Actively Recruiting
Feasibility and Accuracy of an Ultrasound Algorithm for Acute Dyspnea Diagnosis in the Emergency Department
Led by CHOUIHED Tahar · Updated on 2025-01-16
225
Participants Needed
7
Research Sites
226 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
The management of chest pain has revolutionized its prognosis, primarily by improving urgent diagnosis of myocardial infarction. Currently, acute dyspnea is twice as frequent as chest pain and its associated mortality is much higher (16% of acute dyspnea admitted to emergency departments (ED) ). Inappropriate treatment of acute dyspnea in the ED is frequent (30%) and is associated with a tripling of intra-hospital mortality after adjustment for confounding factors (2.83, IC 1.48 to 5.41, p=0.002). Other elements have also highlighted the importance of a quick and appropriate acute dyspnea diagnosis: * The 2015 European Guidelines on acute heart failure emphasize the need for appropriate treatment within 90 minutes after the first medical contact. * Inadequate treatment of chronic bronchitis decompensation is associated with a doubling of intra-hospital mortality. * An initiation of antibiotic treatment within 4 hours of admission for pneumonia is recommended. * 30% of pulmonary embolisms are not diagnosed during the initial emergency department visit, whereas their mortality in the absence of treatment is 25%. Lung, venous and (simplified) cardiac ultrasound is associated with improved diagnostic performance in ED. However, no ultrasound algorithm dedicated to emergency physicians has been formally validated. The Blue Protocol (Lichtenstein et al., Chest 2008) has been validated in intensive care patients with very different phenotypes than those admitted to the ED. Pivetta et al. (Chest 2015) proposed an algorithm focused solely for the diagnosis of heart failure, thus not providing a diagnosis for all the other causes of dyspnea in ED. Finally, Zanbonetti et al. (Chest 2017) proposed an "unguided" ultrasound use, notably integrating inferior vena cava evaluation. However, measuring the inferior vena cava is difficult at the start of ED management when patients are in acute respiratory distress.
CONDITIONS
Official Title
Feasibility and Accuracy of an Ultrasound Algorithm for Acute Dyspnea Diagnosis in the Emergency Department
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Men and women 50 years old or older
- Patients with sudden acute dyspnea not caused by trauma managed in the emergency department
- Patients affiliated with a social security system
You will not qualify if you...
- Patients in cardiac arrest
- Patients in persistent shock
- Patients with impaired consciousness (Glasgow Score less than 9)
- Patients with a history of thoracic surgery or pulmonary fibrosis
- Patients with dementia
- Patients with Acute Coronary Syndrome with ST elevation
- Known current pregnancy
- Patients under guardianship, trusteeship, or legal protection
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
Trial Site Locations
Total: 7 locations
1
CH de Chalons en Champagne
Châlons-en-Champagne, France, 51000
Actively Recruiting
2
Hôpital Simone Veil
Eaubonne, France, 95602
Actively Recruiting
3
CHRU Nancy
Nancy, France, 54500
Actively Recruiting
4
AP-HP - Hôpital Cochin
Paris, France
Actively Recruiting
5
AP-HP - Hôpital Lariboisière
Paris, France
Actively Recruiting
6
CH de Sarreguemines
Sarreguemines, France, 57200
Withdrawn
7
CHRU de Strasbourg, Hôpital de Hautepierre
Strasbourg, France
Actively Recruiting
Research Team
T
Tahar CHOUIHED, MD
CONTACT
N
Nicolas GIRERD, MD PhD
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NA
Model
SINGLE_GROUP
Primary Purpose
DIAGNOSTIC
Number of Arms
1
Not the Right Trial for You?
Explore thousands of other clinical trials that might be a better match.
Sign up to get personalized trial recommendations delivered to your inbox.
Already have an account? Log in here