Evaluation of the Impact of Pleuropulmonary Ultrasound on the Diagnosis of Dyspnea

NCT07104578 | Recruiting

• 2 other identifiers: RC31/25/0219ID-RCB
• Study Type: observational
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Dyspnea is a subjective symptom perceived by the patient as a sensation of "breathing discomfort", "suffocation", "lack of air" or "difficulty inhaling or exhaling". It is a frequent reason for calling for help (8% of calls). The most seriously ill patients require the dispatch of specialized teams capable of initiating respiratory support in order to reduce the morbidity and mortality of these patients. In France, these teams are medicalized by an emergency physician within the Mobile Emergency Resuscitation Services (SMUR). This is only rarely the case outside France, where specialized paramedical teams ("advanced life support paramedic teams") can be dispatched. Apart from their role of initiating possible respiratory support, these teams (SMUR or paramedics) can initiate a diagnostic approach and therapeutics related to the suspected origin of dyspnea. However, there are many diagnoses that can cause dyspnea, and the diagnostic process can be complex. The most common diagnoses described in the prehospital population are: bacterial pneumonia, acute heart failure, and exacerbation of COPD or asthma or pulmonary embolism. Each of these diagnoses requires specific drug treatment, guided by international recommendations. Inappropriate treatment of these pathologies (overtreatment or undertreatment) is common and associated with excess intrahospital mortality. Pleuropulmonary ultrasound (PUS) has shown very interesting diagnostic performance in the intrahospital setting for diagnoses of interest in dyspnea. This performance also appears good in the prehospital setting. In the intrahospital setting, PUS appears to improve the diagnostic approach and appropriate treatments for dyspnea. In the prehospital setting, however, data on this subject are scarce or of limited quality according to the most recent meta-analysis, while the use of this technique is becoming increasingly common in standardized patient care. In addition, the most recent work on the subject included patients in a non-medicalized prehospital system. The use of PUS would allow paramedics to increase the rate of appropriate treatment from 14% to 53%. However, the rate of appropriate treatment expected by a medicalized team is expected to be 62%, and the diagnostic performance of physicians in PUS is probably higher than that of paramedics. These data must therefore be consolidated in a French system before being the subject of higher-level recommendations. The systematic use of PUS during prehospital engagement of a SMUR for dyspnea also may improves the rate of appropriate treatment, even in a context of medicalization of the initial care of patients.

Conditions

Dyspnea

Keywords

dyspnea; pleuropulmonary ultrasound; diagnostic

Outcome Measures

Primary Outcomes (1)

• Evaluation of the impact of pre-hospital EPP on the rate of appropriate treatments offered.

  Therapeutic adequacy at the final diagnosis before and after completion of the PUS. Therapeutic adequacy and inadequacy are defined based on the treatment proposed before and after completion of the PUS, compared to the final diagnosis at hospital discharge. The following are considered inadequate: * In a patient on a pulmonary embolism (PE): * Prescribing beta-agonists or antibiotics (unless septic) * Not prescribing diuretics and nitrates if SBP \> 140 mmHg * In a patient with decompensated COPD: * Prescribing diuretics * Not prescribing beta-agonists * In a patient with a pulmonary infection: * Prescribing diuretics * Not prescribing antibiotics * In a patient with a pulmonary embolism: * Not prescribing curative doses of anticoagulation In the case of multiple diagnoses (e.g., transfer to a PE due to pneumonia), only treatments that are inadequate for each diagnosis will be considered inadequate.

  from the inclusion of the patient until the time he or she leaves the hospital, assessed up 52 weeks, whichever came first

Secondary Outcomes (1)

• Evaluation of the impact of PUS carried out in prehospital settings on the diagnostic process.

  from the inclusion of the patient until the time he or she leaves the hospital, assessed up 52 weeks, whichever came first

Study Arms (1)

patients with respiratory distress

patients in respiratory distress treated by the SMUR

Diagnostic Test: Pleuropulmonary ultra sound

Interventions

Pleuropulmonary ultra sound DIAGNOSTIC_TEST

pleuropulmonary ultrasound performed as part of the treatment

patients with respiratory distress

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

patients admitted to the emergency room for dyspnea

You may qualify if:

• Adult patient
• Treated by a prehospital emergency medical service
• For dyspnea with signs of severity, the following are the following:
• SpO2 \< 90% in AA or O2 required to maintain SpO2 ≥ 90% and
• RR \> 25 cycles/min

You may not qualify if:

• Need for immediate intubation.

Sponsors & Collaborators

• University Hospital, Toulouse: lead

Study Sites (1)

Pôle Médecine d'Urgence Hôpital Purpan Pavillon Louis Lareng Place Docteur Baylac

Toulouse, 31059, France

RECRUITING

MeSH Terms

Conditions

Dyspnea; Disease

Condition Hierarchy (Ancestors)

Respiration Disorders; Respiratory Tract Diseases; Signs and Symptoms, Respiratory; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Pathologic Processes

Study Officials

• Pauline Marchetto, PhD

  University Hospital, Toulouse

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Pauline Marchetto, PHD

CONTACT

0561772579; marchetto.p@chu-toulouse.fr

Manon HEBRARD

CONTACT

0561772579; hebrard.m@chu-toulouse.fr

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: PROSPECTIVE
• Target Duration: 52 Weeks
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 7, 2025
• First Posted: August 5, 2025
• Study Start: August 1, 2025
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): February 1, 2027
• Last Updated: September 26, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)