Point of Care Ultrasound Evaluation in the Post-Anesthesia Unit

NCT04410757 | Completed

• 1 other identifier: 5180035
• Study Type: observational
• Target: 128
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this observational research study is to examine how point-of care ultrasound affects the workup and management of perioperative complications for specific clinical scenarios of low blood pressure (hypotension), low blood oxygen (hypoxemia), in the post- anesthesia care unit (PACU).

Conditions

Hypotension; Hypoxemia; Altered Mental Status; Urine Output Low; Chest Pain

Outcome Measures

Primary Outcomes (1)

• post anesthesia care (PACU) unit length of stay (minutes)

  The primary outcome marker for the study was post anesthesia care (PACU) unit length of stay (minutes), with a hypothesis that patients receiving a POCUS examination for the cardiovascular or pulmonary event would have a shorter PACU LOS.

  during year of the study enrollment

Secondary Outcomes (1)

• number of diagnosis before and after assessment

  during of the study enrollment

Study Arms (2)

Point of Care Ultrasound (POCUS) group

When the provider in charge of covering the post-anesthesia care unit, they would apply POCUS examinations in their PACU assessment as per the study protocol of hypotensive and hypoxic events.

No Point of Care Ultrasound (POCUS) group

When the provider in charge of covering the post-anesthesia care unit, they would apply routine bedside examination techniques in their PACU assessment as per the study protocol of hypotensive and hypoxic events.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Inpatient or outpatient subjects from the age 18 and above with no maximum age limit admitted in the post-anesthesia care unit (PACU) that experienced a hypoxic or hypotensive event and were examined by a physician.

You may qualify if:

• Patients in the post-anesthesia care unit with the following events
• Mean arterial blood pressure \<60 mmHg or \<20% of pre-operative baseline mean arterial blood pressure,) hypoxemia (pulse oximetry saturation \<95% or Pao2 \<80), altered mental status, decreased urine output, chest pain/EKG changes, or to confirm endotracheal Lube placement.

You may not qualify if:

• Patients who are not able to have a point of care ultrasound examination in the post anesthesia recovery area.

Sponsors & Collaborators

• Loma Linda University: lead
• University of California, Los Angeles: collaborator

Study Sites (1)

Loma Linda University Department of Anesthesiology

Loma Linda, California, 92354, United States

Location

Related Publications (6)

• Ramsingh D, Rinehart J, Kain Z, Strom S, Canales C, Alexander B, Capatina A, Ma M, Le KV, Cannesson M. Impact assessment of perioperative point-of-care ultrasound training on anesthesiology residents. Anesthesiology. 2015 Sep;123(3):670-82. doi: 10.1097/ALN.0000000000000776.

  PMID: 26181338 BACKGROUND

• Canty DJ, Royse CF, Kilpatrick D, Bowman L, Royse AG. The impact of focused transthoracic echocardiography in the pre-operative clinic. Anaesthesia. 2012 Jun;67(6):618-25. doi: 10.1111/j.1365-2044.2012.07074.x. Epub 2012 Feb 21.

  PMID: 22352785 BACKGROUND

• Ford JW, Heiberg J, Brennan AP, Royse CF, Canty DJ, El-Ansary D, Royse AG. A Pilot Assessment of 3 Point-of-Care Strategies for Diagnosis of Perioperative Lung Pathology. Anesth Analg. 2017 Mar;124(3):734-742. doi: 10.1213/ANE.0000000000001726.

  PMID: 27828799 BACKGROUND

• Haskins SC, Desai NA, Fields KG, Nejim JA, Cheng S, Coleman SH, Nawabi DH, Kelly BT. Diagnosis of Intraabdominal Fluid Extravasation After Hip Arthroscopy With Point-of-Care Ultrasonography Can Identify Patients at an Increased Risk for Postoperative Pain. Anesth Analg. 2017 Mar;124(3):791-799. doi: 10.1213/ANE.0000000000001435.

  PMID: 27551733 BACKGROUND

• Perlas A, Van de Putte P, Van Houwe P, Chan VW. I-AIM framework for point-of-care gastric ultrasound. Br J Anaesth. 2016 Jan;116(1):7-11. doi: 10.1093/bja/aev113. Epub 2015 May 7. No abstract available.

  PMID: 25951832 BACKGROUND

• Shokoohi H, Boniface KS, Pourmand A, Liu YT, Davison DL, Hawkins KD, Buhumaid RE, Salimian M, Yadav K. Bedside Ultrasound Reduces Diagnostic Uncertainty and Guides Resuscitation in Patients With Undifferentiated Hypotension. Crit Care Med. 2015 Dec;43(12):2562-9. doi: 10.1097/CCM.0000000000001285.

  PMID: 26575653 BACKGROUND

MeSH Terms

Conditions

Hypotension; Hypoxia; Oliguria; Chest Pain

Condition Hierarchy (Ancestors)

Vascular Diseases; Cardiovascular Diseases; Signs and Symptoms, Respiratory; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Urination Disorders; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Urological Manifestations; Pain; Neurologic Manifestations

Study Officials

• Davinder Ramsingh, MD

  Loma Linda University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: OTHER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Director of Clinical Research

Study Record Dates

• First Submitted: May 27, 2020
• First Posted: June 1, 2020
• Study Start: August 1, 2018
• Primary Completion: August 1, 2019
• Study Completion: May 27, 2020
• Last Updated: August 31, 2020

Record last verified: 2020-08

Locations

US (1)