Hypotension Clinical Trial
Official title:
Focused Multiorgan Ultrasound in the Emergency Evaluation of Undifferentiated Hypotension
Background
- Symptomatic undifferentiated hypotension represents a negative prognostic factor and
the strongest predictor of in-hospital mortality.
- Misdiagnosis may lead to delayed or incorrect treatment of some life-threatening
conditions.
Aim
- The aim of the study is to evaluate the feasibility and accuracy of a new bedside
ultrasound method that consists in the focused imaging of the thorax, abdomen and leg veins,
in emergency.
Methods
- Hypotensive (<100 mm/Hg) patients presenting to our emergency department, complaining
of at least one of the neurologic, respiratory and cutaneous signs and symptoms of
inadequate tissue perfusion, are prospectively studied by ultrasound-focused assessment
of the heart, lungs, inferior vena cava, peritoneum, aorta and leg deep veins.
- On the basis of physical examination and ultrasound results, the operator declares the
diagnostic hypothesis without influencing the attending physician and the following
diagnostic procedure (which includes ultrasound, when needed).
- The diagnostic hypothesis is compared with the final diagnosis, obtained after the
hospital route and discussed by a panel of three blinded experts (one radiologist, one
cardiologist and one emergency physician).
- The statistical agreement is calculated by the k of Cohen with p-value, confidence
intervals and raw agreement (Ra).
n/a
Observational Model: Case-Only, Time Perspective: Prospective
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