Hemodynamics, fluids & transfusion
The Impact of Point-of-Care Ultrasound-Guided Resuscitation on Clinical Outcomes in Patients With Shock: A Systematic Review and Meta-Analysis*
Pooled result · 28-day mortalityResult — go to the resultRelative risk 0.88 95% CI 0.78–0.99Authors' conclusion
POCUS-guided resuscitation in shock may yield important patient and health system benefits.
Study context
- Population
- Adults with shock18 randomized controlled trials (RCTs)
- Comparison
- Point-of-care ultrasound (POCUS)-guided resuscitation vs control
- Outcome
- 28-day mortality
- Follow-up
- 28 days
Methodological detailsMEDLINE, Embase and unpublished sources searched from inception to December 2023
- MEDLINE, Embase and unpublished sources searched from inception to December 2023
Pooled result
As reported in the abstract
Relative risk
0.88
95% CI 0.78–0.99
POCUS vs Control
RR 0.88 (95% CI 0.78–0.99)
Further pooled results
| Outcome | Mean difference (d) (95% CI) | |
|---|---|---|
| Duration of vasoactive medicationLow to moderate certainty | −0.73 (−1.16 to −0.30) | |
| −1.5−1−0.500.5Difference, d (linear scale) |
| Outcome | RR (95% CI) | |
|---|---|---|
| Need for RRTLow to moderate certainty | 0.80 (0.63–1.02) | |
| 0.512Relative risk (log scale) |
Lactate clearance
- Probably improved with POCUS-guided resuscitation (high certainty)
IV fluid (IVF) administration and inotropes
- Little to no changes in administration of IVF (low to high certainty) or inotropes (high certainty)
Physicians' plans for IVF and vasoactive medication
- Slightly influenced by POCUS (moderate certainty)
CT scans and diagnostic echocardiograms
- May be no change in CT scans (low certainty); probably fewer diagnostic echocardiograms (moderate certainty)
ICU or hospital admissions, ICU and hospital LOS, need for mechanical ventilation (MV)
- May be little to no difference (low to moderate certainty)
AKI, duration of MV or renal replacement therapy (RRT)
- Uncertain effect (very low certainty)
Original publication
The Impact of Point-of-Care Ultrasound-Guided Resuscitation on Clinical Outcomes in Patients With Shock: A Systematic Review and Meta-Analysis*. Crit Care Med. Published 18 September 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →