Document Type : Original Article
Authors
1
Department of Anesthesia and Intensive Care Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
2
Cardiology Department, Al Jufairi Diagnosis and Treatment, MOH, Qatar.
3
Emergency Medicine Department, Hamad General Hospital, Doha, Qatar.
4
Internal Medicine Department, Mansoura General Hospital, Mansoura, Egypt.
5
Department of Obstetrics and Gynecology, Hamad General Hospital - Doha – Qatar.
6
College of Medicine, Qatar University, Doha, Qatar.
Abstract
Background
Dyspnea is one of the major reasons patients visit the emergency department (ED). Point-of-Care Ultrasound (POCUS) is a novel approach in diagnosing dyspnea, which is comparable to conventional diagnostic modalities such as chest X-rays.
Methodology
A comprehensive literature search was conducted until December 2024.
Results
Our electronic search yielded 510 articles, among which 9 observational studies summarizing data from 3605 patients met our inclusion criteria and were thus included in the review. Our review found that POCUS improved the concordance between ED diagnosis and the final diagnosis from kappa (0.45; 95% CI [0.31, 0.58]) in standard protocol to kappa (0.56; 95% CI [0.43, 0.69] [1] in POCUS based protocols. Furthermore, our review found that the sensitivity of POCUS for the different etiologies for dyspnea ranged from 88% (85.1%-90.6%) to 100.0% (78.2% - 100.0%) for congestive heart failure (CHF), 64.7% (38.3-85.8) to 86.8% (84.2% - 89.2%) for chronic obstructive pulmonary disease (COPD), and 88.5% (86.4% - 90.3%) to 100% (78.2 - 100) for pneumonia. In terms of specificity, our review found that the specificity of POCUS ranged from 95.2% (83.8% - 99.4%) to 96% (95% - 96.8%) for diagnosing CHF, 93.3% (77.9% - 99.2%) to 96.1% (95.1% -96.9%) for COPD, 74% (64% – 82%) to 91.6% (90.1% - 92.9%) for pneumonia.
Conclusion
Our study has found that POCUS is a potential diagnostic modality for acute dyspnea in the emergency department. However, limited research exists on its utility in diagnosing different etiologies of dyspnea.
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