Abstract:
Acute respiratory failure (ARF) is a challenging condition that clinicians, especially in emergency settings, have to face frequently. Especially in emergency settings, many underlying diseases can lead to ARF and life-threatening conditions have to be promptly assessed and correctly treated to avoid unfavorable outcomes. In recent years, point-of-care ultrasound (POCUS) gained growing consideration due to its bedside utilization, reliability and reproducibility even in emergency settings especially in unstable patients. Research on POCUS application to assess ARF has been largely reported mainly with observational studies showing heterogeneous results from many different applications. This narrative review describes the wide potentiality of POCUS to face airways and breathing life-threatening conditions such as upper airway management, pulmonary and pleural pathologies and diaphragm impairment. We conducted extensive research of the literature to report from major studies to case reports deemed useful in practical clinical utilization of POCUS in ARF. Due to the huge amount of the literature found, we focused on airways and breathing assessment trying to systematize the evidence according to clinical care of ARF in emergency settings. Further studies, possibly trials, should determine how POCUS is crucial in clinical practice in terms of standard of care improvements, patient safety and cost-benefit analysis.
摘要:
急性呼吸衰竭(ARF)是一种具有挑战性的疾病,尤其是在紧急情况下,必须经常面对。尤其是在紧急情况下,许多基础疾病可导致ARF,威胁生命的疾病必须及时评估和正确治疗,以避免不良结局.近年来,由于床边使用,护理点超声(POCUS)得到了越来越多的考虑,可靠性和可重复性,即使在紧急情况下,特别是在不稳定的患者。关于POCUS应用于评估ARF的研究已被大量报道,主要是观察性研究显示来自许多不同应用的异质结果。这篇叙述性综述描述了POCUS在面对气道和呼吸威胁生命的情况(如上呼吸道管理)方面的广泛潜力,肺和胸膜病变和膈肌损伤。我们对文献进行了广泛的研究,从主要研究到案例报告,这些报告被认为对ARF中POCUS的实际临床利用有用。由于发现了大量的文献,我们关注的重点是气道和呼吸评估,试图根据急诊ARF的临床护理将证据系统化.进一步研究,可能是试验,应该确定POCUS在临床实践中如何在护理改进标准方面至关重要,患者安全和成本效益分析。