Critical Care and Shock

Impact of shock multi-focused ultrasound diagnostic protocol as routine screening at early intensive care stay on morbidity and mortality rates in shocked critically ill patients: A randomized controlled trial

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Objective: This study aimed to determine whether a shock multi-focused ultrasound protocol would improve mortality and morbidity rates, moreover, to evaluate the effect of ultrasound protocol in improving the secondary endpoint as the length of stay in shocked individuals attended to the intensive care unit (ICU).

Design: A single-center randomized controlled trial.

Setting: This study was done at Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt, during the period between March 2021 and April 2022.

Patients and participants: Our prospective study was performed on 100 shocked individuals.

Interventions: Patients were randomly distributed into 2 groups: Group A, which received conventional management and a routine evaluation with shock multi-focused ultrasound protocol, and Group B, as a control group, which solely provided conventional therapy to startled patients in the ICU in accordance with pre-established protocols.

Results and measurements: This study revealed that a substantially critical reduction was present in vasopressor duration (p-value 0.03), vasopressor doses, and frequency of need for two vasopressors in Group A compared to Group B. Also, the mortality rate did not differ across the groups under study. However, there was a decrease in morbidity and other complications among Group A compared to Group B.

Conclusions: We concluded that multi-focused ultrasound protocol should be seriously considered by physicians managing critically ill shocked patients as a tool to guide resuscitation, augment clinical evaluation, and improve quality of life by lowering morbidity rates, vasopressor doses, and duration.