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Point-of-Care ultrasound on oncology inpatients with respiratory abnormalities

Lior Fuchs

 Here, we present for the first time a case series demonstrating the ability of Point of Care ultrasonography (POCUS) to contribute clinically significant findings, which may affect the management of oncologic inpatients with respiratory symptoms. This is a pilot, prospective case series of 13 patients with various malignancies admitted to the inpatient oncology ward at a large tertiary medical center.

Patients presenting dyspnea or other respiratory abnormalities were examined by POCUS of the heart, lungs, and IVC. Exam findings were delivered to the patients’ treating physicians with no other treatment or management recommendations. Our primary outcome was to assess the association between POCUS findings and the rate of management change among oncology patients with respiratory symptoms. Thirteen cancer patients admitted to the oncology ward that presented with dyspnea or developed a respiratory abnormality during their hospital stay were enrolled in the study. All received POCUS assessment for dyspnea.

The POCUS exam revealed clinically relevant findings and led to alteration management among 11/13 (84%) of patients. Among 6/11 (54.5%) patients, a new procedure was performed (four pleural taps, one pleural drain was removed, one dialysis), in 3/11 patients (27.2%) a new imaging study was ordered (echocardiography in all cases), in 2/11 patients (18.1%) a new consult was requested, and in 3/11 patients (27.2%) a change in medical management was made based on POCUS findings.

Incorporation of POCUS exam into routine diagnostic workup of patients admitted to the oncological ward with new respiratory abnormalities does lead to frequent change in patient management and may potentially improve patient outcomes.