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01-09-2015 | Original

Point-of-care ultrasound in intensive care units: assessment of 1073 procedures in a multicentric, prospective, observational study

Authors: Laurent Zieleskiewicz, Laurent Muller, Karim Lakhal, Zoe Meresse, Charlotte Arbelot, Pierre-Marie Bertrand, Belaid Bouhemad, Bernard Cholley, Didier Demory, Serge Duperret, Jacques Duranteau, Christophe Guervilly, Emmanuelle Hammad, Carole Ichai, Samir Jaber, Olivier Langeron, Jean-Yves Lefrant, Yazine Mahjoub, Eric Maury, Eric Meaudre, Fabrice Michel, Michel Muller, Cyril Nafati, Sébastien Perbet, Hervé Quintard, Béatrice Riu, Coralie Vigne, Kathia Chaumoitre, François Antonini, Bernard Allaouchiche, Claude Martin, Jean-Michel Constantin, Daniel De Backer, Marc Leone

Published in: Intensive Care Medicine | Issue 9/2015

Abstract

Objective

To describe current use and diagnostic and therapeutic impacts of point-of-care ultrasound (POCUS) in the intensive care unit (ICU).

Background

POCUS is of growing importance in the ICU. Several guidelines recommend its use for procedural guidance and diagnostic assessment. Nevertheless, its current use and clinical impact remain unknown.

Methods

Prospective multicentric study in 142 ICUs in France, Belgium, and Switzerland. All the POCUS procedures performed during a 24-h period were prospectively analyzed. Data regarding patient condition and the POCUS procedures were collected. Factors associated with diagnostic and therapeutic impacts were identified.

Results

Among 1954 patients hospitalized during the study period, 1073 (55 %) POCUS/day were performed in 709 (36 %) patients. POCUS served for diagnostic assessment in 932 (87 %) cases and procedural guidance in 141 (13 %) cases. Transthoracic echocardiography, lung ultrasound, and transcranial Doppler accounted for 51, 17, and 16 % of procedures, respectively. Diagnostic and therapeutic impacts of diagnostic POCUS examinations were 84 and 69 %, respectively. Ultrasound guidance was used in 54 and 15 % of cases for central venous line and arterial catheter placement, respectively. Hemodynamic instability, emergency conditions, transthoracic echocardiography, and ultrasounds performed by certified intensivists themselves were independent factors affecting diagnostic or therapeutic impacts.

Conclusions

With regard to guidelines, POCUS utilization for procedural guidance remains insufficient. In contrast, POCUS for diagnostic assessment is of extensive use. Its impact on both diagnosis and treatment of ICU patients seems critical. This study identified factors associated with an improved clinical value of POCUS.

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Title: Point-of-care ultrasound in intensive care units: assessment of 1073 procedures in a multicentric, prospective, observational study
Authors: Laurent Zieleskiewicz
Laurent Muller
Karim Lakhal
Zoe Meresse
Charlotte Arbelot
Pierre-Marie Bertrand
Belaid Bouhemad
Bernard Cholley
Didier Demory
Serge Duperret
Jacques Duranteau
Christophe Guervilly
Emmanuelle Hammad
Carole Ichai
Samir Jaber
Olivier Langeron
Jean-Yves Lefrant
Yazine Mahjoub
Eric Maury
Eric Meaudre
Fabrice Michel
Michel Muller
Cyril Nafati
Sébastien Perbet
Hervé Quintard
Béatrice Riu
Coralie Vigne
Kathia Chaumoitre
François Antonini
Bernard Allaouchiche
Claude Martin
Jean-Michel Constantin
Daniel De Backer
Marc Leone
Publication date: 01-09-2015
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 9/2015
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-015-3952-5

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Springer Medicine

Point-of-care ultrasound in intensive care units: assessment of 1073 procedures in a multicentric, prospective, observational study

Abstract

Objective

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Background

Methods

Results

Conclusions

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