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Point-of-Care Ultrasonography in a Pulmonary Hypertension Clinic: A Randomized Pilot Study

Pulmonary arterial hypertension (PAH) is a rare condition with the potential to progress to right heart failure. Point-of-Care Ultrasonography (POCUS), used and interpreted in real time at the bedside to further the cardiopulmonary assessment, has the potential to improve the longitudinal care of PA...

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Autores principales: Avriel, Avital, Bar Lavie Shay, Anat, Hershko Klement, Anat, Taylor, Jonathan, Shamia, David, Tsaban, Gal, Abu-Shakra, Mahmoud, Granton, John, Fuchs, Lior
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10003668/
https://www.ncbi.nlm.nih.gov/pubmed/36902536
http://dx.doi.org/10.3390/jcm12051752
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author Avriel, Avital
Bar Lavie Shay, Anat
Hershko Klement, Anat
Taylor, Jonathan
Shamia, David
Tsaban, Gal
Abu-Shakra, Mahmoud
Granton, John
Fuchs, Lior
author_facet Avriel, Avital
Bar Lavie Shay, Anat
Hershko Klement, Anat
Taylor, Jonathan
Shamia, David
Tsaban, Gal
Abu-Shakra, Mahmoud
Granton, John
Fuchs, Lior
author_sort Avriel, Avital
collection PubMed
description Pulmonary arterial hypertension (PAH) is a rare condition with the potential to progress to right heart failure. Point-of-Care Ultrasonography (POCUS), used and interpreted in real time at the bedside to further the cardiopulmonary assessment, has the potential to improve the longitudinal care of PAH patients in the ambulatory setting. Patients from PAH clinics at two academic medical centers were randomized to either a POCUS assessment cohort or non-POCUS standard care (ClinicalTrials.gov identifier NCT05332847). The POCUS group received blinded heart, lung, and vascular ultrasound assessments. Thirty-six patients were randomized to the study and followed over time. Mean age was 65 in both groups and majority female (76.5% and 88.9% females in POCUS and control, respectively). Median time for POCUS assessment was 11 min (range 8–16). There were significantly more changes in management in the POCUS group than control (73% vs. 27%, p-value < 0.001). Multivariate analysis revealed that management changes were more likely to occur with a POCUS assessment, with an odds ratio (OR) of 12 when POCUS was added to physical exam vs. OR of 4.6 compared to physical examination alone (p < 0.001). POCUS in the PAH clinic is feasible and, when combined with physical examination, increases the number of findings and results in changes in management without significantly prolonging visit encounters. POCUS may help support clinical evaluation and decision making in ambulatory PAH clinics.
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spelling pubmed-100036682023-03-11 Point-of-Care Ultrasonography in a Pulmonary Hypertension Clinic: A Randomized Pilot Study Avriel, Avital Bar Lavie Shay, Anat Hershko Klement, Anat Taylor, Jonathan Shamia, David Tsaban, Gal Abu-Shakra, Mahmoud Granton, John Fuchs, Lior J Clin Med Article Pulmonary arterial hypertension (PAH) is a rare condition with the potential to progress to right heart failure. Point-of-Care Ultrasonography (POCUS), used and interpreted in real time at the bedside to further the cardiopulmonary assessment, has the potential to improve the longitudinal care of PAH patients in the ambulatory setting. Patients from PAH clinics at two academic medical centers were randomized to either a POCUS assessment cohort or non-POCUS standard care (ClinicalTrials.gov identifier NCT05332847). The POCUS group received blinded heart, lung, and vascular ultrasound assessments. Thirty-six patients were randomized to the study and followed over time. Mean age was 65 in both groups and majority female (76.5% and 88.9% females in POCUS and control, respectively). Median time for POCUS assessment was 11 min (range 8–16). There were significantly more changes in management in the POCUS group than control (73% vs. 27%, p-value < 0.001). Multivariate analysis revealed that management changes were more likely to occur with a POCUS assessment, with an odds ratio (OR) of 12 when POCUS was added to physical exam vs. OR of 4.6 compared to physical examination alone (p < 0.001). POCUS in the PAH clinic is feasible and, when combined with physical examination, increases the number of findings and results in changes in management without significantly prolonging visit encounters. POCUS may help support clinical evaluation and decision making in ambulatory PAH clinics. MDPI 2023-02-22 /pmc/articles/PMC10003668/ /pubmed/36902536 http://dx.doi.org/10.3390/jcm12051752 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Avriel, Avital
Bar Lavie Shay, Anat
Hershko Klement, Anat
Taylor, Jonathan
Shamia, David
Tsaban, Gal
Abu-Shakra, Mahmoud
Granton, John
Fuchs, Lior
Point-of-Care Ultrasonography in a Pulmonary Hypertension Clinic: A Randomized Pilot Study
title Point-of-Care Ultrasonography in a Pulmonary Hypertension Clinic: A Randomized Pilot Study
title_full Point-of-Care Ultrasonography in a Pulmonary Hypertension Clinic: A Randomized Pilot Study
title_fullStr Point-of-Care Ultrasonography in a Pulmonary Hypertension Clinic: A Randomized Pilot Study
title_full_unstemmed Point-of-Care Ultrasonography in a Pulmonary Hypertension Clinic: A Randomized Pilot Study
title_short Point-of-Care Ultrasonography in a Pulmonary Hypertension Clinic: A Randomized Pilot Study
title_sort point-of-care ultrasonography in a pulmonary hypertension clinic: a randomized pilot study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10003668/
https://www.ncbi.nlm.nih.gov/pubmed/36902536
http://dx.doi.org/10.3390/jcm12051752
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