Emergency department point-of-care ultrasonography improves time to pericardiocentesis for clinically significant effusions
Objective Our objective was to determine the utility of point-of-care ultrasound (POCUS) to identify and guide treatment of tamponade or clinically significant pericardial effusions in the emergency department (ED). Methods This was a retrospective cohort study of non-trauma patients who were diagno...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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The Korean Society of Emergency Medicine
2017-09-01
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| Series: | Clinical and Experimental Emergency Medicine |
| Subjects: | |
| Online Access: | http://www.ceemjournal.org/upload/pdf/ceem-16-169.pdf |
| _version_ | 1797895588439654400 |
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| author | Evan Avraham Alpert Uri Amit Larisa Guranda Rafea Mahagna Shamai A. Grossman Ariel Bentancur |
| author_facet | Evan Avraham Alpert Uri Amit Larisa Guranda Rafea Mahagna Shamai A. Grossman Ariel Bentancur |
| author_sort | Evan Avraham Alpert |
| collection | DOAJ |
| description | Objective Our objective was to determine the utility of point-of-care ultrasound (POCUS) to identify and guide treatment of tamponade or clinically significant pericardial effusions in the emergency department (ED). Methods This was a retrospective cohort study of non-trauma patients who were diagnosed with large pericardial effusions or tamponade by the ED physician using POCUS. The control group was composed of those patients later diagnosed on the medical wards or incidentally in the ED by other means such as a computed tomography. The following data were abstracted from the patient’s file: demographics, medical background, electrocardiogram results, chest radiograph readings, echocardiogram results, and patient outcomes. Results There were 18 patients in the POCUS arm and 55 in the control group. The POCUS arm had a decreased time to pericardiocentesis (11.3 vs. 70.2 hours, P=0.055) as well as a shorter length of stay (5.1 vs. 7.0 days, P=0.222). A decreased volume of pericardial fluid was drained (661 vs. 826 mL, P=0.139) in the group diagnosed by POCUS. Conclusion This study suggests that POCUS may effectively identify pericardial effusions and guide appropriate treatment, leading to a decreased time to pericardiocentesis and decreased length of hospital stay. Pericardial tamponade or a large pericardial effusion should be considered in all patients presenting to the ED with clinical, radiographic, or electrocardiographic signs of cardiovascular compromise. |
| first_indexed | 2024-04-10T07:29:22Z |
| format | Article |
| id | doaj.art-0118197fa3184dff923fd29a61d47b9c |
| institution | Directory Open Access Journal |
| issn | 2383-4625 |
| language | English |
| last_indexed | 2024-04-10T07:29:22Z |
| publishDate | 2017-09-01 |
| publisher | The Korean Society of Emergency Medicine |
| record_format | Article |
| series | Clinical and Experimental Emergency Medicine |
| spelling | doaj.art-0118197fa3184dff923fd29a61d47b9c2023-02-24T00:01:38ZengThe Korean Society of Emergency MedicineClinical and Experimental Emergency Medicine2383-46252017-09-014312813210.15441/ceem.16.169143Emergency department point-of-care ultrasonography improves time to pericardiocentesis for clinically significant effusionsEvan Avraham Alpert0Uri Amit1Larisa Guranda2Rafea Mahagna3Shamai A. Grossman4Ariel Bentancur5 Department of Emergency Medicine, Sheba Medical Center, Tel Hashomer, Israel Neufeld Cardiac Research Institute, Sheba Medical Center, Tel-Aviv University, Tel Hashomer, Israel Department of Radiology, Sheba Medical Center, Tel Hashomer, Israel Department of Emergency Medicine, Sheba Medical Center, Tel Hashomer, Israel Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA Department of Emergency Medicine, Sheba Medical Center, Tel Hashomer, IsraelObjective Our objective was to determine the utility of point-of-care ultrasound (POCUS) to identify and guide treatment of tamponade or clinically significant pericardial effusions in the emergency department (ED). Methods This was a retrospective cohort study of non-trauma patients who were diagnosed with large pericardial effusions or tamponade by the ED physician using POCUS. The control group was composed of those patients later diagnosed on the medical wards or incidentally in the ED by other means such as a computed tomography. The following data were abstracted from the patient’s file: demographics, medical background, electrocardiogram results, chest radiograph readings, echocardiogram results, and patient outcomes. Results There were 18 patients in the POCUS arm and 55 in the control group. The POCUS arm had a decreased time to pericardiocentesis (11.3 vs. 70.2 hours, P=0.055) as well as a shorter length of stay (5.1 vs. 7.0 days, P=0.222). A decreased volume of pericardial fluid was drained (661 vs. 826 mL, P=0.139) in the group diagnosed by POCUS. Conclusion This study suggests that POCUS may effectively identify pericardial effusions and guide appropriate treatment, leading to a decreased time to pericardiocentesis and decreased length of hospital stay. Pericardial tamponade or a large pericardial effusion should be considered in all patients presenting to the ED with clinical, radiographic, or electrocardiographic signs of cardiovascular compromise.http://www.ceemjournal.org/upload/pdf/ceem-16-169.pdfcardiac tamponadeultrasonographyemergencies |
| spellingShingle | Evan Avraham Alpert Uri Amit Larisa Guranda Rafea Mahagna Shamai A. Grossman Ariel Bentancur Emergency department point-of-care ultrasonography improves time to pericardiocentesis for clinically significant effusions Clinical and Experimental Emergency Medicine cardiac tamponade ultrasonography emergencies |
| title | Emergency department point-of-care ultrasonography improves time to pericardiocentesis for clinically significant effusions |
| title_full | Emergency department point-of-care ultrasonography improves time to pericardiocentesis for clinically significant effusions |
| title_fullStr | Emergency department point-of-care ultrasonography improves time to pericardiocentesis for clinically significant effusions |
| title_full_unstemmed | Emergency department point-of-care ultrasonography improves time to pericardiocentesis for clinically significant effusions |
| title_short | Emergency department point-of-care ultrasonography improves time to pericardiocentesis for clinically significant effusions |
| title_sort | emergency department point of care ultrasonography improves time to pericardiocentesis for clinically significant effusions |
| topic | cardiac tamponade ultrasonography emergencies |
| url | http://www.ceemjournal.org/upload/pdf/ceem-16-169.pdf |
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