 2014;21(8):843–52. DOI: 10.1111/acem.12435

Alrajhi K, Woo MY, Vaillancourt C. Test characteristics of ultrasonography for the detection of pneumothorax. Chest. 2012;141(3):703–8. DOI: 10.1378/chest.11-0131

Yousefifard M, Baikpour M, Ghelichkhani P, Asady H, Shahsavari Nia K, Moghadas Jafari A, et al. Screening performance characteristic of ultrasonography and radiography in detection of pleural effusion; a meta-analysis. Emergency (Tehran, Iran). 2016;4(1):1–10.

Falster C, Jacobsen N, Coman KE, Højlund M, Gaist TA, Posth S, et al. Diagnostic accuracy of focused deep venous, lung, cardiac and multiorgan ultrasound in suspected pulmonary embolism: a systematic review and meta-analysis. Thorax. Published Online First: 08 September 2021. DOI: 10.1136/thoraxjnl-2021-216838

Orso D, Guglielmo N, Copetti R. Lung ultrasound in diagnosing pneumonia in the emergency department: a systematic review and meta-analysis. Eur J Emerg Med. 2018;25(5). DOI: 10.1097/mej.0000000000000517

Wang M, Luo X, Wang L, Estill J, Lv M, Zhu Y, et al. A comparison of lung ultrasound and computed tomography in the diagnosis of patients with COVID-19: a systematic review and meta-analysis. Diagnostics. 2021;11(8):1351. DOI: 10.3390/diagnostics11081351

Volpicelli G, Gargani L, Perlini S, Spinelli S, Barbieri G, Lanotte A, et al. Lung ultrasound for the early diagnosis of COVID-19 pneumonia: an international multicenter study. Intensive Care Med. 2021;47(4):444–54. DOI: 10.1007/s00134-021-06373-7

Laursen CB, Sloth E, Lassen AT, Christensen Rd, Lambrechtsen J, Madsen PH, et al. Point-of-care ultrasonography in patients admitted with respiratory symptoms: a single-blind, randomised controlled trial. Lancet Respir Med. 2014;2(8):638–46. DOI: 10.1016/s2213-2600(14)70135-3

Pivetta E, Goffi A, Nazerian P, Castagno D, Tozzetti C, Tizzani P, et al. Lung ultrasound integrated with clinical assessment for the diagnosis of acute decompensated heart failure in the emergency department: a randomized controlled trial. J Heart Fail. 2019;21(6):754–66. DOI: 10.1002/ejhf.1379

Baker K, Brierley S, Kinnear F, Isoardi K, Livesay G, Stieler G, et al. Implementation study reporting diagnostic accuracy, outcomes and costs in a multicentre randomised controlled trial of non-expert lung ultrasound to detect pulmonary oedema. Emerg Med Australas. 2020;32(1):45–53. DOI: 10.1111/1742-6723.13333

Gartlehner G, Wagner G, Affengruber L, Chapman A, Dobrescu A, Klerings I, et al. Point-of-care ultrasonography in patients with acute dyspnea: an evidence report for a clinical practice guideline by the American College of Physicians. Ann Intern Med. 2021;174(7):967–76. DOI: 10.7326/M20-5504.

Chauvin A, Bossuyt P, Le Conte P. Clinical ultrasound not centered on patients has questionable value. Eur J Emerg Med. 2022;29(2). DOI: 10.1097/mej.0000000000000876

Daffos Q, Hansconrad E, Plaisance P, Pateron D, Yordanov Y, Chauvin A. Methodological characteristics of randomized controlled trials of ultrasonography in emergency medicine: a review. Am J Emerg Med. 2019;37(2):338-43. DOI: 10.1016/j.ajem.2018.11.017

Bayram B, Limon Ö, Limon G, Hanci V. Bibliometric analysis of top 100 most-cited clinical studies on ultrasound in the emergency department. Am J Emerg Med. 2016;34(7):1210–6. DOI: 10.1016/j.ajem.2016.03.033

Fryback DG, Thornbury JR. The efficacy of diagnostic imaging. Med Decis Making. 1991;11(2):88–94. DOI: 10.1177/0272989x9101100203

Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol. 2018;18(1):143. DOI: 10.1186/s12874-018-0611-x

Peters MD, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015;13(3):141–6. DOI: 10.1097/xeb.000000000000005

Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for coping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467–73. DOI: 10.7326/m18-0850.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. DOI: 10.1371/journal.pmed.1000097

Provenzale JM, Shah K, Patel U, McCrory DC. Systematic review of CT and MR perfusion imaging for assessment of acute cerebrovascular disease. AJNR Am J Neuroradiol. 2008;29(8):1476–82. DOI: 10.3174/ajnr.A1161

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Publiceret

05-09-2022

Citation/Eksport

Ovesen, S. H., Clausen, A. H. ., Kirkegaard, H. ., Løfgren, B. ., Aagaard, R. ., Skaarup, S. H. ., & Weile, J. . (2022). Point-of-care focused lung ultrasound in emergency medicine: Protocol for a scoping review. Dansk Tidsskrift for Akutmedicin, 5(2), 16–22. https://doi.org/10.7146/akut.v5i2.131570

Nummer

Årg. 5 Nr. 2 (2022): August nummer 2022

Sektion

Korte protokolartikler

Licens

Ophavsretten deles mellem forfatter og tidsskrift.