Prehospital ultrasound scanning for abdominal free fluid detection in trauma patients: a systematic review and meta-analysis.

FAST Prehospital Trauma Ultrasound

Journal

BMC emergency medicine
ISSN: 1471-227X
Titre abrégé: BMC Emerg Med
Pays: England
ID NLM: 100968543

Informations de publication

Date de publication:
07 Jan 2024
Historique:
received: 10 03 2023
accepted: 13 12 2023
medline: 8 1 2024
pubmed: 8 1 2024
entrez: 7 1 2024
Statut: epublish

Résumé

Focused assessment with sonography for trauma helps detect abdominal free fluid. Prehospital ultrasound scanning is also important because the early diagnosis of hemoperitoneum may reduce the time to definitive treatment in the hospital. This study investigated whether prehospital ultrasound scanning can help detect abdominal free fluid. In this systematic review, relevant databases were searched for studies investigating prehospital ultrasound examinations for abdominal free fluid in trauma patients. The prehospital ultrasound results were compared with computed tomography, surgery, or hospital ultrasound examination data. The pooled sensitivity and specificity values were analyzed using forest plots. The overall predictive power was calculated by the summary receiver operating characteristic curve. The quality of the included studies was assessed using the quality assessment of diagnostic accuracy studies tool. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was performed to assess the certainty of evidence. This meta-analysis comprised six studies that included 1356 patients. The pooled sensitivity and specificity values were 0.596 (95% confidence interval [CI] = 0.345-0.822) and 0.970 (95% CI = 0.953-0.983), respectively. The pooled area under the summary receiver operating characteristic curve was 0.998. The quality assessment tool showed favorable results. In the GRADE analysis, the quality of evidence was very low for sensitivity and high for specificity when prehospital ultrasound was used for hemoperitoneum diagnosis. The specificity of abdominal free fluid detection using prehospital ultrasound examinations in trauma patients was very high.

Identifiants

pubmed: 38185679
doi: 10.1186/s12873-023-00919-2
pii: 10.1186/s12873-023-00919-2
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

7

Informations de copyright

© 2023. The Author(s).

