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...

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Main Authors: 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
Formato: info:eu-repo/semantics/article
Idioma:English
Publicado: MDPI 2022
Subjects:
Acceso en liña:http://hdl.handle.net/10835/13866
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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.
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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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