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Updated: Jul 10, 2025
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Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
Published on: September 8, 2023
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The sonographic protocol for the emergent evaluation of aortic dissections (SPEED protocol): A multicenter,
Ryan C Gibbons1, Dylan Smith2, Rivka Feig3
1Department of Emergency Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA.
Summary
Point-of-care ultrasound (POCUS) shows high sensitivity for diagnosing aortic dissection (AoD) in unstable patients. This SPEED protocol can aid rapid diagnosis in emergency settings.
Area of Science:
- Emergency Medicine
- Diagnostic Imaging
- Cardiovascular Ultrasound
Background:
- Aortic dissection (AoD) is a critical condition with high mortality.
- Computed tomography angiography is standard but impractical for unstable patients.
- Point-of-care ultrasound (POCUS) offers a potential bedside diagnostic solution.
Purpose of the Study:
- To evaluate the diagnostic performance of a novel POCUS protocol for AoD.
- To determine the test characteristics of the SPEED (Sonographic Protocol for the Evaluation of Aortic Dissection) protocol.
Main Methods:
- A multicenter, prospective, observational cohort study.
- Adult patients with suspected AoD underwent TTE and abdominal aorta POCUS.
- Analysis included three key sonographic signs: pericardial effusion, intimal flap, or aortic outflow tract diameter >35mm.
Main Results:
- The SPEED protocol demonstrated a sensitivity of 93.2% and specificity of 90.9% for AoD.
- Of 44 confirmed AoD cases, 41 showed at least one sonographic finding.
- The protocol achieved 91% accuracy with a negative predictive value of 99.7%.
Conclusions:
- The SPEED protocol exhibits high sensitivity for detecting aortic dissection.
- POCUS can be a valuable tool for rapid AoD assessment in emergency departments.
