The following is a summary of “Diagnostic efficiency of whole-body bedside ultrasonography protocol for syncope patients in the emergency department,” published in the May 2023 issue of Emergency Medicine by Ucar, et al.

For a study, researchers sought to investigate the use of whole-body ultrasonography for syncope (WHOBUS-Syncope) protocol in detecting the critical etiology of syncope in patients presenting to the emergency department (ED). 

A total of 152 patients over the age of 18 years with syncope or near syncope were included in the study. The median age of the patients was 61.5 years (IQR: 41–71.8), and 52.6% were female. The WHOBUS-Syncope protocol included carotid, lung, cardiac, collapsibility of inferior vena cava, abdominal, and compression ultrasonography of the lower extremity veins. 

The study’s primary outcome was to determine the frequency of abnormal sonographic findings associated with syncope/presyncope and the requirement for critical intervention for abnormal sonographic findings. The study found that the most common abnormal sonographic finding was >50% collapse of the inferior vena cava during inspiration, detected in 64.3% of the patients. Abnormal sonographic findings thought to cause syncope/presyncope were detected in 35.5% of the patients. Bolus fluid resuscitation was given in 62 patients (40.8%) with increased inferior vena cava collapse. Critical interventions other than fluid resuscitation were performed for abnormal sonographic findings in 35 (23%) patients. Advanced age, increased heart rate, and high-risk criteria in the European Society of Cardiology Guidelines for Syncope were independent risk factors for detecting abnormal ultrasonographic findings related to syncope/presyncope.

According to the study’s findings, the WHOBUS-Syncope protocol can be used in emergency medicine as part of the routine examination of patients who report to the ED with syncope or presyncope. The protocol was found to be effective in detecting high-risk patients and in guiding critical interventions for abnormal sonographic findings.

Source: sciencedirect.com/science/article/abs/pii/S0735675723000487