Background: The integration of Point of Care Ultrasound (POCUS) in hospital medicine, particularly for inferior vena cava (IVC) assessment, promises significant advancements in patient care. This study investigates the efficacy of POCUS with IVC evaluation in guiding fluid management decisions upon admission, a crucial aspect of hospitalist care.
Methods: Conducted from January 1, 2021, to August 31, 2023, this retrospective study encompassed 4183 patients admitted under hospitalist care. Patients were categorized based on admission diagnoses. Those with congestive heart failure, cirrhosis, renal failure, signs of fluid overload (e.g., dyspnea, lung edema, leg edema, pleural effusion) and shock were assigned to the red color group, while others were placed in the green color group. Utilizing a 10% sampling rate, 418 patients were selected for detailed analysis. Their management, especially fluid prescription, was evaluated pre- and post-POCUS IVC examination.
Results: The study revealed a significant impact of POCUS on clinical decision-making. In the red color group, 75.16% of patients had adjustments in their IV fluid or diuretic prescriptions following POCUS examination. Contrastingly, only 33% in the green color group experienced similar changes. This stark difference underscores the utility of POCUS in specific clinical scenarios.
Conclusions: The findings illuminate the high utility of POCUS, particularly IVC evaluation, in managing patients with conditions like congestive heart failure, cirrhosis, renal failure, fluid overload, and shock. This study not only reinforces the utility of POCUS IVC evaluation in accurately identifying patients requiring tailored fluid management but also advocates for its broader implementation in hospital wards. It marks a significant stride in precision medicine, offering a beacon for enhancing patient outcomes through innovative diagnostic approaches. This paradigm shift in patient evaluation at admission heralds a new era in hospital medicine, emphasizing the need for technological integration in patient care.