SHoC-ED Trial Summary: POCUS in ER for Hypotension

POCUS in ER for hypotension clinical trial

2018 SHOC-ED TRIAL M Does point-of-care ultrasonography improve clinical outcomes in emergency department patients with undifferentiated hypotension? International, multicenter, randomized controlled trial Objective: To determine whether a standardised point-of-care D ultrasound (POCUS) protocol, compared with usual care, improves 30 day or hospital survival in selected non-trauma patients presenting to the ED with undifferentiated hypotension 273 Inclusion criteria: Patients aged >19 years with sustained SBP <100mmHg OR Shock index (systolic BP/HR) of >1.0 (with systolic BP <120 mmHg) patients POCUS n=138) Standard care (n=135) PRIMARY OUTCOME 76.5 Overall survival at 30 days OR hospital discharge % Diff. 0.35; 95% CI – 10.2 to – 11.1 76.1 SECONDARY OUTCOMES Hospital admissions rates % Diff. 1.8; 95% CI -7.7 to 11.2 83 Inotrope administration rates % Diff. 3.6; 95% CI-4.6 to 11.8 7.16 Median ICU length of stay (in days) Diff. 2.01; 95% CI -0.85 to 4.63 5.14 Conclusion: In ED patients with undifferentiated hypotension, the addition of a point of care ultrasound protocol did not translate to additional benefit PR Atkinson et al. Ann Emerg Med. 2018 Oct;72(4):478-489