Point-of-Care Ultrasound (POCUS) as an Extension of the Physical Examination in Patients with Bacteremia or Candidemia
Background: In general, transthoracic echocardiography (TTE) is the first diagnostic test used for patients with bacteremia or candidemia and clinical signs of Infective Endocarditis (IE). Point-of-care ultrasound (POCUS) may be used in addition to physical examination for the detection of structura...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | info:eu-repo/semantics/article |
| Language: | English |
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MDPI
2022
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| Subjects: | |
| Online Access: | http://hdl.handle.net/10835/13866 |
| _version_ | 1789408385087569920 |
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| author | López Palmero, Serafín López Zúñiga, Miguel Angel Rodríguez Martínez, Virginia Reyes Parrilla, Raul Alguacil Muñoz, Ana Maria Sánchez-Yebra Romera, Waldo Martín Rico, Patricia Poquet Catalá, Inmaculada Jiménez Guardiola, Carlos Del Pozo Pérez, Alfonso Lobato Cano, Ruben Lazo Torres, Ana Maria López Martínez, Gines Díez García, Luis Felipe Parrón Carreño, Tesifón |
| author_facet | López Palmero, Serafín López Zúñiga, Miguel Angel Rodríguez Martínez, Virginia Reyes Parrilla, Raul Alguacil Muñoz, Ana Maria Sánchez-Yebra Romera, Waldo Martín Rico, Patricia Poquet Catalá, Inmaculada Jiménez Guardiola, Carlos Del Pozo Pérez, Alfonso Lobato Cano, Ruben Lazo Torres, Ana Maria López Martínez, Gines Díez García, Luis Felipe Parrón Carreño, Tesifón |
| author_sort | López Palmero, Serafín |
| collection | DSpace |
| description | Background: In general, transthoracic echocardiography (TTE) is the first diagnostic test used for patients with bacteremia or candidemia and clinical signs of Infective Endocarditis (IE). Point-of-care ultrasound (POCUS) may be used in addition to physical examination for the detection of structural heart disease and valve abnormalities. Objective: To determine the diagnostic accuracy of POCUS for the detection of signs suggestive of IE, including vegetation, valvular regurgitation, structural heart disease, hepatomegaly, splenomegaly and septic embolisms, in patients with bacteremia or candidemia. Design: Observational, cross-sectional, multicenter study using convenience sampling. Setting: Six Spanish academic hospitals. Patients: Adult patients with bacteremia or candidemia between 1 February 2018 and 31 December 2020. Measurements: The reference test, to evaluate vegetation, valvular regurgitation and structural heart disease, was transesophageal echocardiography (TEE). For patients who did not undergo TEE, transthoracic echocardiography (TTE) was considered the reference test. POCUS was performed by internists, while conventional echocardiography procedures were performed by cardiologists. Results: In 258 patients, for the detection of valvular vegetation, POCUS had sensitivity, specificity, and positive and negative predictive values of 77%, 94%, 82% and 92%, respectively. For valvular regurgitation (more than mild), sensitivity was ≥76% and specificity ≥85%. Sensitivity values for the detection of hepatomegaly and splenomegaly were 92% and 92%, respectively, while those for specificity were 96% and 98%. Conclusion: POCUS could be a valuable tool, as a complement to physical examination, at the hospital bedside for patients with bacteremia or candidemia, helping to identify signs suggestive of IE. |
| format | info:eu-repo/semantics/article |
| id | oai:repositorio.ual.es:10835-13866 |
| institution | Universidad de Cuenca |
| language | English |
| publishDate | 2022 |
| publisher | MDPI |
| record_format | dspace |
