The utility of point of care ultrasonography driven by clinicians in the assessment and investigation of lung pathologies

Molepo, Samuel Ditau
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Background Point of care ultrasonography (POCUS) is increasingly widespread in its use across most developed countries. In South Africa, it has been routinely used within emergency medicine and critical care medicine while its uptake in internal medicine has been slow. Objectives To describe the utility of point of care ultrasonography as used by the division of pulmonology in terms of its indications, findings, and safety profile. Methods A retrospective record review was undertaken of patients who underwent assessment with point of care thoracic ultrasonography at Helen Joseph Hospital by the division of pulmonology from 13 October 2017 to 31 July 2019. Results A total of 141 patients underwent thoracic POCUS of which 19.9% were for qualitative (imaging only) purposes, and 80.1% for interventional purposes. Of the interventional arm, the most common procedures were POCUS guided thoracocentesis followed by POCUS guided lung biopsies. The commonest cause of pleural effusions was found to be exudative pleural effusions that could not be further specified, while the commonest biopsy result was adenocarcinoma of the lung. The major complication rate was 0%, and minor complication rate was 12%. Conclusion There is a role for the expanded use of POCUS within internal medicine, specifically pulmonology. This study, although small, is in line with international literature that shows POCUS to be safe, cost effective, time saving and it can improve diagnostic accuracy.
A dissertation submitted in fulfilment of the requirements for the degree Master of Medicine in Internal Medicine to the Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, 2022