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Observational Study
. 2023 Mar 1;51(3):357-364.
doi: 10.1097/CCM.0000000000005760. Epub 2022 Dec 23.

The Impact of Thoracic Ultrasound on Clinical Management of Critically Ill Patients (UltraMan): An International Prospective Observational Study

Micah L A Heldeweg  1   2 , Jorge E Lopez Matta  2   3 , Luigi Pisani  4 , Stefanie Slot  5 , Mark E Haaksma  1   2 , Jasper M Smit  1   2 , Amne Mousa  1   2 , Giovanna Magnesa  4 , Fabrizia Massaro  4 , Hugo R W Touw  2   6 , Viviane Schouten  5 , Carlos V Elzo Kraemer  2   3 , David J van Westerloo  2   3 , Leo M A Heunks  1 , Pieter R Tuinman  1   2
Affiliations
Observational Study

The Impact of Thoracic Ultrasound on Clinical Management of Critically Ill Patients (UltraMan): An International Prospective Observational Study

Micah L A Heldeweg et al. Crit Care Med. .

Abstract

Objectives: To investigate the impact of thoracic ultrasound (TUS) examinations on clinical management in adult ICU patients.

Design: A prospective international observational study.

Setting: Four centers in The Netherlands and Italy.

Patients: Adult ICU patients (> 18 yr) that received a clinically indicated lung ultrasound examination.

Interventions: None.

Measurements and main results: Clinicians performing TUS completed a pre- and post-examination case report form. Patient characteristics, TUS, and resulting clinical effects were recorded. First, change of management, defined as a TUS-induced change in clinical impression leading to a change in treatment plan, was reported. Second, execution of intended management changes within 8 hours was verified. Third, change in fluid balance after 8 hours was calculated. A total of 725 TUS performed by 111 operators across 534 patients (mean age 63 ± 15.0, 70% male) were included. Almost half of TUS caused a change in clinical impression, which resulted in change of management in 39% of cases. The remainder of TUS confirmed the clinical impression, while a minority (4%) did not contribute. Eighty-nine percent of management changes indicated by TUS were executed within 8 hours. TUS examinations that led to a change in fluid management also led to distinct and appropriate changes in patient's fluid balance.

Conclusions: In this international observational study in adult ICU patients, use of TUS had a major impact on clinical management. These results provide grounds for future randomized controlled trials to determine if TUS-induced changes in decision-making also lead to improved health outcomes.

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Conflict of interest statement

Dr. Heunks’ institution received funding from Liberate Medical; he received funding from Getinge and the American Thoracic Society. The remaining authors have disclosed that they do not have any potential conflicts of interest.

Comment in

  • From Pac-Man to UltraMan.
    Graham JD, Grissom CK. Graham JD, et al. Crit Care Med. 2023 Mar 1;51(3):415-418. doi: 10.1097/CCM.0000000000005777. Epub 2023 Feb 21. Crit Care Med. 2023. PMID: 36809263 No abstract available.

References

    1. Solomon SD, Saldana F: Point-of-care ultrasound in medical education--stop listening and look. N Engl J Med. 2014; 370:1083–1085
    1. Corcoran JP, Tazi-Mezalek R, Maldonado F, et al.: State of the art thoracic ultrasound: Intervention and therapeutics. Thorax. 2017; 72:840–849
    1. Mayo PH, Copetti R, Feller-Kopman D, et al.: Thoracic ultrasonography: A narrative review. Intensive Care Med. 2019; 45:1200–1211
    1. Koh Y, Chua MT, Ho WH, et al.: Assessment of dyspneic patients in the emergency department using point-of-care lung and cardiac ultrasonography-a prospective observational study. J Thorac Dis. 2018; 10:6221–6229
    1. Mongodi S, Orlando A, Arisi E, et al.: Lung ultrasound in patients with acute respiratory failure reduces conventional imaging and health care provider exposure to COVID-19. Ultrasound Med Biol. 2020; 46:2090–2093

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