Références

Rippey JC, Royse AG. Ultrasound in trauma. Best Pract Res Clin Anaesthesiol. 2009;23(3):343–62.
doi: 10.1016/j.bpa.2009.02.011 pubmed: 19862893
Montoya J, Stawicki SP, Evans DC, Bahner DP, Sparks S, Sharpe RP, et al. From FAST to E-FAST: an overview of the evolution of ultrasound-based traumatic injury assessment. Eur J Trauma Emerg Surg. 2016;42(2):119–26.
doi: 10.1007/s00068-015-0512-1 pubmed: 26038031
Trauma AC. .o.S.C.o. ATLS®: advanced trauma life support student course manual. American College of Surgeons; 2018.
Richards JR, McGahan JP. Focused Assessment with Sonography in Trauma (FAST) in 2017: what radiologists can learn. Radiology. 2017;283(1):30–48.
doi: 10.1148/radiol.2017160107 pubmed: 28318439
Clarke JR, Trooskin SZ, Doshi PJ, Greenwald L, Mode CJ. Time to laparotomy for intra-abdominal bleeding from trauma does affect survival for delays up to 90 minutes. J Trauma. 2002;52(3):420–5.
pubmed: 11901314
O’Dochartaigh D, Douma M. Prehospital ultrasound of the abdomen and thorax changes trauma patient management: a systematic review. Injury. 2015;46(11):2093–102.
doi: 10.1016/j.injury.2015.07.007 pubmed: 26264879
van der Weide L, Popal Z, Terra M, Schwarte LA, Ket JCF, Kooij FO, et al. Prehospital Ultrasound in the Management of Trauma Patients: Systematic Review of the Literature Injury. 2019;50(12):2167–75.
pubmed: 31627899
O’Dochartaigh D, Douma M, MacKenzie M. Five-year Retrospective Review of Physician and non-physician Performed Ultrasound in a Canadian critical care Helicopter Emergency Medical Service. Prehosp Emerg Care. 2017;21(1):24–31.
doi: 10.1080/10903127.2016.1204036 pubmed: 27436374
Griffiths E. Helicopter emergency medical services use of thoracic point of care ultrasound for pneumothorax: a systematic review and meta-analysis. Scand J Trauma Resusc Emerg Med. 2021;29(1):163.
doi: 10.1186/s13049-021-00977-0 pubmed: 34801070 pmcid: 8606084
Yates JG, Baylous D. Aeromedical Ultrasound: the evaluation of point-of-care Ultrasound during Helicopter Transport. Air Med J. 2017;36(3):110–5.
doi: 10.1016/j.amj.2017.02.001 pubmed: 28499679
Bøtker MT, Jacobsen L, Rudolph SS, Knudsen L. The role of point of care ultrasound in prehospital critical care: a systematic review. Scand J Trauma Resusc Emerg Med. 2018;26(1):51.
doi: 10.1186/s13049-018-0518-x pubmed: 29940990 pmcid: 6019293
Fitzgibbon JB, Lovallo E, Escajeda J, Radomski MA, Martin-Gill C. Feasibility of out-of-hospital Cardiac Arrest Ultrasound by EMS Physicians. Prehosp Emerg Care. 2019;23(3):297–303.
doi: 10.1080/10903127.2018.1518505 pubmed: 30192687
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.
doi: 10.1136/bmj.n71 pubmed: 33782057 pmcid: 8005924
Huedo-Medina TB, Sánchez-Meca J, Marín-Martínez F, Botella J. Assessing heterogeneity in meta-analysis: Q statistic or I2 index? Psychol Methods. 2006;11(2):193–206.
doi: 10.1037/1082-989X.11.2.193 pubmed: 16784338
Duval S, Tweedie R. Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56(2):455–63.
doi: 10.1111/j.0006-341X.2000.00455.x pubmed: 10877304
Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155(8):529–36.
doi: 10.7326/0003-4819-155-8-201110180-00009 pubmed: 22007046
Brozek JL, Akl EA, Jaeschke R, Lang DM, Bossuyt P, Glasziou P, et al. Grading quality of evidence and strength of recommendations in clinical practice guidelines: part 2 of 3. The GRADE approach to grading quality of evidence about diagnostic tests and strategies. Allergy. 2009;64(8):1109–16.
doi: 10.1111/j.1398-9995.2009.02083.x pubmed: 19489757
Kim CH, Shin SD, Song KJ, Park CB. Diagnostic accuracy of focused assessment with sonography for trauma (FAST) examinations performed by emergency medical technicians. Prehosp Emerg Care. 2012;16(3):400–6.
doi: 10.3109/10903127.2012.664242 pubmed: 22385014
Kumar S, Bansal VK, Muduly DK, Sharma P, Misra MC, Chumber S, et al. Accuracy of focused Assessment with Sonography for Trauma (FAST) in Blunt Trauma Abdomen-A prospective study. Indian J Surg. 2015;77(Suppl 2):393–7.
doi: 10.1007/s12262-013-0851-2 pubmed: 26730032
Simmons CJ, Mack LD, Cronin AJ, Monti JD, Perreault MD, Ahern BJ. FAST performance in a stationary versus In-Motion military ambulance utilizing Handheld Ultrasound: a randomized controlled study. Prehosp Disaster Med. 2020;35(6):632–7.
doi: 10.1017/S1049023X20001028 pubmed: 32843108
Walcher F, Weinlich M, Conrad G, Schweigkofler U, Breitkreutz R, Kirschning T, et al. Prehospital ultrasound imaging improves management of abdominal trauma. Br J Surg. 2006;93(2):238–42.
doi: 10.1002/bjs.5213 pubmed: 16329081
Press GM, Miller SK, Hassan IA, Alade KH, Camp E, Junco DD, et al. Prospective evaluation of prehospital trauma ultrasound during aeromedical transport. J Emerg Med. 2014;47(6):638–45.
doi: 10.1016/j.jemermed.2014.07.056 pubmed: 25281177
Ketelaars R, Holtslag JJM, Hoogerwerf N. Abdominal prehospital ultrasound impacts treatment decisions in a Dutch Helicopter Emergency Medical Service. Eur J Emerg Med. 2019;26(4):277–82.
doi: 10.1097/MEJ.0000000000000540 pubmed: 29381489
Gamberini L, Tartaglione M, Giugni A, Alban L, Allegri D, Coniglio C, et al. The role of prehospital ultrasound in reducing time to definitive care in abdominal trauma patients with moderate to severe liver and spleen injuries. Injury. 2022;53(5):1587–95.
doi: 10.1016/j.injury.2021.12.008 pubmed: 34920877
Lucas B, Hempel D, Otto R, Brenner F, Stier M, Marzi I, et al. Prehospital FAST reduces time to admission and operative treatment: a prospective, randomized, multicenter trial. Eur J Trauma Emerg Surg. 2022;48(4):2701–8.
doi: 10.1007/s00068-021-01806-w pubmed: 34661691
Partyka C, Coggins A, Bliss J, Burns B, Fiorentino M, Goorkiz P, et al. A multicenter evaluation of the accuracy of prehospital eFAST by a physician-staffed helicopter emergency medical service. Emerg Radiol. 2022;29(2):299–306.
doi: 10.1007/s10140-021-02002-4 pubmed: 34817706
Jones CM. And T.J.T.A.o.t.s. Athanasiou. Summary Receiver Operating Characteristic Curve Analysis Techniques in the Evaluation of Diagnostic Tests. 2005;79(1):16–20.
Daly KP, Ho CP, Persson DL, Gay SB. Trauma Retroperitoneal Injuries: Rev Multidetector CT Find Radiographics. 2008;28(6):1571–90.
Mondie C, Maguire NJ, Rentea RM. Retroperitoneal Hematoma, in StatPearls. 2022, StatPearls Publishing Copyright © 2022, StatPearls Publishing LLC.: Treasure Island (FL).
Blackbourne LH, Soffer D, McKenney M, Amortegui J, Schulman CI, Crookes B, et al. Secondary ultrasound examination increases the sensitivity of the FAST exam in blunt trauma. J Trauma. 2004;57(5):934–8.
doi: 10.1097/01.TA.0000149494.40478.E4 pubmed: 15580013
Rajabzadeh Kanafi A, Giti M, Gharavi MH, Alizadeh A, Pourghorban R, Shekarchi B. Diagnostic accuracy of secondary ultrasound exam in blunt abdominal trauma. Iran J Radiol. 2014;11(3):e21010.
doi: 10.5812/iranjradiol.21010 pubmed: 25763079 pmcid: 4341171
Mercer CB, Ball M, Cash RE, Rivard MK, Chrzan K, Panchal AR. Ultrasound Use in the Prehospital setting for trauma: a systematic review. Prehosp Emerg Care. 2021;25(4):566–82.
doi: 10.1080/10903127.2020.1811815 pubmed: 32815755
BET 2: Is prehospital focused abdominal ultrasound useful during triage at mass casualty incidents? Emerg Med J. 2013;30(7):596–597.
Wydo SM, Seamon MJ, Melanson SW, Thomas P, Bahner DP, Stawicki SP. Portable ultrasound in Disaster triage: a focused review. Eur J Trauma Emerg Surg. 2016;42(2):151–9.
doi: 10.1007/s00068-015-0498-8 pubmed: 26038019
Bodnar D, Rashford S, Hurn C, Quinn J, Parker L, Isoardi K, et al. Characteristics and outcomes of patients administered blood in the prehospital environment by a road based trauma response team. Emerg Med J. 2014;31(7):583–8.
doi: 10.1136/emermed-2013-202395 pubmed: 23645008

