Comparison of CLAUS protocol and bedside ultrasound rapid management protocol in the etiological diagnosis of acute respiratory distress in critically ill patients in the emergency room

Corresponding author: Mao yun, 94385390@sohu.com

DOI: 10.12201/bmr.202412.00087

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  Abstract: Objective Exploring the comparison between cardiopulmonary and additional ultrasound (CLAUS) protocol and point-of-care ultrasound rapid management (POCURM) protocol in the etiological diagnosis of acute respiratory distress in critically ill patients in the emergency room.Methods 242 patients with acute respiratory distress admitted to the emergency department of our hospital from January 2022 to January 2024 were selected as the research subjects. According to the final diagnosis after discharge, they were divided into 144 cases of cardiogenic respiratory distress (cardiogenic group) and 98 cases of pulmonary respiratory distress (pulmonary group). Compare the findings of two CLAUS groups and the accuracy of POCURM and CLLAUS protocols in diagnosing the etiology of acute respiratory distress.Results The history of heart disease in the cardiogenic group was higher than that in the pulmonary group, and the difference was statistically significant (P<0.05); The lung disease history of patients in the cardiogenic group was lower than that in the pulmonary source group, and the difference was statistically significant (P<0.05); There was no significant difference in other clinical general data between the two groups of patients (P>0.05). The proportion of pleural smoothness/slight thickening, sliding presence/slight weakening, left heart dysfunction, right heart dysfunction, and B-line pulmonary ultrasound scores in the cardiogenic group were higher than those in the pulmonary source group, and the differences were statistically significant (P<0.05). The sensitivity, specificity, missed diagnosis rate, misdiagnosis rate, positive predictive value, negative predictive value, and diagnostic accuracy of the POURM protocol for diagnosing acute respiratory distress were 90.28%, 91.84%, 9.82%, 8.16%, 94.20%, 86.54%, and 90.91%, respectively. The sensitivity, specificity, missed diagnosis rate, misdiagnosis rate, positive predictive value, negative predictive value, and diagnostic accuracy of the CLAUS protocol for diagnosing acute respiratory distress were 96.53%, 97.96%, 3.47%, 2.04%, 98.58%, 95.05%, and 97.11%, respectively. The diagnostic accuracy of the CLAUS regimen (97.11%) was higher than that of the POURM regimen (90.91%) (χ2=8.253, P=0.004).Conclusion The CLAUS regimen can effectively diagnose the specific causes of acute respiratory distress in patients, with higher accuracy than the POCURM regimen.

  Key words: Acute respiratory distress; Emergency room critical illness; Cardiopulmonary and additional ultrasound; Point-of-Care Ultrasound Rapid Management; diagnosis

  Submit time: 31 December 2024

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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