Abstract：
OBJECTIVE: Diaphragm and lung ultrasound (DLUS) is emerging as an important point-of-care respiratory assessment tool and is being used in clinical care by trained respiratory physiotherapists, both in Australia and internationally. However, the impact of DLUS on physiotherapists\' clinical decision-making remains largely unknown. This systematic review aims to review the evidence for implementing DLUS in acute respiratory physiotherapy management.
METHODS: We conducted a systematic review.
METHODS: We searched PubMed, Embase, CINAHL, CENTRAL, and Scopus from inception to 18th April 2023 for all original clinical studies reporting on the physiotherapy clinical decision-making, following a DLUS examination and/or where DLUS was used to evaluate the effect of respiratory physiotherapy, in adults over 18 years of age.
METHODS: Two authors independently performed study selection and data extraction. Individual study risk of bias was assessed using the Newcastle-Ottawa Scale, and certainty in outcomes was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations framework.
RESULTS: A total of seven observational studies (n = 299) were included, all of which were in the intensive care setting. DLUS changed physiotherapy diagnosis, management, and treatment in 63.9% (50-64%), 16.8% (15-50%), and 48.4% (25-50%) of patients, respectively. There was a significant improvement in the lung ultrasound score post respiratory physiotherapy treatment (mean difference -2.31, 95% Confidence Interval (95% CI) -4.42 to -0.21; very low certainty) compared to before respiratory physiotherapy treatment. Moderate risk of bias was present in six studies, and there was variance in the DLUS methodology across included studies.
CONCLUSIONS: The findings of this review suggest DLUS influences physiotherapy clinical decision-making and can be used to evaluate the effects of acute respiratory physiotherapy treatment. However, the available data is limited, and further high-quality studies are needed.
BACKGROUND: This study is registered with the International Prospective Register of Systematic Reviews; CRD42023418312.
METHODS: We conducted a systematic review.
METHODS: We searched PubMed, Embase, CINAHL, CENTRAL, and Scopus from inception to 18th April 2023 for all original clinical studies reporting on the physiotherapy clinical decision-making, following a DLUS examination and/or where DLUS was used to evaluate the effect of respiratory physiotherapy, in adults over 18 years of age.
METHODS: Two authors independently performed study selection and data extraction. Individual study risk of bias was assessed using the Newcastle-Ottawa Scale, and certainty in outcomes was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations framework.
RESULTS: A total of seven observational studies (n = 299) were included, all of which were in the intensive care setting. DLUS changed physiotherapy diagnosis, management, and treatment in 63.9% (50-64%), 16.8% (15-50%), and 48.4% (25-50%) of patients, respectively. There was a significant improvement in the lung ultrasound score post respiratory physiotherapy treatment (mean difference -2.31, 95% Confidence Interval (95% CI) -4.42 to -0.21; very low certainty) compared to before respiratory physiotherapy treatment. Moderate risk of bias was present in six studies, and there was variance in the DLUS methodology across included studies.
CONCLUSIONS: The findings of this review suggest DLUS influences physiotherapy clinical decision-making and can be used to evaluate the effects of acute respiratory physiotherapy treatment. However, the available data is limited, and further high-quality studies are needed.
BACKGROUND: This study is registered with the International Prospective Register of Systematic Reviews; CRD42023418312.
摘要：
目的：隔膜和肺部超声（DLUS）正在成为一种重要的护理点呼吸评估工具，并被训练有素的呼吸物理治疗师用于临床护理，在澳大利亚和国际上。然而,DLUS对物理治疗师临床决策的影响在很大程度上仍然未知.本系统评价旨在回顾在急性呼吸理疗管理中实施DLUS的证据。
方法：我们进行了系统评价。
方法：我们搜索了PubMed，Embase,CINAHL,中部,和Scopus从开始到2023年4月18日，用于所有关于物理治疗临床决策的原始临床研究报告，在进行DLUS检查和/或使用DLUS评估呼吸理疗效果后，18岁以上的成年人。
方法：两位作者独立进行研究选择和数据提取。使用纽卡斯尔-渥太华量表评估个体研究偏倚风险，结果的确定性使用建议分级进行评估，评估,发展,和评估框架。
结果：共纳入7项观察性研究（n=299），所有这些都在重症监护病房。DLUS改变了物理治疗诊断，管理,治疗率为63.9%(50-64%)，16.8%（15-50%），和48.4％（25-50％）的患者，分别。与呼吸物理治疗前相比，呼吸物理治疗后的肺部超声评分显着改善（平均差异-2.31，95％置信区间（95％CI）-4.42至-0.21；确定性非常低）。在六项研究中存在中等偏倚风险，纳入研究的DLUS方法存在差异。
结论：这篇综述的结果表明，DLUS影响物理治疗的临床决策，可用于评估急性呼吸道物理治疗的效果。然而,可用数据有限，需要进一步的高质量研究。
背景：本研究已在国际前瞻性系统审查注册中心CRD42023418312注册。
方法：我们进行了系统评价。
方法：我们搜索了PubMed，Embase,CINAHL,中部,和Scopus从开始到2023年4月18日，用于所有关于物理治疗临床决策的原始临床研究报告，在进行DLUS检查和/或使用DLUS评估呼吸理疗效果后，18岁以上的成年人。
方法：两位作者独立进行研究选择和数据提取。使用纽卡斯尔-渥太华量表评估个体研究偏倚风险，结果的确定性使用建议分级进行评估，评估,发展,和评估框架。
结果：共纳入7项观察性研究（n=299），所有这些都在重症监护病房。DLUS改变了物理治疗诊断，管理,治疗率为63.9%(50-64%)，16.8%（15-50%），和48.4％（25-50％）的患者，分别。与呼吸物理治疗前相比，呼吸物理治疗后的肺部超声评分显着改善（平均差异-2.31，95％置信区间（95％CI）-4.42至-0.21；确定性非常低）。在六项研究中存在中等偏倚风险，纳入研究的DLUS方法存在差异。
结论：这篇综述的结果表明，DLUS影响物理治疗的临床决策，可用于评估急性呼吸道物理治疗的效果。然而,可用数据有限，需要进一步的高质量研究。
背景：本研究已在国际前瞻性系统审查注册中心CRD42023418312注册。
