Impact of focused cardiac and lung ultrasound screening performed by a junior doctor during admission to the surgical ward on patients before emergency non‐cardiac surgery: A pilot prospective observational study
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Le résumé fourni par la source
Purpose: To assess whether pre-operative focused cardiac ultrasound and lung ultrasound screening performed by a junior doctor can change diagnosis and clinical management of patients aged ≥65 years undergoing emergency, non-cardiac surgery. Method: This pilot prospective observational study included patients scheduled for emergency, non-cardiac surgery. The treating team completed a diagnosis and management plan before and after focused cardiac and lung ultrasound, which was performed by a junior doctor. Changes to diagnosis and management after ultrasound were recorded. Ultrasound images were assessed for image and diagnostic interpretation by an independent expert. Results: There was a total of 57 patients at age 77 ± 8 years. Cardiopulmonary pathology was suspected after clinical assessment in 28% vs. 72% after ultrasound (including abnormal haemodynamic state in 61%, valvular lesions in 32%, acute pulmonary oedema/interstitial syndrome in 9% and bilateral pleural effusions in 2%). In 67% of patients, the perioperative management was changed. The changes were in fluid therapy in 30%, cardiology consultation in 7%, formal in- or out-patient, transthoracic echocardiography in 11% and 30% respectively. Discussion: The impact of pre-operative focused cardiac and lung ultrasound on diagnosis and management of patients on the hospital ward before emergency non-cardiac surgery by a junior doctor was comparable to previous studies of anaesthetists experienced in focused ultrasound. However, the ability to recognise when image quality is insufficient for diagnosis is an important consideration for novice sonographers. Conclusions: Focused cardiac and lung ultrasound examination by a junior doctor is feasible and may change preoperative diagnosis and management in patients of 65 years or older, admitted for emergency non-cardiac surgery.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Impact of focused cardiac and lung ultrasound screening performed by a junior doctor during admission to the surgical ward on patients before emergency non‐cardiac surgery: A pilot prospective observational study
- Date Crossref
- 13/10/2022
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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The Royal Melbourne Hospital Department of Anaesthesia and Pain Management pays non établi dans la noticeOrganisme public
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The University of Melbourne Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
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Monash Health pays non établi dans la noticeÉtablissement de santé
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Monash University Department of Medicine pays non établi dans la noticeUniversité ou école supérieure
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Cleveland Clinic Outcomes Research Consortium pays non établi dans la noticeÉtablissement de santé
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Outcomes Research Consortium pays non établi dans la noticeOrganisation à but non lucratif
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Footscray Hospital pays non établi dans la noticeÉtablissement de santé
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Western Hospital Intensive Care Unit pays non établi dans la noticeÉtablissement de santé
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Copenhagen University Hospital Department of Anaesthesia pays non établi dans la noticeÉtablissement de santé
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Rigshospitalet pays non établi dans la noticeÉtablissement de santé
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Department of Anaesthesia and Pain Management Royal Melbourne Hospital Parkville Victoria Australia pays non établi dans la noticeÉtablissement de santé
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Department of Surgery University of Melbourne Melbourne Victoria Australia pays non établi dans la noticeUniversité ou école supérieure
Department of Anaesthesia and Pain Management — The Royal Melbourne Hospital, Department of Surgery — The University of Melbourne et Monash Health, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.