01.09.2017 | Point of Care Thoracic Ultrasound (S Koenig, Section Editor)
Diagnosis of Deep Venous Thrombosis at the Point-of-Care
verfasst von:
Stella S. Hahn
Erschienen in:
Current Pulmonology Reports
|
Ausgabe 3/2017
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Abstract
Purpose of Review
The diagnosis of deep vein thrombosis (DVT) using compression ultrasound, at the point-of-care, by the treating physician is gaining acceptance, as the literature supports its diagnostic accuracy to be similar to that of exams performed by radiologists. While a traditional radiology DVT study uses both color and spectral Doppler in addition to compression (duplex or triplex exam), point-of-care ultrasonography in the diagnosis of DVT relies on compression alone without loss of sensitivity or specificity. Point-of-care ultrasound for DVT (POCdvt) has numerous advantages to radiology performed ultrasonography. Most importantly, there is no clinical or time dissociation when the exam is performed by the treating physician, may be performed whenever the clinical story warrants an exam, and may be repeated as needed. POCdvt is easy to learn, and portable ultrasound machines are becoming commonplace in both intensive care units, as well as general medical floors. This review is a summary of the literature of point-of-care ultrasound for DVTs.
Recent Findings
Point-of-care ultrasonography performed by bedside clinicians to diagnose proximal DVT using B-mode compression technique has good diagnostic accuracy with sensitivity and specificity that is comparable to radiology performed and interpreted exams.
Summary
Point-of-care ultrasonography to diagnose DVT has many clinical advantages and is becoming more widely used. Available literature supports the use of point-of-care ultrasound by bedside clinicians to diagnosis DVT using a compression-only technique. While it is clear that non-radiologists can become competent at performing POCdvt, the number of compression points required to adequately assess for DVT remains unclear, as numerous protocols have been described.