Uso de ecografía a pie de cama en al evaluación de la disnea aguda: una revision exhaustiva de la evidencia sobre su utilidad diagnóstica

Use of bedside ultrasound in the evaluation of acute dyspnea: a comprehensive review of evidence on diagnostic usefulness

Contenido principal del artículo

Ivan David Lozada-Martinez
Isabela Zenilma Daza-Patiño
Gerardo Jesus Farley Reina-González
Sebastián Rojas-Pava
Ailyn Zenith Angulo-Lara
María Paola Carmona-Rodiño
Olga Gissela Sarmiento-Najar
Jhon Mike Romero-Madera
Yesid Alonso Ángel-Hernandez

Resumen

Introducción: La disnea aguda es uno de los síntomas más frecuentemente observados en los servicios de urgencias, que puede estar causada principalmente por la afectación del sistema pulmonar o cardíaco. La ecografía a pie de cama se postula como una herramienta innovadora, al complementar la exploración física con la evaluación rapida de las estructuras intratorácicas.


Objetivos: Sintetizar la evidencia reciente sobre el uso de la ecografía a pie de cama en la evaluación de la disnea aguda.


Materiales y Métodos: Se realizó una búsqueda bibliográfica utilizando términos de búsqueda como "Bedside Ultrasound" y "Acute Dyspnea", así como sinónimos, que se combinaron con operadores booleanos, en 5 bases de datos.


Resultados: Se evidenció que el uso de la ecografía a pie de cama cambia el diagnóstico principal asociado a la disnea aguda en más del 60% de los casos, siendo los más frecuentes la insuficiencia cardiaca aguda descompensada y la neumonía. Protocolos como el SEARCH 8Es para la evaluación de la disnea en el servicio de urgencias, tiene un rendimiento con parámetros de sensibilidad, especificidad, valor predictivo positivo y negativo superiores al 95%.


Conclusion: La evidencia actual sobre el uso de la ecografía a pie de cama en el tratamiento de los pacientes con disnea aguda en el servicio de urgencias es limitada. No obstante, sugiere que esta herramienta puede favorecer el rendimiento diagnóstico de la disnea aguda de causa pulmonar o cardíaca, mejorar el tiempo de diagnóstico y aumentar la confianza del médico en el diagnóstico.

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