PDF(Pubmed)
Abstract：
UNASSIGNED: Thoracic ultrasound is a valuable tool that helps diagnose cardiopulmonary disorders and guide management in intensive care unit patients. Intensive care unit nurses were trained to perform thoracic ultrasound examinations, after which they were named \'UltraNurses\' for clinical recognizability. UltraNurses demonstrated rapid learning trajectories, but the impact on clinical-decision making remained unknown. The aim of this study was to investigate the effects of UltraNurse ultrasound on clinical management.
UNASSIGNED: This was a prospective observational single center study within a mixed medical and surgical intensive care unit. All adult patients with an indication for UltraNurse thoracic ultrasound were included. The study consisted of three steps: pre- and post- data collection, with the ultrasound examination conducted in-between these two steps. The examination consisted of a standardized ultrasound protocol aimed at the lungs and cardiac output. Primary outcome was what percentage of ultrasounds led to a change of management. Secondary outcomes included: percentage of changes executed within first 8 hours, frequency of pathology found, percentage of diagnosis change, and frequency of UltraNurse ultrasounds per shift.
UNASSIGNED: A total of 102 ultrasound examinations were performed in 65 patients (89% mechanically-ventilated). Ultrasound examinations suggested changes of management in 26% of cases, of which 96% were executed within 8 hours. Most changes were within the nursing scope (56%), specifically: 44% of examinations changed fluid management. UltraNurse ultrasound detected pathology in 97% of cases. In 7% of cases, the diagnosis was changed, sometimes leading to life-saving interventions. UltraNurses performed one thoracic ultrasound examination per four shifts.
UNASSIGNED: In adult intensive care unit patients, UltraNurse thoracic ultrasound led to a change of management in more than a quarter of the cases, of which almost all were executed within the first 8 hours.
UNASSIGNED: Netherlands Trial Registration NL9047, VUmc 2020.011 (prospectively registered on: 13-11-2020).
UNASSIGNED: This was a prospective observational single center study within a mixed medical and surgical intensive care unit. All adult patients with an indication for UltraNurse thoracic ultrasound were included. The study consisted of three steps: pre- and post- data collection, with the ultrasound examination conducted in-between these two steps. The examination consisted of a standardized ultrasound protocol aimed at the lungs and cardiac output. Primary outcome was what percentage of ultrasounds led to a change of management. Secondary outcomes included: percentage of changes executed within first 8 hours, frequency of pathology found, percentage of diagnosis change, and frequency of UltraNurse ultrasounds per shift.
UNASSIGNED: A total of 102 ultrasound examinations were performed in 65 patients (89% mechanically-ventilated). Ultrasound examinations suggested changes of management in 26% of cases, of which 96% were executed within 8 hours. Most changes were within the nursing scope (56%), specifically: 44% of examinations changed fluid management. UltraNurse ultrasound detected pathology in 97% of cases. In 7% of cases, the diagnosis was changed, sometimes leading to life-saving interventions. UltraNurses performed one thoracic ultrasound examination per four shifts.
UNASSIGNED: In adult intensive care unit patients, UltraNurse thoracic ultrasound led to a change of management in more than a quarter of the cases, of which almost all were executed within the first 8 hours.
UNASSIGNED: Netherlands Trial Registration NL9047, VUmc 2020.011 (prospectively registered on: 13-11-2020).
摘要：
■胸部超声是一种有价值的工具，可帮助诊断心肺疾病并指导重症监护病房患者的管理。重症监护病房护士接受了胸部超声检查的培训，此后，由于临床可识别性，他们被命名为“UltraNurses”。UltraNurses展示了快速的学习轨迹，但对临床决策的影响尚不清楚.这项研究的目的是探讨UltraNurse超声对临床管理的影响。
■这是一项在内科和外科重症监护病房内进行的前瞻性观察性单一中心研究。包括所有具有UltraNurse胸部超声指征的成年患者。这项研究包括三个步骤：前和后数据收集，在这两个步骤之间进行超声检查。检查包括针对肺和心输出量的标准化超声协议。主要结果是超声检查导致管理改变的百分比。次要结果包括：前8小时内执行的更改百分比，发现病理的频率，诊断变化的百分比，以及每班超声的频率。
■对65例患者（89％机械通气）进行了102次超声检查。超声检查提示26％的病例改变管理，其中96％在8小时内被处决。大多数变化在护理范围内(56%)，具体而言:44%的检查改变了液体管理。在97％的病例中，超声检查发现了病理。在7%的案例中，诊断改变了，有时会导致挽救生命的干预措施。UltraNurses每四个班次进行一次胸部超声检查。
■在成人重症监护病房患者中，超Nurse胸部超声导致超过四分之一的病例改变了管理，其中几乎全部在最初的8小时内被处决。
■荷兰试验注册NL9047，VUmc2020.011（预期注册时间：13-11-2020）。
■这是一项在内科和外科重症监护病房内进行的前瞻性观察性单一中心研究。包括所有具有UltraNurse胸部超声指征的成年患者。这项研究包括三个步骤：前和后数据收集，在这两个步骤之间进行超声检查。检查包括针对肺和心输出量的标准化超声协议。主要结果是超声检查导致管理改变的百分比。次要结果包括：前8小时内执行的更改百分比，发现病理的频率，诊断变化的百分比，以及每班超声的频率。
■对65例患者（89％机械通气）进行了102次超声检查。超声检查提示26％的病例改变管理，其中96％在8小时内被处决。大多数变化在护理范围内(56%)，具体而言:44%的检查改变了液体管理。在97％的病例中，超声检查发现了病理。在7%的案例中，诊断改变了，有时会导致挽救生命的干预措施。UltraNurses每四个班次进行一次胸部超声检查。
■在成人重症监护病房患者中，超Nurse胸部超声导致超过四分之一的病例改变了管理，其中几乎全部在最初的8小时内被处决。
■荷兰试验注册NL9047，VUmc2020.011（预期注册时间：13-11-2020）。
