Diagnostic Accuracy of Ultrasound in Intensive Care Patients with Undifferentiated Shock: A Systematic Review and Meta-analysis.

IF 1.5 Q3 CRITICAL CARE MEDICINE

Indian Journal of Critical Care Medicine Pub Date : 2024-12-01 Epub Date: 2024-11-30 DOI:10.5005/jp-journals-10071-24851

Lohith Karigowda, Bhavna Gupta, Hatem Elkady, Kush Deshpande

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引用次数: 0

Abstract

Purpose: This systematic review aimed to assess the accuracy of ultrasound in diagnosing shock types among intensive care patients.

Materials and methods: A comprehensive search of PubMed, Embase, Scopus, Cochrane Central Register, and Google Scholar was conducted for controlled trials published up to June 2023. Two intensivists independently screened articles for full-text reviews and abstracts, evaluating study quality using the QUADAS-2 tool. Prospective studies assessing ultrasound for diagnosing shock types in critically ill patients with undifferentiated shock were included.

Results: Among 7287 articles identified, four met the inclusion criteria for meta-analysis. Pooled positive likelihood ratios were 8.8 (95% CI: 2.4-32.37) for distributive shock and 137.56 (95% CI: 27.76-681.64) for obstructive shock. Summary receiver operating characteristic (SROC) curves showed an area under the curve (AUC) of 0.99 for cardiogenic and obstructive shock, 0.5 for hypovolemic and mixed shock, and 0.76 for distributive shock. Pooled negative likelihood ratios ranged from 0.05 (95% CI: 0.010 to 0.24) for cardiogenic shock to 0.22 (95% CI: 0.127-0.38) for mixed-etiology shock.

Conclusion: Ultrasound demonstrates high accuracy in diagnosing obstructive and cardiogenic shock among intensive care patients with undifferentiated shock. However, its utility for other shock types appears limited.

How to cite this article: Karigowda L, Gupta B, Elkady H, Deshpande K. Diagnostic Accuracy of Ultrasound in Intensive Care Patients with Undifferentiated Shock: A Systematic Review and Meta-analysis. Indian J Crit Care Med 2024;28(12):1159-1169.

查看原文本刊更多论文

超声诊断重症监护患者未分化性休克的准确性：一项系统回顾和荟萃分析。

目的：本系统综述旨在评估超声诊断重症监护患者休克类型的准确性。材料和方法：综合检索PubMed、Embase、Scopus、Cochrane Central Register和谷歌Scholar，检索截至2023年6月发表的对照试验。两名专家独立筛选文章全文综述和摘要，使用QUADAS-2工具评估研究质量。前瞻性研究评估超声诊断休克类型的危重患者未分化性休克。结果：在7287篇文献中，有4篇符合meta分析的纳入标准。分布性休克的合并阳性似然比为8.8 (95% CI: 2.4-32.37)，阻塞性休克的合并阳性似然比为137.56 （95% CI: 27.76-681.64）。综受者工作特征（SROC）曲线显示，心源性和阻塞性休克的曲线下面积（AUC）为0.99，低血容量性和混合性休克为0.5，分布性休克为0.76。心源性休克的合并负似然比为0.05 (95% CI: 0.010 ~ 0.24)，混合病因性休克的合并负似然比为0.22 （95% CI: 0.127 ~ 0.38）。结论：超声对未分化性休克重症监护患者的梗阻性和心源性休克诊断具有较高的准确性。然而，它对其他冲击类型的效用似乎有限。Karigowda L, Gupta B, Elkady H, Deshpande K.超声诊断非分化性休克的准确性：系统评价和meta分析。中华检验医学杂志；2009;28(12):1159-1169。

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来源期刊

Indian Journal of Critical Care Medicine CRITICAL CARE MEDICINE-

CiteScore

3.50

自引率

10.00%

发文量

299

期刊介绍： Indian Journal of Critical Care Medicine (ISSN 0972-5229) is specialty periodical published under the auspices of Indian Society of Critical Care Medicine. Journal encourages research, education and dissemination of knowledge in the fields of critical and emergency medicine.