| spelling | oai:repositorio.ual.es:10835-138662023-04-12T19:18:16Z Point-of-Care Ultrasound (POCUS) as an Extension of the Physical Examination in Patients with Bacteremia or Candidemia López Palmero, Serafín López Zúñiga, Miguel Angel Rodríguez Martínez, Virginia Reyes Parrilla, Raul Alguacil Muñoz, Ana Maria Sánchez-Yebra Romera, Waldo Martín Rico, Patricia Poquet Catalá, Inmaculada Jiménez Guardiola, Carlos Del Pozo Pérez, Alfonso Lobato Cano, Ruben Lazo Torres, Ana Maria López Martínez, Gines Díez García, Luis Felipe Parrón Carreño, Tesifón point-of-care ultrasound (POCUS) bacteremia candidemia infective endocarditis Background: In general, transthoracic echocardiography (TTE) is the first diagnostic test used for patients with bacteremia or candidemia and clinical signs of Infective Endocarditis (IE). Point-of-care ultrasound (POCUS) may be used in addition to physical examination for the detection of structural heart disease and valve abnormalities. Objective: To determine the diagnostic accuracy of POCUS for the detection of signs suggestive of IE, including vegetation, valvular regurgitation, structural heart disease, hepatomegaly, splenomegaly and septic embolisms, in patients with bacteremia or candidemia. Design: Observational, cross-sectional, multicenter study using convenience sampling. Setting: Six Spanish academic hospitals. Patients: Adult patients with bacteremia or candidemia between 1 February 2018 and 31 December 2020. Measurements: The reference test, to evaluate vegetation, valvular regurgitation and structural heart disease, was transesophageal echocardiography (TEE). For patients who did not undergo TEE, transthoracic echocardiography (TTE) was considered the reference test. POCUS was performed by internists, while conventional echocardiography procedures were performed by cardiologists. Results: In 258 patients, for the detection of valvular vegetation, POCUS had sensitivity, specificity, and positive and negative predictive values of 77%, 94%, 82% and 92%, respectively. For valvular regurgitation (more than mild), sensitivity was ≥76% and specificity ≥85%. Sensitivity values for the detection of hepatomegaly and splenomegaly were 92% and 92%, respectively, while those for specificity were 96% and 98%. Conclusion: POCUS could be a valuable tool, as a complement to physical examination, at the hospital bedside for patients with bacteremia or candidemia, helping to identify signs suggestive of IE. 2022-06-29T15:55:21Z 2022-06-29T15:55:21Z 2022-06-23 info:eu-repo/semantics/article 2077-0383 http://hdl.handle.net/10835/13866 10.3390/jcm11133636 en https://www.mdpi.com/2077-0383/11/13/3636 Attribution-NonCommercial-NoDerivatives 4.0 Internacional http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess MDPI |
| spellingShingle | point-of-care ultrasound (POCUS) bacteremia candidemia infective endocarditis López Palmero, Serafín López Zúñiga, Miguel Angel Rodríguez Martínez, Virginia Reyes Parrilla, Raul Alguacil Muñoz, Ana Maria Sánchez-Yebra Romera, Waldo Martín Rico, Patricia Poquet Catalá, Inmaculada Jiménez Guardiola, Carlos Del Pozo Pérez, Alfonso Lobato Cano, Ruben Lazo Torres, Ana Maria López Martínez, Gines Díez García, Luis Felipe Parrón Carreño, Tesifón Point-of-Care Ultrasound (POCUS) as an Extension of the Physical Examination in Patients with Bacteremia or Candidemia |
| title | Point-of-Care Ultrasound (POCUS) as an Extension of the Physical Examination in Patients with Bacteremia or Candidemia |
| title_full | Point-of-Care Ultrasound (POCUS) as an Extension of the Physical Examination in Patients with Bacteremia or Candidemia |
| title_fullStr | Point-of-Care Ultrasound (POCUS) as an Extension of the Physical Examination in Patients with Bacteremia or Candidemia |
| title_full_unstemmed | Point-of-Care Ultrasound (POCUS) as an Extension of the Physical Examination in Patients with Bacteremia or Candidemia |
| title_short | Point-of-Care Ultrasound (POCUS) as an Extension of the Physical Examination in Patients with Bacteremia or Candidemia |
| title_sort | point-of-care ultrasound (pocus) as an extension of the physical examination in patients with bacteremia or candidemia |
| topic | point-of-care ultrasound (POCUS) bacteremia candidemia infective endocarditis |
| url | http://hdl.handle.net/10835/13866 |
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