Impact of an enhanced focused cardiac ultrasound on treatment changes in a population of internal medicine patients

Background: Hospitalized patients with acute shortness of breath (SOB) could benefit from an enhanced focused cardiac ultrasound (eFoCUS) with Doppler measurements to reassess treatment and diagnosis.Methods: This was a retrospective observational study performed in a medical ward. Included patients were those hospitalized for acute SOB. The objectives were to assess therapeutic and diagnosis changes associated with eFoCUS. The primary endpoint of the analysis was a composite of introduction or discontinuation of diuretics, antibiotics or anticoagulation following eFoCUS.Results: Results: Between January 2018 and July 2021, 119 patients were included, 67 women and 52 men, mean age 84 +/- 11 years old. The eFoCUS was performed within a median time of 55 h (1st-3rd IQ: 21-107) following hospital admission. Overall, eFoCUS was associated with a change in diagnostic in 40 patients (34% [CI 95%: 25%-43%], p < 10(-4)) and a change in treatment in 53 patients (45% [CI 95%: 35%-54%], p < 10(-4)). Diuretics were prescribed in 94 patients before eFoCUS and in 56 after (p = 10(-4)), antibiotics in 34 before and 27 after and anticoagulation in 30 before and 40 after.Conclusion: eFoCUS was associated with both therapeutic and diagnostic changes in patients with SOB. Such results should be confirmed in multicentric prospective studies.