Ultrasound imaging technology and techniques have rapidly advanced over the past decade and are now at the point where they should be considered a standard and critical component of critical care practice. All current and future intensivists should be thoroughly familiar with the myriad of applications of point-of-care ultrasound (POCUS) for assisting in the assessment, diagnostic workup, and therapeutic interventions in the intensive care unit (ICU) setting. POCUS differs from comprehensive ultrasound (US) in its intent and use. POCUS is performed bedside by a clinician, employed to detect acute and often life-threatening conditions to facilitate treatment or to guide performance of an invasive procedure. It is quick and usually only focuses on a single or limited set of organs. Its clinical applications can be viewed as procedural guidance, diagnostics, monitoring, or resuscitation, with guidelines for the appropriate use of bedside ultrasound in the ICU set forth by the Society of Critical Care Medicine. By following evidence-based recommendations regarding the appropriate use of ultrasound in the ICU, clinicians can provide selected patients with effective and efficient care. This chapter will review the key points and strategies for ICU physicians to incorporate POCUS into their day-to-day practice.
Ultrasound Imaging Echocardiography Parasternal long-axis view PLAX Parasternal short- axis view PSAX Apical four-chamber view A4C Apical five-chamber view Subcostal long-axis four-chamber view Subcostal IVC longitudinal view Intensive care unit Point of care Critical care
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Dussik KT. Uber die moglichkeit hochfrequente mechanische schwingungen als diagnostisches hilfsmittel zu verwerten. Zeitschrift für die gesamte Neurologie und Psychiatrie. 1942;174(1):153–68.CrossRefGoogle Scholar
Levitov A, Mayo P, Slonim A. Critical care ultrasound. 2nd ed. New York: McGraw Hill; 2014.Google Scholar
Frankel H, Kirkpatrick A, Elbarbary M, et al. Guidelines for the appropriate use of bedside general and cardiac ultrasonography in the evaluation of critically ill patients part I: general ultrasonography. Crit Care Med. 2015;43(11):2479–502.CrossRefPubMedGoogle Scholar
Levitov A, Frankel H, Blaivas M, et al. Guidelines for the appropriate use of bedside general and cardiac ultrasonography in the evaluation of critically ill patients part II: cardiac ultrasonography. Crit Care Med. 2016;44(6):1206–27.CrossRefPubMedGoogle Scholar
Mayo P, Beaulieu Y, Doelken P, et al. American College of Chest Physicians/La Société de Réanimation de Langue Française Statement on Competence in Critical Care Ultrasonography*. Chest. 2009;135:1050–60.CrossRefPubMedPubMedCentralGoogle Scholar
Mayo P, Vieillard-Baron A. International consensus statement on training standards for advanced critical care echocardiography. Intensive Care Med. 2014;40(5):654–66.CrossRefGoogle Scholar
Huang SJ, McLean AS. Do we need a critical care ultrasound certification program? Implications from an Australian medical-legal perspective. Crit Care. 2010;14:313.CrossRefPubMedPubMedCentralGoogle Scholar
McConnell MV, Solomon SD, Rayan ME, Come PC, Goldhaber SZ, Lee RT. Regional right ventricular dysfunction detected by echocardiography in acute pulmonary embolism. Am J Cardiol. 1996;78:469–73.CrossRefPubMedGoogle Scholar