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首页> 外文期刊>Canadian Journal of Emergency Medicine >The diagnostic accuracy of a point-of-care ultrasound protocol for shock etiology: A systematic review and meta-analysis
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The diagnostic accuracy of a point-of-care ultrasound protocol for shock etiology: A systematic review and meta-analysis

机译：休克病因现场超声检查协议的诊断准确性：系统评价和荟萃分析

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ObjectiveThe aim of this study was to perform a systematic review and meta-analysis of the diagnostic accuracy of a point-of-care ultrasound exam for undifferentiated shock in patients presenting to the emergency department.MethodsOvid MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, and research meeting abstracts were searched from 1966 to June 2018 for relevant studies. QUADAS-2 was used to assess study quality, and meta-analysis was conducted to pool performance data of individual categories of shock.ResultsA total of 5,097 non-duplicated studies were identified, of which 58 underwent full-text review; 4 were included for analysis. Study quality by QUADAS-2 was considered overall a low risk of bias. Pooled positive likelihood ratio values ranged from 8.25 (95% CI 3.29 to 20.69) for hypovolemic shock to 40.54 (95% CI 12.06 to 136.28) for obstructive shock. Pooled negative likelihood ratio values ranged from 0.13 (95% CI 0.04 to 0.48) for obstructive shock to 0.32 (95% CI 0.16 to 0.62) for mixed-etiology shock.ConclusionThe rapid ultrasound for shock and hypotension (RUSH) exam performs better when used to rule in causes of shock, rather than to definitively exclude specific etiologies. The negative likelihood ratios of the exam by subtype suggest that it most accurately rules out obstructive shock.
机译：目的本研究旨在对急诊科就诊的未分化休克患者进行即时超声检查的诊断准确性进行系统的回顾和荟萃分析。 ，并检索了1966年至2018年6月的研究会议摘要以进行相关研究。使用QUADAS-2评估研究质量，并进行荟萃分析以汇总各个类别休克的表现数据。结果共鉴定出5,097项非重复研究，其中58篇进行了全文审查;包括4个进行分析。 QUADAS-2的研究质量总体上被认为是低偏见风险。合并的正似然比值范围从低血容量性休克的8.25（95％CI 3.29到20.69）到阻塞性休克的40.54（95％CI 12.06到136.28）。合并的消极似然比值范围从阻塞性休克的0.13（95％CI 0.04至0.48）到混合病因休克的0.32（95％CI 0.16至0.62）。结论使用休克和低血压（RUSH）进行快速超声检查时效果更好确定休克原因，而不是明确排除特定病因。子类型检查的负似然比表明，它最准确地排除了阻塞性休克。

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