Bedside Lung Ultrasonography by Nurses in Acute Dyspnea. (LUS)

Bedside Lung Ultrasonography by Emergency Department Nurses as an Aid for Identifying Heart Failure in Patients With Acute Dyspnea

This study assesses the potential of lung ultrasonography to diagnose heart failure.

Study Overview

• Status: Completed
• Conditions: Dyspnea; Cardiac
• Intervention / Treatment: Diagnostic test: we perform a lung ultrasound to all the patients admitted for dyspnea independantly from the final diagnosis

Detailed Description

Dyspnea is one of the most distressing situations for the patient . Emergency cases do not always present in conditions that are ideal for immediate diagnosis, which sometimes compromises outcome. Physical examination, laboratory findings and radiography are imperfect, resulting in a need for sophisticated test results that delay management.

Lung ultrasonography is becoming a standard tool in critical cases in the ED.

the investigators aim to perform ultrasonography on consecutive patients admitted to the ICU with dyspnea, comparing lung ultrasonography results on initial presentation with the final diagnosis by the nurses.

Three items were assessed: artifacts (horizontal A lines or vertical B lines indicating interstitial syndrome), lung sliding, and alveolar consolidation and/or pleural effusion, these items were grouped to assess ultrasound profiles.

the study aimed to evaluate the accuracy and reproducibility of B-lines testing assessed by emergency nurses after 12-h training in the diagnosis of HF in patients admitted to the emergency department with acute dyspnea.

• Study Type: Observational
• Enrollment (Actual): 216

Contacts and Locations

Study Locations

• Tunisia
  • Monastir, Tunisia, 5000
    • Nouira Semir

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

A convenience sampling approach, including all patients admitted to the ED for acute dyspnea as chief complaint, was used.

Description

Inclusion Criteria:

• non traumatic dyspnea with the final diagnosis of heart failure

Exclusion Criteria:

• age less than 18 years
• impossibility to give consent to participate in the study
• post-traumatic dyspnea
• pregnant women
• need for endotracheal intubation or inotropic drugs
• patients who were deemed too unstable for sonography by the treating team

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
nurses; ED nurses trained to perform LUS and blinded to the final diagnosis	Diagnostic test: we perform a lung ultrasound to all the patients admitted for dyspnea independantly from the final diagnosis; Patients were placed in a semi-recumbent or supine position depending on their respiratory tolerance. For each side of the chest, 4 zones have to be assessed : 2 anterior and 2 lateral. The operator should calculate the number of B-lines when present .; Other Names: lus
emergency physician; certified emergency physician who had accomplished a full mentoring program for "Ultra-Sound Life Support".	Diagnostic test: we perform a lung ultrasound to all the patients admitted for dyspnea independantly from the final diagnosis; Patients were placed in a semi-recumbent or supine position depending on their respiratory tolerance. For each side of the chest, 4 zones have to be assessed : 2 anterior and 2 lateral. The operator should calculate the number of B-lines when present .; Other Names: lus

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
the accuracy of LUS performed by nurses in the diagnosis of heart failure	the accuracy of LUS in the diagnosis of heart failure measured by sensitivity .	0 days
the Specificity of LUS by nurses in the diagnosis of heart failure	the accuracy of LUS in the diagnosis of heart failure measured by specificity.	0 days
the reproducibility of LUS in by nurses the diagnosis of heart failure	the accuracy of LUS in the diagnosis of heart failure measured by area under the roc curve	0 days
Agreement between nurses and expert's	Agreement between nurses and expert's interpretation was assessed by kappa agreement index for ordinal LUS scale classification	0 days

Collaborators and Investigators

• Sponsor: University of Monastir

Study record dates

Study Major Dates

• Study Start (ACTUAL): January 1, 2018
• Primary Completion (ACTUAL): January 31, 2019
• Study Completion (ACTUAL): January 31, 2019

Study Registration Dates

• First Submitted: September 29, 2021
• First Submitted That Met QC Criteria: November 8, 2021
• First Posted (ACTUAL): November 19, 2021

Study Record Updates

• Last Update Posted (ACTUAL): November 19, 2021
• Last Update Submitted That Met QC Criteria: November 8, 2021
• Last Verified: November 1, 2021

More Information

Terms related to this study

• Keywords: Lung ultrasound; heart failure; diagnosis; accuracy; nurses
• Additional Relevant MeSH Terms: Respiratory Tract Diseases; Respiration Disorders; Signs and Symptoms, Respiratory; Dyspnea
• Other Study ID Numbers: LR12SP18

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No