Evaluation of the Impact of Pleuropulmonary Ultrasound on the Diagnosis of Dyspnea

NCT ID: NCT07104578

Last Updated: 2025-09-26

Basic Information

• Recruitment Status: RECRUITING
• Total Enrollment: 40 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2025-08-01
• Study Completion Date: 2027-02-01

Brief Summary

Dyspnea is a subjective symptom perceived by the patient as a sensation of "breathing discomfort", "suffocation", "lack of air" or "difficulty inhaling or exhaling". It is a frequent reason for calling for help (8% of calls). The most seriously ill patients require the dispatch of specialized teams capable of initiating respiratory support in order to reduce the morbidity and mortality of these patients. In France, these teams are medicalized by an emergency physician within the Mobile Emergency Resuscitation Services (SMUR). This is only rarely the case outside France, where specialized paramedical teams ("advanced life support paramedic teams") can be dispatched. Apart from their role of initiating possible respiratory support, these teams (SMUR or paramedics) can initiate a diagnostic approach and therapeutics related to the suspected origin of dyspnea. However, there are many diagnoses that can cause dyspnea, and the diagnostic process can be complex. The most common diagnoses described in the prehospital population are: bacterial pneumonia, acute heart failure, and exacerbation of COPD or asthma or pulmonary embolism. Each of these diagnoses requires specific drug treatment, guided by international recommendations. Inappropriate treatment of these pathologies (overtreatment or undertreatment) is common and associated with excess intrahospital mortality.

Pleuropulmonary ultrasound (PUS) has shown very interesting diagnostic performance in the intrahospital setting for diagnoses of interest in dyspnea. This performance also appears good in the prehospital setting. In the intrahospital setting, PUS appears to improve the diagnostic approach and appropriate treatments for dyspnea. In the prehospital setting, however, data on this subject are scarce or of limited quality according to the most recent meta-analysis, while the use of this technique is becoming increasingly common in standardized patient care. In addition, the most recent work on the subject included patients in a non-medicalized prehospital system. The use of PUS would allow paramedics to increase the rate of appropriate treatment from 14% to 53%. However, the rate of appropriate treatment expected by a medicalized team is expected to be 62%, and the diagnostic performance of physicians in PUS is probably higher than that of paramedics. These data must therefore be consolidated in a French system before being the subject of higher-level recommendations. The systematic use of PUS during prehospital engagement of a SMUR for dyspnea also may improves the rate of appropriate treatment, even in a context of medicalization of the initial care of patients.

Conditions

Dyspnea

Study Design

• Observational Model Type: CASE_ONLY
• Study Time Perspective: PROSPECTIVE

Study Groups

patients with respiratory distress

patients in respiratory distress treated by the SMUR

Pleuropulmonary ultra sound

Intervention Type: DIAGNOSTIC_TEST

pleuropulmonary ultrasound performed as part of the treatment

Interventions

Pleuropulmonary ultra sound

pleuropulmonary ultrasound performed as part of the treatment

Intervention Type: DIAGNOSTIC_TEST

Eligibility Criteria

Inclusion Criteria

• Adult patient
• Treated by a prehospital emergency medical service
• For dyspnea with signs of severity, the following are the following:

• SpO2 < 90% in AA or O2 required to maintain SpO2 ≥ 90% and
• RR > 25 cycles/min

Exclusion Criteria

• Opposition to inclusion
• Need for immediate intubation.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University Hospital, Toulouse

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Pauline Marchetto, PhD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Toulouse

Locations

Pôle Médecine d'Urgence Hôpital Purpan Pavillon Louis Lareng Place Docteur Baylac

Toulouse, , France

Site Status: RECRUITING

Countries

France

Central Contacts

Pauline Marchetto, PHD

Role: CONTACT

marchetto.p@chu-toulouse.fr

0561772579 ext. 33

Manon HEBRARD

Role: CONTACT

hebrard.m@chu-toulouse.fr

0561772579

Facility Contacts

Emeline Muller

Role: primary

muller.E@chu-toulouse.Fr

05 61 77 87 07 ext. 33

Other Identifiers

ID-RCB

Identifier Type: OTHER

Identifier Source: secondary_id

RC31/25/0219

Identifier Type: -

Identifier Source: org_study_id