The main objective of our study is to compare the effects of two care strategies for dyspneic patients on the length of hospital stay: (1) standard care (=contextual analysis + conventional clinical chest radiography) versus (2) standard care + pleuropulmonary ultrasound.
The secondary objectives of this study are to assess the following for both arms: A-fatality rate, B-degree of concordance between the diagnosis orientation in the emergency department and final diagnosis determined by an expert committee using patient records one month later (blind evaluation by a panel of experts) C-clinical improvement between early emergency care and later care outside the emergency department (clinical parameters = blood gases and other biological parameters) D-imaging parameters.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
85
Standard care for dyspneic patients including contextual analysis, conventional clinical exam and a chest X-Ray.
Standard care (as described for the other intervention) + pleuropulmonary ultrasound using the Vscan portable ultrasound device (GE Healthcare, Wauwatosa, WI).
CHU de Nîmes - Hôpital Universitaire Carémeau
Nîmes, France
Length of hospital stay in days
Time frame: 1 month
Patient deceased? yes/no
Time frame: 1 month
Diagnosis in the emergency room
Time frame: upon discharge from the emergency department (max 1 month)
Diagnosis given by expert committee based on patient file
Time frame: 1 month
Glasgow scale
Time frame: Baseline, day 0
Glasgow scale
Time frame: day 3
Heart rate
Time frame: baseline, day 0
Heart rate
Time frame: day 3
Respiratory rate
Time frame: baseline, day 0
Respiratory rate
Time frame: day 3
Systolic blood pressure
Time frame: baseline, day 0
Systolic blood pressure
Time frame: day 3
Diastolic blood pressure
Time frame: baseline, day 0
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Diastolic blood pressure
Time frame: day 3
Temperature
Time frame: baseline, day 0
Temperature
Time frame: day 3
blood pH
Time frame: baseline, day 0
blood pH
Time frame: day 3
CO2 arterial pressure
Time frame: baseline, day 0
CO2 arterial pressure
Time frame: day 3
O2 arterial pressure
Time frame: baseline, day 0
O2 arterial pressure
Time frame: day 3
O2 saturation
Time frame: baseline, day 0
O2 saturation
Time frame: day 3
Alkaline reserve
Time frame: baseline, day 0
Alkaline reserve
Time frame: day 3
white blood cell count
Time frame: baseline, day 0
white blood cell count
Time frame: day 3
C-reactive protein
Time frame: baseline, day 0
C-reactive protein
Time frame: day 3
Brain Natriuretic Peptide
Time frame: baseline, day 0
Brain Natriuretic Peptide
Time frame: day 3
hemoglobin
Time frame: baseline, day 0
hemoglobin
Time frame: day 3
Pulmonary x-ray, yes/no
Time frame: baseline, day 0
right alveolar opacities on x-ray, yes/no
Time frame: baseline, day 0
left alveolar opacities on x-ray, yes/no
Time frame: baseline, day 0
right parenchymal origin on x-ray, yes/no
Time frame: baseline, day 0
left parenchymal origin on x-ray, yes/no
Time frame: baseline, day 0
right pleural effusion on x-ray, yes/no
Time frame: baseline, day 0
left pleural effusion on x-ray, yes/no
Time frame: baseline, day 0
pleuropulmonary ultrasound, yes/no
Time frame: baseline, day 0
right alveolar-interstitial syndrome on ultrasound, yes/no
Time frame: baseline, day 0
left alveolar-interstitial syndrome on ultrasound, yes/no
Time frame: baseline, day 0
right lung consolidation on ultrasound, yes/no
Time frame: baseline, day 0
left lung consolidation on ultrasound, yes/no
Time frame: baseline, day 0
right pleural effusion on ultrasound, yes/no
Time frame: baseline, day 0
left pleural effusion on ultrasound, yes/no
Time frame: baseline, day 0
right pneumothorax on ultrasound, yes/no
Time frame: baseline, day 0
left pneumothorax on ultrasound, yes/no
Time frame: baseline, day 0