Comparative Analysis of Point-of-Care Ultrasound and Conventional Clinical Assessment for Volume Status Evaluation in Newly Admitted Hospital Patients

Background: Accurate determination of volume status in newly admitted hospital patients, particularly those with undifferentiated hypotension or suspected volume overload, remains a clinical challenge. Conventional bedside assessments including vital signs, history, and physical examination are often unreliable and limited by patient body habitus. Point-of-care ultrasound (POCUS) has emerged as a valuable adjunct for real-time, non-invasive evaluation of intravascular volume. Objective: This prospective observational cohort study aims to compare the diagnostic utility of POCUS with conventional clinical assessment in evaluating volume status in newly admitted hospital patients. Methods: The study will enroll adult patients admitted to the intensive care unit or emergency department of King Abdullah Medical City. Participants will undergo both conventional clinical volume assessment and POCUS evaluation, including inferior vena cava (IVC) diameter, collapsibility index (IVC-CI), lung ultrasound for B-lines, and focused cardiac ultrasound. The primary outcome is the accuracy of each method in diagnosing volume overload or depletion, as determined by a blinded expert panel using a composite clinical standard. Secondary outcomes include length of hospital stay, incidence of acute kidney injury, fluid administration volumes, and mortality. Results: Expected results will demonstrate the superior diagnostic accuracy of POCUS over conventional assessment, with particular emphasis on IVC dynamics and lung ultrasound findings correlating with volume status. Conclusion: POCUS is anticipated to offer a more precise, timely, and individualized approach to volume status assessment, potentially guiding more appropriate fluid management strategies and improving patient outcomes in acute care settings.