Diagnostic accuracy of multi-organ point-of-care ultrasound for pulmonary embolism in critically ill patients: a systematic review and meta-analysis.

backgroundThe clinical presentation of acute pulmonary embolism (PE) can range from mild symptoms to severe shock, circulatory arrest and even death, thereby presenting with a significant high mortality when undiagnosed. Computed tomography pulmonary angiography (CTPA) is the gold-standard imaging modality for diagnosing PE, however, it has several practical limitations and is not widely available in low-income country settings. In this context, point-of-care ultrasound (POCUS) has emerged as a valuable bedside, non-invasive diagnostic tool. This meta-analysis assesses the accuracy of multi-organ POCUS for diagnosing PE in critical care settings. STUDY DESIGN AND

methodsWe conducted a systematic search of Pubmed, Embase, Scopus and the Cochrane Library databases for studies comparing multi-organ POCUS with CTPA or ventilation-perfusion scans for PE diagnosis in critical care departments. Two reviewers independently completed search, data abstraction and conducted quality assessment with QUADAS-2 tool. Heterogeneity was examined with I

resultsFour studies met the inclusion criteria, comprising 594 patients. The mean age of participants ranged from 55.2 to 71 years. Prevalence of PE ranged from 28 to 66.2%. CTPA was the primary reference standard used in most studies. Multi-organ POCUS for PE diagnosis demonstrated a pooled DOR of 25.3 (95% CI 4.43-82.9) with a pooled sensitivity of 0.90 (95% CI 0.85-0.94; I

conclusionsMulti-organ POCUS has high diagnostic accuracy for PE diagnosis in critically ill patients. Further research is needed to validated these findings across different patient populations. PROSPERO REGISTRATION: CRD42024614328.