Palipocus: The Use of POCUS in the Palliative Care Setting
DOI:
https://doi.org/10.24950/rspmi.651Keywords:
Internal Medicine, Palliative Care, Point-of-Care Systems, UltrasonographyAbstract
Palliative care is the holistic care of individuals with serious health-related suffering due to severe illness. The improving survival in malignant and non-malignant diseases results in an ageing population who live with advanced chronic diseases that commonly present to acute care settings. With our improved ability to relief symptoms and treat intercurrent complications, imaging can be an important aspect of modern palliative care. Point-of-care ultrasound (POCUS) is ultrasound used at the bedside to answer directed clinical questions and guide clinical care. The goals of our review are to provide greater understanding about utility and appropriateness of the use of POCUS in palliative care. The use of POCUS in the clinical setting has increased substantially in recent years, and its characteristics make it an attractive diagnostic and therapeutic adjunct in palliative care, namely in home-based care.
Downloads
References
Radbruch L, De Lima L, Knaul F, Wenk R, Ali Z, Bhatnaghar S, et al. Redefining Palliative Care-A New Consensus-Based Definition. J Pain Symptom Manage. 2020;60:754-64. doi: 10.1016/j.jpainsymman.2020.04.027.
Wang DH. Beyond Code Status: Palliative Care Begins in the Emergency Department. Ann Emerg Med. 2017:437-443. doi: 10.1016/j.annemergmed.2016.10.027.
World Health Organization. Palliative Care Key facts.. Geneva: WHO; 2020.
Grudzen CR, Stone SC, Morrison RS. The palliative care model for emergency department patients with advanced illness. J Palliat Med.
;14:945-50. doi: 10.1089/jpm.2011.0011.
Breakey N, Osterwalder J, Mathis G, Lehmann B, Sauter TC. Point of care ultrasound for rapid assessment and treatment of palliative care patients in acute medical settings. Eur J Intern Med. 2020;81:7-14. doi: 10.1016/j.ejim.2020.08.007.
Dean AJ, Melniker LA. Hospice and palliative medicine ultrasound: a new horizon for emergency medicine? Acad Emerg Med.m2010;17:330-2. doi: 10.1111/j.1553-2712.2010.00688.x.
Grant MP, Cardin A, O'Connor N, Eastman P. Examining Clinical Utility of Imaging for Inpatient Palliative Care. Am J Hosp Palliat Care. 2017. doi: 10.1177/1049909116640524.
LoPresti CM, Jensen TP, Dversdal RK, Astiz DJ. Point-of-Care Ultrasound for Internal Medicine Residency Training: A Position Statement from the Alliance of Academic Internal Medicine. Am J Med. 2019:1356-1360. doi: 10.1016/j.amjmed.2019.07.019.
Vargas-Bermúdez A, Valverde-Vega A, Vargas-Aguilar K, Espinoza-Sánchez A. Point-of-Care Ultrasound in the Academic Training of Palliative Medicine Residents. J Palliat Med. 2017:699-700. doi: 10.1089/jpm.2017.0055. Epub 2017 Mar 15. PMID: 28296557.
Ambasta A, Balan M, Mayette M, Goffi A, Mulvagh S, Buchanan B, Montague S, Ruzycki S, Ma IWY; Canadian Internal Medicine Ultrasound (CIMUS) Group. Education Indicators for Internal Medicine Point-of-Care Ultrasound: a Consensus Report from the Canadian Internal Medicine Ultrasound (CIMUS) Group. J Gen Intern Med. 2019:2123-2129. doi: 10.1007/s11606-019-05124-1. Erratum in: J Gen Intern Med. 2020:624.
Nuernberg D, Jenssen C, Fröhlich E, Ignee A, Mathis G, Dietrich CF. Bedeutung der Sonografie in der Palliativmedizin (Palliative Sonografie) Teil 2 [Ultrasound in palliative care medicine, Part II]. Z Gastroenterol. 2017:582-591. doi: 10.1055/s-0043-104780.
Gishen F, Trotman I. Bedside ultrasound--experience in a palliative care unit. Eur J Cancer Care. 2009;18:642-4. doi: 10.1111/j.1365-
-2354.2009.01071.x.13. Villalobos K. Ultrasound application in point of care by palliative medicine physicians: Initial experience of oncology palliative medicine consultation in two rural area hospitals in Costa Rica. J Clin Oncol. 2017; 35; 254. doi: 10.1200/JCO.2017.35.31_suppl.254.
Solano JP, Gomes B, Higginson IJ. A comparison of symptom prevalence in far advanced cancer, AIDS, heart disease, chronic obstructive pulmonary disease and renal disease. J Pain Symptom Manage. 2006:58-69. doi: 10.1016/j.jpainsymman.2005.06.007. 15. Shreves A, Pour TR. Emergency department management of dyspnea in the dying patient. Emerg Med Pract. 2018:1-20.
Currow DC, Smith J, Davidson PM, Newton PJ, Agar MR, Abernethy AP. Do the trajectories of dyspnea differ in prevalence and intensity by diagnosis at the end of life? A consecutive cohort study. J Pain Symptom Manage. 2010:680-90. doi: 10.1016/j.jpainsymman.2009.09.017.
Rempell JS, Noble VE. Using lung ultrasound to differentiate patients in acute dyspnea in the prehospital emergency setting. Crit Care. 2011;15:161. doi: 10.1186/cc10226.
Breakey N, Osterwalder J, Mathis G, Lehmann B, Sauter TC. Point of care ultrasound for rapid assessment and treatment of palliative care patients in acute medical settings. Eur J Intern Med. 2020;81:7-14. doi: 10.1016/j.ejim.2020.08.007.