Auteurs

Kun-Te Lin (KT)

Department of Emergency and Critical Care Medicine, Changhua Christian Hospital, 135 Nanshsiao Street, 500, Changhua, Taiwan.

Zih-Yang Lin (ZY)

Department of Emergency and Critical Care Medicine, Changhua Christian Hospital, 135 Nanshsiao Street, 500, Changhua, Taiwan.

Cheng-Chieh Huang (CC)

Department of Emergency and Critical Care Medicine, Changhua Christian Hospital, 135 Nanshsiao Street, 500, Changhua, Taiwan.
Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.

Shang-Yan Yu (SY)

Fire Bureau of Changhua County Government, Changhua, Taiwan.

Jing-Lan Huang (JL)

Fire Bureau of Changhua County Government, Changhua, Taiwan.

Jian-Houng Lin (JH)

Fire Bureau of Changhua County Government, Changhua, Taiwan.

Yan-Ren Lin (YR)

Department of Emergency and Critical Care Medicine, Changhua Christian Hospital, 135 Nanshsiao Street, 500, Changhua, Taiwan. h6213.lac@gmail.com.
Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan. h6213.lac@gmail.com.
School of Medicine, Chung Shan Medical University, Taichung, Taiwan. h6213.lac@gmail.com.

Classifications MeSH