Does the Integration of Personalized Ultrasound Change Patient Management in Critical Care Medicine? Observational Trials

Objective. To test the influence of personalized ultrasound (PersUS) on patient management in critical care. Design of the Study. Prospective, observational, and critical care setting. Four substudies compared PersUS and mobile ultrasound, work distribution, and diagnostic and procedural quality. Pa...

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Main Authors: Raoul Breitkreutz, Marco Campo delľ Orto, Christian Hamm, Colleen Cuca, Peter M. Zechner, Tanja Stenger, Felix Walcher, Florian H. Seeger
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Emergency Medicine International
Online Access:http://dx.doi.org/10.1155/2013/946059
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author Raoul Breitkreutz
Marco Campo delľ Orto
Christian Hamm
Colleen Cuca
Peter M. Zechner
Tanja Stenger
Felix Walcher
Florian H. Seeger
author_facet Raoul Breitkreutz
Marco Campo delľ Orto
Christian Hamm
Colleen Cuca
Peter M. Zechner
Tanja Stenger
Felix Walcher
Florian H. Seeger
author_sort Raoul Breitkreutz
collection DOAJ
description Objective. To test the influence of personalized ultrasound (PersUS) on patient management in critical care. Design of the Study. Prospective, observational, and critical care setting. Four substudies compared PersUS and mobile ultrasound, work distribution, and diagnostic and procedural quality. Patients and Interventions. 640 patient ultrasound exams including 548 focused diagnostic exams and 92 interventional procedures. Main Outcome Measures. Number of studies, physician’s judgement of feasibility, time of usage per patient, and referrals to echo lab. Results. Randomized availability of PersUS increased its application in ICU work shifts more than twofold from 33 to 68 exams mainly for detection and therapy of effusions. Diagnostic and procedural quality was rated as excellent/very good in PersUS-guided puncture in 95% of cases. Integrating PersUS within an initial physical examination of 48 randomized cases in an emergency department, PersUS extended the examination time by 100 seconds. Interestingly, PersUS integration into 53 randomized regular ward rounds of 1007 patients significantly reduced average contact time per patient by 103 seconds from 8.9 to 7.2 minutes. Moreover, it lowered the patient referral rate to an echo lab from 20% to 2% within the study population. Conclusions. We propose the development of novel ultrasound-based clinical pathways by integration of PersUS.
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spelling doaj-art-d3519412edce4f24a2162b29dedd85452025-08-20T02:19:51ZengWileyEmergency Medicine International2090-28402090-28592013-01-01201310.1155/2013/946059946059Does the Integration of Personalized Ultrasound Change Patient Management in Critical Care Medicine? Observational TrialsRaoul Breitkreutz0Marco Campo delľ Orto1Christian Hamm2Colleen Cuca3Peter M. Zechner4Tanja Stenger5Felix Walcher6Florian H. Seeger7Emergency Department, Hospital of the City of Frankfurt (Höchst), Gotenstraße 6-8, 65929 Frankfurt am Main, GermanyEmergency Ultrasound Regional Network and the Frankfurt Institute of Emergency Medicine and Simulation Training, Johann Wolfgang Goethe University Hospital, Marienburgstraße 5-7, 60528 Frankfurt am Main, GermanyDepartment of Cardiology, Kerckhoff Klinik Bad Nauheim, Benekestraße 2-8, 61231 Bad Nauheim, GermanyDeptartment of Anaesthesiology and Intensive Care, Hospital zum Heiligen Geist, Lange Straße, 60311 Frankfurt, GermanyLandeskrankenhaus Graz West, Abteilung für Innere Medizin, Göttinger Straße 22, 8020 Graz, AustriaStädtisches Klinikum Neunkirchen, Brunnenstraße 20, 66538 Neunkirchen/Saar, GermanyTrauma Surgery, Johann Wolfgang Goethe University Hospital, Theodor Stern Kai 7, 60590 Frankfurt am Main, GermanyDepartment of Cardiology, Johann Wolfgang Goethe University Hospital, Theodor Stern Kai 7, 60590 Frankfurt am Main, GermanyObjective. To test the influence of personalized ultrasound (PersUS) on patient management in critical care. Design of the Study. Prospective, observational, and critical care setting. Four substudies compared PersUS and mobile ultrasound, work distribution, and diagnostic and procedural quality. Patients and Interventions. 640 patient ultrasound exams including 548 focused diagnostic exams and 92 interventional procedures. Main Outcome Measures. Number of studies, physician’s judgement of feasibility, time of usage per patient, and referrals to echo lab. Results. Randomized availability of PersUS increased its application in ICU work shifts more than twofold from 33 to 68 exams mainly for detection and therapy of effusions. Diagnostic and procedural quality was rated as excellent/very good in PersUS-guided puncture in 95% of cases. Integrating PersUS within an initial physical examination of 48 randomized cases in an emergency department, PersUS extended the examination time by 100 seconds. Interestingly, PersUS integration into 53 randomized regular ward rounds of 1007 patients significantly reduced average contact time per patient by 103 seconds from 8.9 to 7.2 minutes. Moreover, it lowered the patient referral rate to an echo lab from 20% to 2% within the study population. Conclusions. We propose the development of novel ultrasound-based clinical pathways by integration of PersUS.http://dx.doi.org/10.1155/2013/946059
spellingShingle Raoul Breitkreutz
Marco Campo delľ Orto
Christian Hamm
Colleen Cuca
Peter M. Zechner
Tanja Stenger
Felix Walcher
Florian H. Seeger
Does the Integration of Personalized Ultrasound Change Patient Management in Critical Care Medicine? Observational Trials
Emergency Medicine International
title Does the Integration of Personalized Ultrasound Change Patient Management in Critical Care Medicine? Observational Trials
title_full Does the Integration of Personalized Ultrasound Change Patient Management in Critical Care Medicine? Observational Trials
title_fullStr Does the Integration of Personalized Ultrasound Change Patient Management in Critical Care Medicine? Observational Trials
title_full_unstemmed Does the Integration of Personalized Ultrasound Change Patient Management in Critical Care Medicine? Observational Trials
title_short Does the Integration of Personalized Ultrasound Change Patient Management in Critical Care Medicine? Observational Trials
title_sort does the integration of personalized ultrasound change patient management in critical care medicine observational trials
url http://dx.doi.org/10.1155/2013/946059
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