Feasibility of a point-of-care ultrasound protocol for cardiorespiratory evaluation of horses in different clinical settings.
Authors: Bevevino Kari E, Cohen Noah D, Gordon Sonya G, Navas de Solis Cristobal
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary: Point-of-Care Ultrasound for Equine Cardiorespiratory Assessment Rapid assessment of the heart and lungs at the roadside, in the stable, or at a competition has long been limited to auscultation and clinical observation, yet a standardised ultrasound protocol for this purpose has never been formally described. Bevevino and colleagues tested the feasibility of a portable ultrasound-based protocol (CRASH) comprising seven acoustic windows across the cardiorespiratory system, training sonographers-in-training to acquire these views and timing examinations in 161 horses: 27 healthy controls, 14 competing athletes, and 120 animals presenting with clinical disease across hospital, barn, and competition environments. Examinations could be completed in 5.5–6.9 minutes regardless of setting, with thoracic windows obtained most reliably; when reviewed by an expert, the protocol readily detected pathology including pleural effusion, lung consolidation, B-lines, and significant left-sided valvular disease. Whilst this study demonstrates that portable ultrasound is a practical adjunct to field assessment and the protocol itself is operationally feasible, clinicians should recognise that diagnostic accuracy and inter-observer agreement remain to be established—meaning further validation is essential before this tool can be reliably incorporated into decision-making for triage or treatment across different clinical scenarios.
Read the full abstract on PubMed
Practical Takeaways
- •Point-of-care ultrasound can provide rapid cardiorespiratory assessment in under 7 minutes at any location where horses are kept or compete, enabling faster clinical decision-making
- •Pocket-sized ultrasound devices are practical for field use and can detect significant abnormalities like pleural fluid and heart disease, supporting early diagnosis of compromised horses
- •Training sonographers on this protocol prioritizes thoracic and right parasternal windows as these are most reliably obtained, allowing focused skill development
Key Findings
- •The CRASH protocol was completed in 5.5±0.9 minutes for athletic horses and 6.9±1.9 minutes for horses with clinical disease using a pocket-sized ultrasound device
- •Thoracic windows were obtained most consistently, followed by right parasternal long-axis echocardiographic windows
- •Frequently detected abnormalities included pleural fluid, lung consolidation, B-lines, and moderate-to-severe left-sided heart disease
- •The protocol was feasible across multiple clinical settings including hospital, barn, and competition venues