Point-of-care Ultrasound in Suspected Pulmonary Embolism

Summary

Pulmonary embolism (PE) is a common cardiovascular condition with an estimated incidence of 0.60 to 1.12 per 1000 inhabitants in the United States of America, and the diagnosis is challenging as patients with PE present with a wide array of symptoms.

Computed tomography pulmonary angriography (CTPA) and lung ventilation-perfusion scintigraphy (VQ) are considered the gold-standards in PE-diagnostics but may not always be feasible. CTPA is contraindicated by contrast allergy or renal failure and both modalities require involvement of multiple staff-members and transport of the patient. Lung scintigraphy cannot be performed in an emergency situation, with unstable patients and patients unable to comply to the examination.

Ultrasound represent a possible tool in confirming or dismissing clinical PE suspicion. Ultrasound is non-invasive and can be performed bedside by the clinician, an approach known as point-of-care ultrasound (PoCUS), reducing both time, radiation-exposure and costs.

The aim of this study is to investigate whether integrating cardiac, lung and deep venous ultrasound in the clinical evaluation of suspected PE reduces the need for referral to CTPA or lung scintigraphy, during emergency department work up, while maintaining safety standards.

Conditions

• Pulmonary Embolism
• Pulmonary Embolus/Emboli

Interventions

DIAGNOSTIC_TEST

Point-of-care-ultrasound examination

The intervention consists of three ultrasound modalities: 1. Cardiac ultrasound assessing signs of right ventricular strain or other obvious pathology. 2. Deep venous ultrasound assessing presence of a deep venous thrombus 3. Lung ultrasound assessing presence of pulmonary infarctions, pleural effusion, pneumothorax or interstitial syndrome.

Sponsors & Collaborators

• University of Southern Denmark

  collaborator OTHER

• Snedkermester Sophus Jacobsen and hustru Astrid Jacobsens Foundation

  collaborator OTHER

• Odense Patient Data Explorative Network

  collaborator OTHER

• Odense University Hospital

  lead OTHER

Principal Investigators

• Casper Falster, MD · Odense University Hospital

• Christian B Laursen, Prof. MD · Odense University Hospital

Study Design

Allocation

RANDOMIZED

Purpose

DIAGNOSTIC

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-06-15

Primary Completion

2023-02-01

Completion

2023-07-01

Countries

• Denmark

Study Locations