The role of ultrasound in patients with possible penetrating cardiac wounds: A prospective multicenter study

Background: Ultrasound is quickly becoming part of the trauma surgeon's pra ctice, but its role in the patient with a penetrating truncal injury is not well defined. The purpose of this study was to evaluate the accuracy of em ergency ultrasound as it was introduced into five Level I trauma centers fo r the diagnosis of acute hemopericardium. Methods: Surgeons or cardiologists (four centers) and technicians tone cent er) performed pericardial ultrasound examinations on patients with penetrat ing truncal wounds, By protocol, patients with positive examinations underw ent immediate operation. Vital signs, base deficit, time from examination t o operation, operative findings, treatment, and outcome were recorded, Results: Pericardial ultrasound examinations were performed in 261 patients . There were 225 (86.2%) true-negative, 29 (11.1%) true-positive, 0 false-n egative, and 7 (2.7%) false-positive examinations, resulting in sensitivity of 100%, specificity of 96.9%, and accuracy of 97.3%, The mean time from u ltrasound to operation was 12.1 +/- 5 minutes. Conclusion: Ultrasound should be the initial modality for the evaluation of patients with penetrating precordial wounds because it is accurate and rap id.