Hemodynamics, fluids & transfusion
Diagnostic accuracy of point-of-care ultrasound for shock: a systematic review and meta-analysis
Authors' conclusion
The identification of the etiology for each type of shock using POCUS was characterized by high sensitivity and positive likelihood ratios, especially for obstructive shock.
Study context
- Population
- Patients with shock (circulatory failure)
- Participants
- 1,132 patients · 12 studies
- Comparison
- Point-of-care ultrasound (POCUS) for identifying the etiology of shock
- Outcome
- Pooled diagnostic accuracy of POCUS for each type of shock
Methodological detailsQUADAS-2 quality assessment, PRISMA, prospectively registered protocol
- QUADAS-2 quality assessment
- PRISMA
- Prospectively registered protocol
Pooled result
As reported in the abstract
Pooled sensitivity and specificity (95% CI)
| Group | Sensitivity | Specificity | Positive likelihood ratio |
|---|---|---|---|
| Obstructive shock | 0.82 (0.68-0.91) | 0.98 (0.92-0.99) | 40 (11-105) |
| Cardiogenic shock | 0.78 (0.56-0.91) | 0.96 (0.92-0.98) | — not stated in the abstract |
| Hypovolemic shock | 0.90 (0.84-0.94) | 0.92 (0.88-0.95) | — not stated in the abstract |
| Distributive shock | 0.79 (0.71-0.85) | 0.96 (0.91-0.98) | — not stated in the abstract |
Sensitivity
Obstructive shock0.82 (0.68-0.91)
Cardiogenic shock0.78 (0.56-0.91)
Hypovolemic shock0.90 (0.84-0.94)
Distributive shock0.79 (0.71-0.85)
Specificity
Obstructive shock0.98 (0.92-0.99)
Cardiogenic shock0.96 (0.92-0.98)
Hypovolemic shock0.92 (0.88-0.95)
Distributive shock0.96 (0.91-0.98)
Positive likelihood ratio
Obstructive shock40 (11-105)
Cardiogenic shock— not stated in the abstract
Hypovolemic shock— not stated in the abstract
Distributive shock— not stated in the abstract
— not stated in the abstract
- AUC for each type of shock approximately
- 0.95
- Positive likelihood ratios for each type of shock all greater than
- 10
- Negative likelihood ratio for each type of shock approximately
- 0.2
Original publication
Diagnostic accuracy of point-of-care ultrasound for shock: a systematic review and meta-analysis. Crit Care. Published 25 May 2023. doi:10.
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