Clinical trial NCT04410757: Point of Care Ultrasound Evaluation in the Post-Anesthesia Unit
Official title: Point of Care Ultrasound Evaluation in the Post-Anesthesia Unit- A Collaborative Observational Study Between UCLA and Loma Linda University Medical Centers
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Hypotension
Hypoxemia
Altered Mental Status
Urine Output Low
Chest Pain
Lead sponsor: Loma Linda University
Sponsor class: OTHER
Collaborators: name: University of California, Los Angeles
First posted: 2020-06-01
Enrollment: 128
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_CONTROL
Time perspective: OTHER
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Inpatient or outpatient subjects from the age 18 and above with no maximum age limit admitted in the post-anesthesia care unit (PACU) that experienced a hypoxic or hypotensive event and were examined by a physician.

Brief summary: The purpose of this observational research study is to examine how point-of care ultrasound affects the workup and management of perioperative complications for specific clinical scenarios of low blood pressure (hypotension), low blood oxygen (hypoxemia), in the post- anesthesia care unit (PACU).


Eligibility criteria: Inclusion Criteria:

* Patients in the post-anesthesia care unit with the following events
* Mean arterial blood pressure \<60 mmHg or \<20% of pre-operative baseline mean arterial blood pressure,) hypoxemia (pulse oximetry saturation \<95% or Pao2 \<80), altered mental status, decreased urine output, chest pain/EKG changes, or to confirm endotracheal Lube placement.

Exclusion Criteria:

* Patients who are not able to have a point of care ultrasound examination in the post anesthesia recovery area.

Primary outcomes:
measure: post anesthesia care (PACU) unit length of stay (minutes)
timeFrame: during year of the study enrollment
Secondary outcomes:
measure: number of diagnosis before and after assessment
timeFrame: during of the study enrollment
Other outcomes:
Locations:
city: Loma Linda
country: United States
facility: Loma Linda University Department of Anesthesiology
state: California
Study officials:
affiliation: Loma Linda University
name: Davinder Ramsingh, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Ramsingh D, Rinehart J, Kain Z, Strom S, Canales C, Alexander B, Capatina A, Ma M, Le KV, Cannesson M. Impact assessment of perioperative point-of-care ultrasound training on anesthesiology residents. Anesthesiology. 2015 Sep;123(3):670-82. doi: 10.1097/ALN.0000000000000776.
citation: Canty DJ, Royse CF, Kilpatrick D, Bowman L, Royse AG. The impact of focused transthoracic echocardiography in the pre-operative clinic. Anaesthesia. 2012 Jun;67(6):618-25. doi: 10.1111/j.1365-2044.2012.07074.x. Epub 2012 Feb 21.
citation: Ford JW, Heiberg J, Brennan AP, Royse CF, Canty DJ, El-Ansary D, Royse AG. A Pilot Assessment of 3 Point-of-Care Strategies for Diagnosis of Perioperative Lung Pathology. Anesth Analg. 2017 Mar;124(3):734-742. doi: 10.1213/ANE.0000000000001726.
citation: Haskins SC, Desai NA, Fields KG, Nejim JA, Cheng S, Coleman SH, Nawabi DH, Kelly BT. Diagnosis of Intraabdominal Fluid Extravasation After Hip Arthroscopy With Point-of-Care Ultrasonography Can Identify Patients at an Increased Risk for Postoperative Pain. Anesth Analg. 2017 Mar;124(3):791-799. doi: 10.1213/ANE.0000000000001435.
citation: Perlas A, Van de Putte P, Van Houwe P, Chan VW. I-AIM framework for point-of-care gastric ultrasound. Br J Anaesth. 2016 Jan;116(1):7-11. doi: 10.1093/bja/aev113. Epub 2015 May 7. No abstract available.
citation: Shokoohi H, Boniface KS, Pourmand A, Liu YT, Davison DL, Hawkins KD, Buhumaid RE, Salimian M, Yadav K. Bedside Ultrasound Reduces Diagnostic Uncertainty and Guides Resuscitation in Patients With Undifferentiated Hypotension. Crit Care Med. 2015 Dec;43(12):2562-9. doi: 10.1097/CCM.0000000000001285.