Utility of Point-of-Care Ultrasound in the Early Detection of Sepsis: A Prospective Observational Study

Abstract

Objectives: To assess the effectiveness of point-of-care ultrasound in identifying sepsis at an early stage among patients presenting with suspected infection.

Methodology: A prospective observational single-center clinical study was undertaken at the POF Hospital, Wah Cantt, Pakistan, from July to December 2024. A total of 150 adult patients presenting with suspected sepsis were enrolled. Point-of-Care Ultrasound (POCUS) examination took place during the first hour of presentation, which assessed volume status by evaluating collapsibility of the inferior vena cava (IVC) and included assessment for potential sources of infection (pneumonia, biliary tract infection, urinary tract obstruction, intra-abdominal fluid collection etc). The results were contrasted with traditional diagnostic techniques and the ultimate clinical diagnoses.

Results Within the first hour of presentation, 117 patients (78%) out of 150 had a probable infectious source found by POCUS. The most commonly identified sources of infection were intra-abdominal fluid collections (12 cases, 8%), abnormal biliary function (21 cases, 14%), urinary tract obstruction (18 cases, 12%), and lung consolidation due to pneumonia (42 cases, 28%). The volume evaluations of IVC resulted in identifying that 64 of the patients studied (43%) were hypovolemic, 55 of them (37%) were euvolemic, and 31 of them (21%) hypervolemic. The sensitivity of POCUS for identifying sepsis-related conditions was calculated to be 89%, and the specificity was calculated to be 82%, coinciding with the final clinical determination for 131 of the patients studied (87%).

Conclusion: POCUS has shown to be an effective tool to rapidly identify infection sources and assess fluid status to aid in the early assessment and diagnosis of this condition. Incorporating the use of POCUS in initial sepsis diagnostic protocols for critical care and emergency physicians may lead to greater improvement in patient outcomes and care.

Keywords: Critical Care, Early Diagnosis, Point-of-Care Systems, Sepsis, Ultrasonography.