This is a prospective cohort study that describes focused lung ultrasound (FLUS) findings in patients presenting with symptoms of an acute lower respiratory tract infection (LRTI) in general practice in Denmark. Ten general practitioners (GPs) will perform FLUS in addition to their usual care of adults presenting with symptoms of an acute LRTI where the GP suspects a community-acquired pneumonia (CAP). Eligible patients will consecutively be invited to participate during a two months' study period until each GP has included a total of ten patients. The GPs will register information about patients including age, gender, symptoms, clinical findings, results of any point-of-care test performed, if antibiotic treatment was prescribed and they will register information on FLUS performance and findings.
Study Type
OBSERVATIONAL
Enrollment
91
The participating GPs use ultrasonography on a weekly basis and will use the ultrasonography device already available to them; however, the ultrasound machine system and type of transducer will be reported. The GPs will use a 14-zone FLUS scanning protocol that has previously been validated in a general practice setting. Each of the scanning zones on the patient's left side can be denoted from 1L to 7L and from 1R to 7R on the right side. Each scanning zone should be assessed using FLUS. The transducer is placed in the middle of a scanning zone making a cross sectional image of an intercostal space and the underlying pleura blades. The patients will be examined in an upright position. The GPs will be trained in the 14-zone scanning protocol during a FLUS training program prior to recruitment of patients. FLUS pathological findings are predefined, and the variables will be dichotomized into present or not present for each scanning zone.
Center for General Practice at Aalborg University
Aalborg, Denmark
FLUS findings
Description of FLUS findings in patients with symptoms of acute LRTI in general practice where the GP suspects CAP.
Time frame: 2022
Distribution of FLUS findings
Distribution of FLUS findings in each of the 14 scanning zones.
Time frame: 2022
FLUS image quality
Proportion of FLUS examinations with acceptable image quality assessed by expert reviewers.
Time frame: 2022
Agreement on FLUS findings
Level of agreement between GPs and expert reviewers on FLUS findings.
Time frame: 2022
Unexpected events
Any unexpected events during the FLUS examination.
Time frame: 2022
Clinical impact of FLUS
Clinical impact of FLUS on antibiotics prescription, working diagnosis, confidence in working diagnosis, plans for treatment and visitation.
Time frame: 2022
FLUS feasibility
Number of patients where FLUS was not performed or only partially completed and the reasons for this. Number of technical breakdowns or ultrasound machine not available.
Time frame: 2022
Characteristics of patients
Characteristics of patients including age, gender, symptoms, clinical findings, results of any point-of-care test performed, if antibiotic treatment was prescribed, referral to secondary care for other imaging, examination or treatment.
Time frame: 2022
Complications and hospitalisation
Number of reported complications and hospitalisations within 28 days of follow-up. Complications included: Empyema, lung abscess, pleural effusion or sepsis.
Time frame: 2022
GP follow-up initiatives
Any GP follow-up initiatives within 28 days of follow-up.
Time frame: 2022
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