Evidence map›Paper›PMID 35104693›Full record

Observational studyJournal of critical care2022

Multi-organ point-of-care ultrasound for detection of pulmonary embolism in critically ill COVID-19 patients - A diagnostic accuracy study.

Arthur Lieveld, M L A Heldeweg, J M Smit, M E Haaksma, L Veldhuis, R S Walburgh-Schmidt, J Twisk, P W B Nanayakkara, L Heunks, P R Tuinman

Open access · hybridAbstract readObservational Study
In one paragraph

Observational study in Journal of critical care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
  7. Venous Thromboembolism in Pregnancy: Challenges and Solutions.Vascular health and risk management · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Arthur LieveldAcute Internal Medicine, Amsterdam UMC, Location VUmc, the Netherlands; Department of Intensive Care Medicine, Amsterdam University Medical Centers, Location VUmc, the Netherlands.. Electronic address: a.lieveld@amsterdamumc.nl.
M L A HeldewegDepartment of Intensive Care Medicine, Amsterdam University Medical Centers, Location VUmc, the Netherlands.; Department of Epidemiology and Data Science, Amsterdam UMC, Location VUmc, the Netherlands.
J M SmitDepartment of Intensive Care Medicine, Amsterdam University Medical Centers, Location VUmc, the Netherlands.; Department of Epidemiology and Data Science, Amsterdam UMC, Location VUmc, the Netherlands.
M E HaaksmaDepartment of Intensive Care Medicine, Amsterdam University Medical Centers, Location VUmc, the Netherlands.; Department of Epidemiology and Data Science, Amsterdam UMC, Location VUmc, the Netherlands.
L VeldhuisDepartment of Intensive Care Medicine, Amsterdam University Medical Centers, Location VUmc, the Netherlands.; Department of anesthesiology, Amsterdam University Medical Centers, Location AMC, the Netherlands.
R S Walburgh-SchmidtDepartment of Intensive Care Medicine, Amsterdam University Medical Centers, Location VUmc, the Netherlands.
J TwiskAmsterdam Leiden IC Focused Echography (ALIFE, www.alifeofpocus.com), the Netherlands.
P W B NanayakkaraAcute Internal Medicine, Amsterdam UMC, Location VUmc, the Netherlands.
L HeunksDepartment of Intensive Care Medicine, Amsterdam University Medical Centers, Location VUmc, the Netherlands.
P R TuinmanDepartment of Intensive Care Medicine, Amsterdam University Medical Centers, Location VUmc, the Netherlands.; Amsterdam Leiden IC Focused Echography (ALIFE, www.alifeofpocus.com), the Netherlands.
Amsterdam UMC Location VUmc · NLAmsterdam University Medical Centers · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCritically ill COVID-19 patients have an increased risk of developing pulmonary embolism (PE). Diagnosis of PE by point-of-care ultrasound (POCUS) might reduce the need for computed tomography pulmonary angiography (CTPA), while decreasing time-to-diagnosis. MATERIALS &

methodsThis prospective, observational study included adult ICU patients with COVID-19. Multi-organ (lungs, deep vein, cardiac) POCUS was performed within 24 h of CTPA, looking for subpleural consolidations, deep venous thrombosis (DVT), and right ventricular strain (RVS). We reported the scan time, and calculated diagnostic accuracy measures for these signs separately and in combination.

results70 consecutive patients were included. 23 patients (32.8%) had a PE. Median scan time was 14 min (IQR 11-17). Subpleural consolidations' diagnostic accuracy was: 42.9% (95%CI [34.1-52.0]). DVT's and RVS' diagnostic accuracy was: 75.6% (95%CI [67.1-82.9]) and 74.4% (95%CI [65.8-81.8]). Their sensitivity was: 24.0% (95%CI [9.4-45.1]), and 40.0% (95%CI [21.3-61.3]), while their specificity was: 88.8% (95%CI [80.8-94.3]), and: 83.0% (95%CI [74.2-89.8]), respectively. Multi-organ POCUS sensitivity was: 87.5% (95%CI [67.6-97.3]), and specificity was: 25% (95%CI [16.9-34.7]).

conclusionsMulti-organ rather than single-organ POCUS can be of aid in ruling out PE in critically ill COVID-19 and help select patients for CTPA. In addition, finding RVS can make PE more likely, while a DVT would preclude the need for a CTPA. REGISTRATION: www.trialregister.nl: NL8540.

Indexed as

COVID-19Pulmonary EmbolismVenous ThrombosisAdultCritical IllnessHumansPoint-of-Care SystemsProspective StudiesCOVID-19DiagnosticsICUPOCUSPoint-of-care ultrasoundPulmonary embolism

Identifiers

PMID35104693
PMCPMC8808351
OpenAlexW4210595380

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.