Preoperative Rapid Pou Ultrasound Assessment in Critically Ill Patients Undergoing Emergency Surgery

Study Overview
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Brief Summary
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With the development of society, the number of emergency critical operations is increasing year by year. Traditionally, the patient's systemic and circulatory status is indirectly assessed by testing and blood pressure heart rate. There are cases where the diagnosis is imperfect and the results are unreliable. Preoperative POU rapid ultrasound is a preoperative bedside ultrasound evaluation method first proposed by the Anesthesiology Department of Huaxi Hospital (three engineering units). This project will cooperate with Huaxi Hospital to explore whether the effect of intraoperative anesthesia management under POU guidance is better than traditional anesthesia management. This study will provide a new preoperative evaluation anesthesia management program for emergency critically ill patients with important clinical and social significance.

Detailed Description
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According to the inclusion and exclusion criteria, the patients will be randomly divided into two groups：In the control group, the anesthesiologist performed according to the existing preoperative evaluation program and existing experience, and guided the anesthesia management with the evaluation results.The experimental group used POU protocol ultrasound to perform a heart scan and a standard scan, a large vascular scan under the xiphoid, a body cavity scan, a standard section, and a lung scan in 10 minutes. Comprehensive preoperative circulation and assessment of systemic conditions, and guided intraoperative anesthesia management with assessment results.

Official Title
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Preoperative Rapid Pou Ultrasound（Pre-operative Ultrasound Evaluation Protocol） Assessment of Randomized Controlled Clinical Trials for Optimal Management of Anesthesia in Critically Ill Patients Undergoing Emergency Surgery.

Conditions
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Emergency Surgery

Intervention / Treatment
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* Device: POU protocol ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1.pulse oxygen saturation (spO2) ≤ 92% when inhaling air. 2.respiratory frequency ≥ 20 beats / min. 3.systolic blood pressure (sbp) <90mmHg. 4.heart rate (hr)>100 times/min. 5.requires positive inotropic drugs and/or vasopressors. 6.need artificial ventilation. 7.Signing informed consent. Exclusion Criteria: 1.age <14 years old. 2.unable to perform ultrasound evaluation (bandage, clam shell). 3.participated in other clinical trials in the first 3 months of the study. 4.researchers believe that it is not appropriate to include this tester. 5.any reason can not cooperate with this study. 6.cardiac surgery patient 7.organ transplant patient. 8.obstetric surgery patient. 9.you can start rescue after entering the room (such as CPR, etc.), and you are not allowed to perform ultrasound scans.

Ages Eligible for Study
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Minimum Age: 14 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: POU ultrasound intervention test group<br>The experimental group used POU protocol ultrasound to perform a heart scan and a standard scan, a large vascular scan under the xiphoid, a body cavity scan, a standard section, and a lung scan in 10 minutes. Comprehensive preoperative circulation and assessment of systemic conditions, and guided intraoperative anesthesia management with assessment results. | Device: POU protocol ultrasound<br>* The evaluation method performed a preoperative examination of the patient within 10 minutes by a heart scan and a standard scan of the face, a large vascular scan under the xiphoid, a body cavity scan, and a standard scan of the face and a lung scan. Preparation, providing anesthesia and surgeons with a fast, comprehensive and accurate preoperative judgment with important clinical and social significance.<br>|
| No Intervention: Control group<br>the anesthesiologist performed according to the existing preoperative evaluation program and existing experience, and guided the anesthesia management with the evaluation results. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Severe complication rate | Serious complications include cardiac arrest, respiratory failure, hemorrhagic shock, pulmonary embolism, etc. | The follow-up period ranges from the first patient recruited to the last patient within 6 months after admission, up to 2 years | 
| mortality rate | The number of patients who died from any cause since the date of randomization. | The follow-up period ranges from the first patient recruited to the last patient within 6 months after admission, up to 2 years | 
| Subjects' health status scores 30 days, 90 days, half a year, and one year after surgery. | Follow-up was performed 30 days, 90 days, half a year, and one year after surgery, and the patient's prognosis was assessed using a health score sheet. | The follow-up period ranges from the first patient recruited to the last patient within 6 months after admission, up to 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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anesthesia, Preoperative rapid POU ultrasound, clinical trials