LUng and Cardiac Ultrasound for REspiratory Distress in ElDerly

Официальное название

Impact of a Management Strategy for Acute Dyspnea in Elderly Subjects Based on the Use of Lung and Cardiac Ultrasonography

Обзор

Prospective trial to evaluate the impact on the initial therapeutic inadequacy of a management strategy for acute dyspnea in the elderly based on the use of lung and cardiac ultrasonography.

Подробное описание

Acute dyspnea is a frequent and serious reason of admission in Emergency Department (ED), with a one-month mortality close to 16%. It is difficult to diagnose in the initial assessment phase since the cause of this symptom can vary (cardiological, pulmonary, infectious, etc.) and the symptoms can be misleading. This difficulty in diagnosing delays the implementation of appropriate therapeutic management even as the timeliness of management is associated with a reduction in mortality. These issues are particularly important in the elderly.

Lung and cardiac ultrasonography performed by the emergency physician, immediately available at the patient's bedside, could reduce the diagnostic and therefore therapeutic delay.

However, the impact of a diagnostic strategy based on lung and cardiac ultrasonography in dyspneic elderly subjects has not been evaluated.

Patients will be randomized in two groups : "standard of care" or "clinical ultrasound" group. Treatments initiated in Emergency Department (ED) will be noted to be compared to final diagnosis.

Вмешательства

• Диагностический тест diagnostic strategy based on lung and cardiac ultrasonography
  cardiopulmonary ultrasound performed by the emergency physician, immediately at patient's bed

Первичные конечные точки

• therapeutic inadequacy [Срок оценки: Hour 1]

Вторичные конечные точки (5)

• correct diagnosis [Срок оценки: emergency department discharge (up to hour 4)]
• duration of emergency department stay [Срок оценки: emergency department discharge (up to hour 4)]
• Post-emergency hospital stay [Срок оценки: Day 30]
• Number of days alive outside hospital between D0 and D30 [Срок оценки: Day 30]
• Care cost [Срок оценки: Day 30]

Критерии участия

Критерии включения

Eligible patients will be aged over 65 years, affiliated with the French social security system, and presenting to the ED with acute dyspnea (onset <14 days) accompanied by severity signs before or at triage (respiratory rate ≥22 and SpO2 <92% on room air). The enrolling emergency physician (EP) must be the patient's treating physician and must be trained in LuCUS. Written informed consent from the patient or their legal representative is required for inclusion

Критерии исключения

dyspnea secondary to thoracic trauma, dyspnea clearly related to COVID-19, known pulmonary fibrosis or lung cancer, prior administration of specific treatment for dyspnea before inclusion, immediate need for endotracheal intubation, patients identified as being at end-of-life, and individuals under legal guardianship or deprived of liberty.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Простое слепое

Основная цель

Диагностика

Центры проведения

Франция · 1 центр

• UHToulouse — Toulouse

Публикации

• Balen F, Hebrard M, Delmas C, Dubucs X, Noel-Savina E, Costa N, Shourick J; LUC REED investigators; and the LUC REED investigators. Lung and cardiac ultrasound for respiratory distress in the elderly: study protocol of the LUC REED stepped-wedge cluster randomised trial. BMJ Open. 2025 Aug 16;15(8):e104715. doi: 10.1136/bmjopen-2025-104715. PMID 40819865

Идентификаторы

NCT: NCT06807983 · RC31/23/0386 · 2024-A01678-39

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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