New research finds an ultrasound screening may improve the outcomes of the critically ill. The research focuses on patients who have a catheter in the main artery in their thigh called the femoral artery. The study finds ultrasound screening is cost effective and could help in the prevention of blood clots or venous thrombosis.
Almost half of the 31 million patients admitted into the intensive care unit each year receive a central venous catheter. It's estimated femoral vein placement of the catheter is associated with the development of blood clots in around 8 per cent to 27 per cent of the patients. Since there are many advantages to using the vein in the thigh for a catheter, researchers from Duke University Medical Center conducted a study to see if it is cost effective to do an ultrasound screening on these patients and whether that could help detect a blood clot and future problems.
Researchers say in about half of the patients who develop a blood clot, pulmonary embolism occurs. A pulmonary embolism is the blockage of the pulmonary artery or one of its branches by a blood clot. The risk of death from pulmonary embolism increases in the critically ill.
For the study, researchers used a model to analyze the outcomes of 1,000 patients with assumed acute respiratory failure requiring mechanical ventilation. They assumed the patients received ventilation for seven days, as well as an intensive care unit stay of eight days, and an additional eight days in the hospital. After calculating the costs, researchers say the ultrasound strategy costs $8,688 per quality adjusted life year gained, $5,305 per pulmonary embolism averted, and $98,286 per pulmonary embolism death averted.
Overall, researchers say the ultrasound results show that 253 nonfatal and 14 fatal pulmonary embolisms could be avoided with the screening. They conclude the ultrasound screening is not only cost effective, but could also improve the outcomes of critically ill patients.