Chest ultrasound in Italian geriatric wards: use, applications and clinicians’ attitudes

Background and aims. Bedside chest ultrasound has emerged as aversatile and accurate diagnostic tool for the management of respiratoryconditions in several clinical settings, integrating traditional imaging. Thecurrent utilization of this technique in geriatric hospital wards is still unknown.Our aim was to assess availability, uses and applications of chestultrasonography in a convenience sample of 25 Italian geriatric wards.Methods. A questionnaire, based on the current literature state-of-theart,was e-mailed to head doctors of geriatric wards of Italian hospitals.The questionnaire explored ultrasound equipment availability, practiceof chest ultrasound, expertise of ward physicians, clinical indications,and perceived impact on patient care.Results. Ultrasound equipment was available in 92% of wards, andchest ultrasound was performed in 82% of cases. Among the wardswhere chest ultrasound was performed, it was considered as routine assessmentin only 52% of cases, mainly for diagnosis of pleural effusions(95%) and acute heart failure (89%), assessment of volemic state (79%),and assistance to invasive procedures (79%). It was used in emergency/urgency assessment of acute dyspnea in only 53% of cases. In mostwards, only three or less physicians were able to perform chest ultrasound.In 53% of cases, head doctors declared that they perceived benefitsof chest ultrasound in patient care in only selected cases.Conclusions. Chest ultrasound utilization in Italian geriatric wards isinhomogeneous, and the number of trained physicians is still limited.Geriatricians’ attitude towards chest ultrasound is generally cautious.Research and training programs are needed to spread the correct useof this technique in geriatric practice.