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The following is a summary of “Diagnostic accuracy of multi-organ point-of-care ultrasound for pulmonary embolism in critically ill patients: a systematic review and meta-analysis,” published in the April 2025 issue of Critical Care by Melo et al. 

The clinical presentation of acute pulmonary embolism (PE) ranged from mild symptoms to fatal outcomes, with high mortality observed when undiagnosed, while limitations of computed tomography pulmonary angiography (CTPA) highlighted the value of point-of-care ultrasound (POCUS) as a bedside diagnostic tool.  

Researchers conducted a retrospective study to assess the accuracy of multi-organ POCUS in diagnosing PE in critical care settings.  

They searched PubMed, Embase, Scopus, and the Cochrane Library for studies comparing multi-organ POCUS with CTPA or ventilation-perfusion scans for diagnosing PE in critical care settings, 2 reviewers independently conducted the search, data extraction, and quality assessment using the QUADAS-2 tool. Heterogeneity was assessed using I² (Inconsistency index) statistics. A bivariate random-effects model was applied to summarize pooled diagnostic odds ratio (DOR), sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and summary receiver operating characteristic (SROC).  

The results showed that 4 studies with 594 participants met the inclusion criteria. The participants’ mean age ranged from 55.2 to 71 years, with PE prevalence varying from 28% to 66.2%. Most studies used CTPA as the reference standard. Multi-organ POCUS for diagnosing PE had a pooled DOR of 25.3 (95% CI 4.43–82.9), sensitivity of 0.90 (95% CI 0.85–0.94; I  = 0%), and specificity of 0.69 (95% CI 0.42–0.87; I²  = 95%). The PLR was 3.35 (95% CI 1.43–8.02), and the NLR was 0.16 (95% CI 0.08–0.32). The SROC curve showed an area under the curve (AUC) of 0.89 (95% CI 0.81–0.94).  

Investigators concluded that multi-organ POCUS exhibited high diagnostic accuracy for PE in patients with critically illness, but further validation across diverse populations was necessary. 

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-025-05359-x