Impact of point-of-care ultrasound on the hospital length of stay for internal medicine inpatients with cardiopulmonary diagnosis at admission: study protocol of a randomized controlled trial—the IMFCU-1 (Internal Medicine Focused Clinical Ultrasound) study
Abstract Background Point-of-care ultrasound (POCUS) is emerging as a reliable and valid clinical tool that impacts diagnosis and clinical decision-making as well as timely intervention for optimal patient management. This makes its utility in patients admitted to internal medicine wards attractive....
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| Format: | Article |
| Language: | English |
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BMC
2020-01-01
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| Series: | Trials |
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| Online Access: | https://doi.org/10.1186/s13063-019-4003-2 |
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| author | Ximena Cid David Canty Alistair Royse Andrea B. Maier Douglas Johnson Doa El-Ansary Sandy Clarke-Errey Timothy Fazio Colin Royse |
| author_facet | Ximena Cid David Canty Alistair Royse Andrea B. Maier Douglas Johnson Doa El-Ansary Sandy Clarke-Errey Timothy Fazio Colin Royse |
| author_sort | Ximena Cid |
| collection | DOAJ |
| description | Abstract Background Point-of-care ultrasound (POCUS) is emerging as a reliable and valid clinical tool that impacts diagnosis and clinical decision-making as well as timely intervention for optimal patient management. This makes its utility in patients admitted to internal medicine wards attractive. However, there is still an evidence gap in all the medical setting of how its use affects clinical variables such as length of stay, morbidity, and mortality. Methods/design A prospective randomized controlled trial assessing the effect of a surface POCUS of the heart, lungs, and femoral and popliteal veins performed by an internal medicine physician during the first 24 h of patient admission to the unit with a presumptive cardiopulmonary diagnosis. The University of Melbourne iHeartScan, iLungScan, and two-point venous compression protocols are followed to identify left and right ventricular function, significant valvular heart disease, pericardial and pleural effusion, consolidation, pulmonary edema, pneumothorax, and proximal deep venous thrombosis. Patient management is not commanded by the protocol and is at the discretion of the treating team. A total of 250 patients will be recruited at one tertiary hospital. Participants are randomized to receive POCUS or no POCUS. The primary outcome measured will be hospital length of stay. Secondary outcomes include the change in diagnosis and management, 30-day hospital readmission, and healthcare costs. Discussion This study will evaluate the clinical impact of multi-organ POCUS in internal medicine patients admitted with cardiopulmonary diagnosis on the hospital length of stay. Recruitment of participants commenced in September 2018 and is estimated to be completed by March 2020. Trial registration Australian and New Zealand Clinical Trial Registry, ACTRN12618001442291. Registered on 28 August 2018. |
| first_indexed | 2024-12-14T10:25:02Z |
| format | Article |
| id | doaj.art-c993c20a610f4da7a76002461d8edd67 |
| institution | Directory Open Access Journal |
| issn | 1745-6215 |
| language | English |
| last_indexed | 2024-12-14T10:25:02Z |
| publishDate | 2020-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Trials |
| spelling | doaj.art-c993c20a610f4da7a76002461d8edd672022-12-21T23:06:22ZengBMCTrials1745-62152020-01-0121111510.1186/s13063-019-4003-2Impact of point-of-care ultrasound on the hospital length of stay for internal medicine inpatients with cardiopulmonary diagnosis at admission: study protocol of a randomized controlled trial—the IMFCU-1 (Internal Medicine Focused Clinical Ultrasound) studyXimena Cid0David Canty1Alistair Royse2Andrea B. Maier3Douglas Johnson4Doa El-Ansary5Sandy Clarke-Errey6Timothy Fazio7Colin Royse8Department of Surgery, University of MelbourneDepartment of Surgery, University of MelbourneDepartment of Surgery, University of MelbourneDepartment of Medicine and Community Care, Royal Melbourne HospitalDepartment of Medicine and Community Care, Royal Melbourne HospitalDepartment of Surgery, University of MelbourneStatistical Consulting Centre, University of MelbourneBusiness Intelligence Unit, Melbourne