Utility of Point of Care Ultrasound (POCUS) in Early Diagnosis of Shock and Its Correlation with Multiple Biomarkers
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 180
- 试验地点
- 1
研究概览
简要总结
Shock is a life threatening condition commonly encountered in critically ill patients and requires rapid identification of its underlying cause for timely management. Early differentiation between various types of shock is often difficult at the bedside using clinical examination alone. Point of care ultrasound using the RUSH protocol and biochemical markers such as lactate NT proBNP and INR may help in early diagnosis and classification of shock.
This prospective observational study was conducted in the Department of Critical Care Medicine at RIMS Ranchi. Adult patients who developed shock during ICU stay were enrolled. Shock was defined as systolic blood pressure less than 90 mmHg with a shock index greater than 1. As soon as shock was identified a bedside ultrasound examination was performed using the RUSH protocol and blood samples were simultaneously collected for estimation of lactate NT proBNP and INR.
The RUSH protocol findings and biomarker values obtained at the time of initial shock recognition were used to identify the type of shock. The final diagnosis of shock was established later based on detailed clinical evaluation laboratory investigations imaging studies and response to treatment. Diagnostic performance of lactate NT proBNP INR and RUSH protocol was assessed using ROC curve analysis and optimal cutoff values for biomarkers were determined using Youdens index.
The study aims to evaluate and compare the diagnostic utility of bedside ultrasound and commonly available biomarkers in early identification and differentiation of various types of shock. The findings of this study may help clinicians in rapid decision making and improve early management of shock in critical care settings.
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 18.00 Year(s) 至 75.00 Year(s)（—）
- 性别
- All
入选标准
- •Age more than 18 years.
- •Patients with clinical features of circulatory shock (criteria of shock consisted of hypotension (systolic blood pressure less than 90 mm Hg) or a 30-mmHg fall in baseline blood pressure) with one or more signs of organ hypoperfusion- cool extremities, confusion or altered mental status, heart rate more than 100, respiratory rate more than
- •urine output less than 0.5 mL/kg/h for the previous 6 h, or blood lactate more than 2 mmol/l).
- •Further laboratory findings that supported the diagnosis of shock include lactate more than 2 mmol/L, base deficit less than 4 mEq/L, and Paco2 less than 32 mm Hg. Shock index more than
- •Shock index (SI) is defined as the heart rate (HR) divided by systolic blood pressure (SBP).
排除标准
- •Pregnant patients.
- •Patients with circulatory shock secondary to trauma.
- •Patients already have ascites and pleural effusion because of known chronic diseases.
研究者
Dr Jag Mohan Kumar
Rajendra Institute of Medical Sciences