Telemedicine ultrasound in intensive care unit: A pilot diagnostic accuracy study.

IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Emanuele König Klever, Gabriela de Oliveira Laguna Silva, Mariana Motta Dias da Silva, Jacqueline Castro da Rocha, Márcio Gustavo Santanna da Silva, Maria Eulália Vinadé Chagas, Jerusa da Rosa de Amorim, Aristóteles de Almeida Pires, Daniella Cunha Birriel, Hilda Maria Rodrigues Moleda Constant, Taís de Campos Moreira, Felipe Cezar Cabral
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引用次数: 0

Abstract

Introduction: Digital health is an opportune way of facilitating the implementation of point-of-care ultrasound (POCUS) in intensive care units (ICUs) of the Brazilian Unified Health System (SUS) through remote tele-mentored ultrasound (RTMUS). Therefore, this pilot diagnostic accuracy study aims to evaluate the sensitivity and specificity of RTMUS, using POCUS as the gold standard for the diagnosis of pulmonary oedema. As a secondary objective, these metrics will be assessed for pneumonia, chronic obstructive pulmonary disease (COPD), pneumothorax, pulmonary embolism, and cardiac tamponade.

Methods: The study was conducted in three adult ICUs, monitored by the TeleUTI project, and included 23 patients who underwent POCUS carried out by an ICU medical professional and RTMUS carried out by a tele-intensivist from the institution that proposed the project.

Results: The accuracy in diagnosing pulmonary oedema was 71.43%, COPD 89.96%, and for pneumonia, the results showed an accuracy of 65.22%. Analyses demonstrated that RTMUS has the same capability as POCUS for detecting true positive cases of pulmonary oedema, the same results of true negative cases for COPD, and a limitation in performance for pneumonia.

Conclusions: For COPD and pulmonary oedema, remote examination can support healthcare teams, suggesting that RTMUS has the potential to be a substitute for POCUS. We emphasise that the results should be interpreted within the context of the study, which is considered small and should be validated on a larger scale to consolidate the conclusions.

重症监护室的远程医疗超声检查:诊断准确性试点研究。
简介在巴西统一医疗系统(SUS)的重症监护病房(ICU)中,通过远程遥控超声波检查(RTMUS),数字医疗是促进护理点超声波检查(POCUS)实施的一个有利途径。因此,这项诊断准确性试点研究旨在评估 RTMUS 的灵敏度和特异性,并将 POCUS 作为诊断肺水肿的金标准。作为次要目标,这些指标还将评估肺炎、慢性阻塞性肺疾病(COPD)、气胸、肺栓塞和心脏填塞:这项研究在三个成人重症监护病房进行,由远程UTI项目进行监控,包括23名患者,由重症监护病房的专业医生进行POCUS检查,并由提出该项目的机构的远程重症监护医生进行RTMUS检查:肺水肿的诊断准确率为 71.43%,慢性阻塞性肺病的诊断准确率为 89.96%,肺炎的诊断准确率为 65.22%。分析表明,RTMUS 检测肺水肿真阳性病例的能力与 POCUS 相同,检测慢性阻塞性肺病真阴性病例的结果与 POCUS 相同,而检测肺炎的能力有限:结论:对于慢性阻塞性肺病和肺水肿,远程检查可为医疗团队提供支持,这表明 RTMUS 有潜力替代 POCUS。我们强调,应在研究范围内解释这些结果,因为研究规模较小,应在更大范围内进行验证,以巩固结论。
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来源期刊
Ultrasound
Ultrasound RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
1.70
自引率
0.00%
发文量
55
期刊介绍: Ultrasound is the official journal of the British Medical Ultrasound Society (BMUS), a multidisciplinary, charitable society comprising radiologists, obstetricians, sonographers, physicists and veterinarians amongst others.
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