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Master Thesis

Apport de l'échographie ultraportable dans l'évaluation initiale des patients admis aux urgences pour dyspnée

Abstract : Interest of cardiovascular screening by pocket-size ultrasound in patients with dyspnea in the emergency setting. Introduction: We aimed to determine the diagnostic accuracy of the ED doctor, the cardiologist and the resident in cardiology using a pocket-size ultrasound as an additional tool, versus the final diagnosis, in patients referred for dyspnea in the ED. Methods: Between February 2014 and April 2014, patients presenting at emergency room in the ED with dyspnea were included. They underwent physical examination, ECG, routine laboratory tests including BNP and chest X-ray. The ED doctor and cardiologist gave their diagnosis based on these data. The resident in cardiology performed an examination using pocket-size ultrasound (US) and gave his diagnosis, blinded from the previous diagnoses. Sensitivity, specificity, negative (NPV) and positive predictive values (PPV) of the 3 primary diagnoses were compared to the diagnosis at the time of hospital discharge. Results: Thirty patients (18 men, 42.6 ± 14.6 years) were included in this pilot study. Final diagnosis was heart failure in 20 patients, infectious pneumonitis in 2 patients, mixed cardio-respiratory decompensation in 2 patients, pulmonary embolism in 4 patients and other diagnosis in 2 patients. For the diagnosis of heart failure, the ED doctor had a sensitivity, specificity, NPV and PPV values of 50.0, 90.0, 90.9 and 47.4% respectively; the cardiologist had 80.0, 90.0, 94.1 and 69.2%; and the resident in cardiology with pocket-size ultrasound had 100, 90.0, 95.2 and 100% respectively. Conclusions: Our pilot study demonstrated that the use of pocket-size ultrasound in patients with dyspnea in the ED improved the diagnostic accuracy of the cause of acute dyspnea.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01208514
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Submitted on : Friday, October 2, 2015 - 4:57:10 PM
Last modification on : Friday, October 23, 2020 - 4:33:03 PM
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  • HAL Id : dumas-01208514, version 1

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Charlotte Castelain Poulizac. Apport de l'échographie ultraportable dans l'évaluation initiale des patients admis aux urgences pour dyspnée. Médecine humaine et pathologie. 2015. ⟨dumas-01208514⟩

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