This study aims to evaluate the clinical impact of the systematic implementation of point-of-care ultrasound (POCUS) in the management of patients with septic shock in the intensive care unit (ICU). Septic shock is associated with high morbidity and mortality, and its management requires timely and accurate hemodynamic assessment. Traditional monitoring methods have limitations in evaluating cardiac function, fluid responsiveness, and tissue perfusion. POCUS provides real-time, bedside, non-invasive assessment that may improve clinical decision-making. This is a retrospective, single-center cohort study comparing two time periods: a pre-implementation cohort (2016-2019) and a post-implementation cohort (2022-2025), excluding the COVID-19 pandemic period. The primary objective is to assess whether the implementation of POCUS is associated with an improvement in early organ dysfunction, measured as the change in SOFA score at 48 hours (delta SOFA). Secondary outcomes include mortality at 28, 60, and 90 days, incidence of acute kidney injury, duration of organ support therapies, and length of ICU and hospital stay.
Study Type
OBSERVATIONAL
Enrollment
200
Clínica Universidad de Navarra
Pamplona, Navarre, Spain
Change in SOFA score at 48 hours (Delta SOFA)
Difference between the Sequential Organ Failure Assessment (SOFA) score at ICU admission and at 48 hours.
Time frame: Baseline (ICU admission) and 48 hours after ICU admission
28-day mortality
All-cause mortality within 28 days from ICU admission
Time frame: Up to 28 days after ICU admission
60-day mortality
All-cause mortality within 60 days from ICU admission
Time frame: Up to 60 days after ICU admission
90-day mortality
All-cause mortality within 90 days from ICU admission
Time frame: Up to 90 days after ICU admission
Incidence of acute kidney injury
Occurrence of acute kidney injury during ICU stay
Time frame: From ICU admission to ICU discharge
Vasopressor-free days up to day 28
Number of days alive and free from vasopressor support within the first 28 days after ICU admission
Time frame: From ICU admission to day 28
Mechanical ventilation-free days up to day 28
Number of days alive and free from mechanical ventilation within the first 28 days after ICU admission
Time frame: From ICU admission to day 28
Renal replacement therapy-free days up to day 28
Number of days alive and free from renal replacement therapy within the first 28 days after ICU admission
Time frame: From ICU admission to day 28
ICU length of stay
Length of stay in the intensive care unit
Time frame: From ICU admission to day 28
Hospital length of stay
Total length of hospital stay
Time frame: Through hospital discharge, an average of 28 days
Change in qSOFA score at 24 and 72 hours
Change in quick Sequential Organ Failure Assessment (qSOFA) score at 24 and 72 hours from ICU admission
Time frame: Baseline (ICU admission), 24 hours, and 72 hours
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