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Corresponding Author

Ahmed Saad-Eldin Ahmed Behiry

Document Type

Original Article

Abstract

Background: Identifying the type of shock is crucial in the field of critical care medicine and emergency medicine; in many cases, the cause of shock is not easily detected. The emergence of non-invasive imaging may help detect the cause of shock and, thus, facilitate early management.

Aim and objectives: to evaluate the sensitivity and specificity of combined lung ultrasonography, IVC collapsibility index, and routine echocardiography in identifying the type of shock.

Patients and methods: This study is a prospective cross-sectional correlative study. Sixty (60) patients in shock state were included and recruited from the Intensive Care Unit and Emergency Department of Al-Azhar University Hospitals and Kasr Al-Ainy Hospital from December 2022 to December 2023. The following echocardiography/ultrasound parameters were recorded: Left ventricle systolic function by M mode, Left ventricle outflow tract Velocity Time Integral (LVOT VTI), signs of pulmonary embolism, signs of cardiac tamponade, valves to identify the presence of masses, IVC diameter, collapsibility index, focused assessment with sonography in trauma (FAST) exam and lung ultrasonography to identify pneumonia, pulmonary edema, pleural effusion, and pneumothorax.

Result: The integrated point-of-care ultrasound approach had good sensitivity (84.7-100%), specificity (90.2-100%), and accuracy (89.3-100%) for differentiating between major shock categories, including distributive, cardiogenic, hypovolemic, obstructive, and mixed distributive-cardiogenic shock.

Conclusion: This study demonstrates that an integrated point-of-care ultrasound incorporating lung ultrasound, inferior vena cava collapsibility metrics, and echocardiography provides a valuable tool for enhancing the rapidity and reliability of detecting shock and distinguishing between specific shock etiologies.

Keywords

Lung Ultrasound; Echocardiography; Shock; Collapsibility Index

Subject Area

Emergency and ICU medicine

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