HealthDepartment of Surgery, University of MelbourneAbstract Background Point-of-care ultrasound (POCUS) is emerging as a reliable and valid clinical tool that impacts diagnosis and clinical decision-making as well as timely intervention for optimal patient management. This makes its utility in patients admitted to internal medicine wards attractive. However, there is still an evidence gap in all the medical setting of how its use affects clinical variables such as length of stay, morbidity, and mortality. Methods/design A prospective randomized controlled trial assessing the effect of a surface POCUS of the heart, lungs, and femoral and popliteal veins performed by an internal medicine physician during the first 24 h of patient admission to the unit with a presumptive cardiopulmonary diagnosis. The University of Melbourne iHeartScan, iLungScan, and two-point venous compression protocols are followed to identify left and right ventricular function, significant valvular heart disease, pericardial and pleural effusion, consolidation, pulmonary edema, pneumothorax, and proximal deep venous thrombosis. Patient management is not commanded by the protocol and is at the discretion of the treating team. A total of 250 patients will be recruited at one tertiary hospital. Participants are randomized to receive POCUS or no POCUS. The primary outcome measured will be hospital length of stay. Secondary outcomes include the change in diagnosis and management, 30-day hospital readmission, and healthcare costs. Discussion This study will evaluate the clinical impact of multi-organ POCUS in internal medicine patients admitted with cardiopulmonary diagnosis on the hospital length of stay. Recruitment of participants commenced in September 2018 and is estimated to be completed by March 2020. Trial registration Australian and New Zealand Clinical Trial Registry, ACTRN12618001442291. Registered on 28 August 2018.https://doi.org/10.1186/s13063-019-4003-2Randomized controlled trialEchocardiographyFocused assessment sonographyLung ultrasoundInternal medicine |
| spellingShingle | Ximena Cid David Canty Alistair Royse Andrea B. Maier Douglas Johnson Doa El-Ansary Sandy Clarke-Errey Timothy Fazio Colin Royse Impact of point-of-care ultrasound on the hospital length of stay for internal medicine inpatients with cardiopulmonary diagnosis at admission: study protocol of a randomized controlled trial—the IMFCU-1 (Internal Medicine Focused Clinical Ultrasound) study Trials Randomized controlled trial Echocardiography Focused assessment sonography Lung ultrasound Internal medicine |
| title | Impact of point-of-care ultrasound on the hospital length of stay for internal medicine inpatients with cardiopulmonary diagnosis at admission: study protocol of a randomized controlled trial—the IMFCU-1 (Internal Medicine Focused Clinical Ultrasound) study |
| title_full | Impact of point-of-care ultrasound on the hospital length of stay for internal medicine inpatients with cardiopulmonary diagnosis at admission: study protocol of a randomized controlled trial—the IMFCU-1 (Internal Medicine Focused Clinical Ultrasound) study |
| title_fullStr | Impact of point-of-care ultrasound on the hospital length of stay for internal medicine inpatients with cardiopulmonary diagnosis at admission: study protocol of a randomized controlled trial—the IMFCU-1 (Internal Medicine Focused Clinical Ultrasound) study |
| title_full_unstemmed | Impact of point-of-care ultrasound on the hospital length of stay for internal medicine inpatients with cardiopulmonary diagnosis at admission: study protocol of a randomized controlled trial—the IMFCU-1 (Internal Medicine Focused Clinical Ultrasound) study |
| title_short | Impact of point-of-care ultrasound on the hospital length of stay for internal medicine inpatients with cardiopulmonary diagnosis at admission: study protocol of a randomized controlled trial—the IMFCU-1 (Internal Medicine Focused Clinical Ultrasound) study |
| title_sort | impact of point of care ultrasound on the hospital length of stay for internal medicine inpatients with cardiopulmonary diagnosis at admission study protocol of a randomized controlled trial the imfcu 1 internal medicine focused clinical ultrasound study |
| topic | Randomized controlled trial Echocardiography Focused assessment sonography Lung ultrasound Internal medicine |
| url | https://doi.org/10.1186/s13063-019-4003-2 |
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