Effect of Focused Cardiac Ultrasound in Combination with Lung Ultrasound on Critically Ill Patients: A Multicenter Observational Study in China.

Hong-Min Zhang, Lina Zhang, Li-Xia Liu, Ying Zhu, Wan-Hong Yin, Wei He, Xiu-Ling Shang, Yan-Gong Chao, Li-Wen Lv, Xiao-Ting Wang, Da-Wei Liu
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Abstract

Objective Focused cardiac ultrasound (FCU) and lung ultrasound (LU) are increasingly being used in critically ill patients. This study aimed to investigate the effect of FCU in combination with LU on these patients and to determine if the timing of ultrasound examination was associated with treatment change. Methods This is a multicenter cross-sectional observational study. Consecutive patients admitted to the intensive care unit (ICU) were screened for enrollment. FCU and LU were performed within the first 24 h, and treatment change was proposed by the performer based on the ultrasound results and other clinical conditions. Results Among the 992 patients included, 502 were examined within 6 h of ICU admission (early phase group), and 490 were examined after 6 h of admission (later phase group). The early phase group and the later phase group had similar proportions of treatment change (48.8% vs. 49.0%, χ 2=0.003, P=0.956). In the multivariable analysis, admission for respiratory failure was an independent variable associated with treatment change, with an odds ratio (OR) of 2.357 [95% confidence interval (CI): 1.284-4.326, P=0.006]; the timing of examination was not associated with treatment change (OR=0.725, 95%CI: 0.407-1.291, P=0.275). Conclusions FCU in combination with LU, whether performed during the early phase or later phase, had a significant impact on the treatment of critically ill patients. Patients with respiratory failure were more likely to experience treatment change after the ultrasound examination.

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聚焦心脏超声联合肺超声对危重病人的疗效:中国一项多中心观察研究。
目的聚焦心脏超声(FCU)和肺超声(LU)在危重患者中的应用越来越广泛。本研究旨在探讨FCU联合LU对这些患者的影响,并确定超声检查的时间是否与治疗改变有关。方法采用多中心横断面观察性研究。连续入住重症监护病房(ICU)的患者被筛选入组。FCU和LU在前24 h内进行,由术者根据超声结果及其他临床情况提出治疗方案的改变。结果纳入的992例患者中,入院6 h内检查502例(早期组),入院6 h后检查490例(晚期组)。早期组与晚期组治疗改变比例相近(48.8% vs 49.0%, χ 2=0.003, P=0.956)。在多变量分析中,因呼吸衰竭入院是与治疗改变相关的独立变量,比值比(OR)为2.357[95%可信区间(CI): 1.284-4.326, P=0.006];检查时间与治疗改变无关(OR=0.725, 95%CI: 0.407-1.291, P=0.275)。结论FCU联合LU无论是在早期还是后期实施,对危重患者的治疗均有显著影响。呼吸衰竭患者在超声检查后更容易改变治疗方法。
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