Cylwik J, Buda N. Possibilities of ultrasonography in diagnosing causes of dyspnea in palliative care cancer patients. Palliative Med Pact. 2020;14:205–11. doi: 10.5603/PMPI.2020.0024
Lichtenstein DA, Mezière GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest. 2008;134:117-25. doi: 10.1378/chest.07-2800. Erratum in: Chest. 2013;144:721.
Prentice J, Amer T, Tasleem A, Aboumarzouk O. Malignant ureteric obstruction decompression: how much gain for how much pain? A narrative review. J R Soc Med. 2018;111:125-135. doi: 10.1177/0141076818766725.
D'Silva KA, Dahm P, Wong CL. Does this man with lower urinary tract symptoms have bladder outlet obstruction?: The Rational Clinical Examination: a systematic review. JAMA. 2014;312:535-42. doi: 10.1001/jama.2014.5555. Erratum in: JAMA. 2016;315:518.
Bergstra TG, Gutmanis I, Byrne J, Faulds C, Whitfield P, McCallum S, Shadd J. Urinary Retention and Medication Utilization on a Palliative Care Unit: A Retrospective Observational Study. J Pain Palliat Care Pharmacother. 2017;31:212-217. doi: 10.1080/15360288.2017.1417951.
Tintinalli JE. Acute urinary retention as a presenting sign of spinal cord compression. Ann Emerg Med. 1986;15:1235-7. doi: 10.1016/s0196-0644(86)80876-9.
Abernethy AP, Wheeler JL, Zafar SY. Management of gastrointestinal symptoms in advanced cancer patients: the rapid learning cancer clinic model. Curr Opin Support Palliat Care. 2010;4:36-45. doi: 10.1097/SPC.0b013e32833575fd.
Tomizawa M, Shinozaki F, Hasegawa R, Shirai Y, Motoyoshi Y, Sugiyama T, Yamamoto S, Ishige N. Abdominal ultrasonography for patients with abdominal pain as a first-line diagnostic imaging modality. Exp Ther Med. 2017;13:1932-1936. doi: 10.3892/etm.2017.4209.
Palliative Care in the Acute Care Setting: Background, Symptoms and Pathophysiology, Frequency [Internet]. [cited 2021 Jun 11]. Available from: https://emedicine.medscape.com/article/1407757-overview#a14
White C, Noble SIR, Watson M, Swan F, Allgar VL, Napier E, et al. Prevalence, symptom burden, and natural history of deep vein thrombosis in people with advanced cancer in specialist palliative care units (HIDDen): a prospective longitudinal observational study. Lancet Haematol. 2019:e79-e88. doi: 10.1016/S2352-3026(18)30215-1. Erratum in: Lancet Haematol. 2019:e294.
Sandset PM, Dahm AEA. Is venous thromboembolism a problem in patients with cancer in palliative care? Lancet Haematol. 2019:e61-e62. doi: 10.1016/S2352-3026(18)30218-7.
Noble S. Venous thromboembolism and palliative care. Clin Med. 2019;19:315-318. doi: 10.7861/clinmedicine.19-4-315.
Needleman L, Cronan JJ, Lilly MP, Merli GJ, Adhikari S, Hertzberg BS, et al. Ultrasound for Lower Extremity Deep Venous Thrombosis: Multidisciplinary Recommendations From the Society of Radiologists in Ultrasound Consensus Conference. Circulation. 2018;137:1505-15. doi: 10.1161/CIRCULATIONAHA.117.030687.
Landers A, Ryan B. The use of bedside ultrasound and community-based paracentesis in a palliative care service. J Prim Health Care. 2014:148-51.
Mariani PJ, Setla JA. Palliative ultrasound for home care hospice patients. Acad Emerg Med. 2010;17:293-6. doi: 10.1111/j.1553-
-2712.2009.00678.x.
Dhamija E, Thulkar S, Bhatnagar S. Utility and potential of bedside ultrasound in palliative care. Indian J Palliat Care. 2015;21:132-6. doi: 10.4103/0973-1075.156465.
Muduly D, Deo S, Subi Ts, Kallianpur A, Shukla N. An update in the management of malignant pleural effusion. Indian J Palliat Care.
;17:98-103. doi: 10.4103/0973-1075.84529.
Neal JM, Brull R, Chan VW, Grant SA, Horn JL, Liu SS, et al. The ASRA evidence-based medicine assessment of ultrasound-guided regional anesthesia and pain medicine: Executive summary. Reg Anesth Pain Med. 2010;35:S1-9. doi: 10.1097/AAP.0b013e3181d22fe0. Erratum in: Reg Anesth Pain Med. 2010;35:325.
Chernack B, Knowlton SE, Kohler MJ. The Use of Ultrasound in Palliative Care and Hospice. Am J Hosp Palliat Care. 2017;34:385-391. doi: 10.1177/1049909115625960.
Egan G, Healy D, O'Neill H, Clarke-Moloney M, Grace PA, Walsh SR. Ultrasound guidance for difficult peripheral venous access: systematic review and meta-analysis. Emerg Med J. 2013;30:521-6. doi: 10.1136/emermed-2012-201652.
Bortolussi R, Zotti P, Conte M, Marson R, Polesel J, Colussi A, et al. Quality of Life, Pain Perception, and Distress Correlated to Ultrasound-Guided Peripherally Inserted Central Venous Catheters in Palliative Care Patients in a Home or Hospice Setting. J Pain Symptom Manage. 2015;50:118-23. doi: 10.1016/j.jpainsymman.2015.02.027.
Shokoohi H, Duggan NM, Adhikari S, Selame LA, Amini R, Blaivas M. Point-of-care ultrasound stewardship. J Am Coll Emerg Physicians Open. 2020:1326. doi: 10.1002/emp2.12279
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Medicina Interna
Open Access
