Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Intensive Care
Published in: Annals of Intensive Care 1/2018

Open Access 01-12-2018 | Research

Point-of-care ultrasonography in Brazilian intensive care units: a national survey

Authors: José Augusto Santos Pellegrini, Ricardo Luiz Cordioli, Ana Cristina Burigo Grumann, Patrícia Klarmann Ziegelmann, Leandro Utino Taniguchi

Published in: Annals of Intensive Care | Issue 1/2018

Login to get access

Abstract

Background

Point-of-care ultrasonography (POCUS) has recently become a useful tool that intensivists are incorporating into clinical practice. However, the incorporation of ultrasonography in critical care in developing countries is not straightforward.

Methods

Our objective was to investigate current practice and education regarding POCUS among Brazilian intensivists. A national survey was administered to Brazilian intensivists using an electronic questionnaire. Questions were selected by the Delphi method and assessed topics included organizational issues, POCUS technique and training patterns, machine availability, and main applications of POCUS in daily practice.

Results

Of 1533 intensivists who received the questionnaire, 322 responded from all of Brazil’s regions. Two hundred and five (63.8%) reported having access to an ultrasound machine dedicated to the intensive care unit (ICU); however, this was more likely in university hospitals than in non-university hospitals (80.6 vs. 59.6%; risk ratio [RR] = 1.35 [1.16–1.58], p = 0.002). The main applications of POCUS were ultrasound-guided central vein catheterization (49.4%) and bedside echocardiographic assessment (33.9%). Two hundred and fifty-eight (80.0%) reported having at least one POCUS-trained intensivist in their staff (trained units). Trained units were more likely to perform routine ultrasound-guided jugular vein catheterization than non-trained units (38.6 vs. 16.4%; RR = 2.35 [1.31–4.23], p = 0.001). The proportion of POCUS-trained intensivists and availability of a dedicated ultrasound machine were both independently associated with performing ultrasound-guided jugular vein catheterization (RR = 1.91 [1.32–2.77], p = 0.001) and (RR = 2.20 [1.26–3.29], p = 0.005), respectively.

Conclusions

A significant proportion of Brazilian ICUs had at least one intensivist with POCUS capability in their staff. Although ultrasound-guided central vein catheterization constitutes the main application of POCUS, adherence to guideline recommendations is still suboptimal.
Appendix
Available only for authorised users
Literature
1.
Lichtenstein D, van Hooland S, Elbers P, Malbrain ML. Ten good reasons to practice ultrasound in critical care. Anaesthesiol Intensive Ther. 2014;46(5):323–35.CrossRefPubMed
2.
Cardenas-Garcia J, Mayo PH. Bedside ultrasonography for the intensivist. Crit Care Clin. 2015;31(1):43–66.CrossRefPubMed
3.
Frankel HL, Kirkpatrick AW, Elbarbary M, Blaivas M, Desai H, Evans D, 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.CrossRefPubMed
4.
Levitov A, Frankel HL, Blaivas M, Kirkpatrick AW, Su E, Evans D, 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.CrossRefPubMed
5.
Maizel J, Bastide MA, Richecoeur J, Frenoy E, Lemaire C, Sauneuf B, et al. Practice of ultrasound-guided central venous catheter technique by the French intensivists: a survey from the BoReal study group. Ann Intensive Care. 2016;6(1):76.CrossRefPubMedPubMedCentral
6.
Soni NJ, Reyes LF, Keyt H, Arango A, Gelfond JA, Peters JI, et al. Use of ultrasound guidance for central venous catheterization: a national survey of intensivists and hospitalists. J Crit Care. 2016;36:277–83.CrossRefPubMed
7.
Bailey PL, Glance LG, Eaton MP, Parshall B, McIntosh S. A survey of the use of ultrasound during central venous catheterization. Anesth Analg. 2007;104(3):491–7.CrossRefPubMed
8.
Quintard H, Philip I, Ichai C. French survey on current use of ultrasound in the critical care unit: ECHOREA. Ann Fr Anesth Reanim. 2011;30(11):e69–73.CrossRefPubMed
9.
Zieleskiewicz L, Muller L, Lakhal K, Meresse Z, Arbelot C, Bertrand PM, et al. Point-of-care ultrasound in intensive care units: assessment of 1073 procedures in a multicentric, prospective, observational study. Intensive Care Med. 2015;41(9):1638–47.CrossRefPubMed
10.
Berlet T, Fehr T, Merz TM. Current practice of lung ultrasonography (LUS) in the diagnosis of pneumothorax: a survey of physician sonographers in Germany. Crit Ultrasound J. 2014;6(1):16.CrossRefPubMedPubMedCentral
11.
Estenssoro E, Alegria L, Murias G, Friedman G, Castro R, Nin Vaeza N, et al. Organizational issues, structure, and processes of care in 257 ICUs in Latin America: a study from the Latin America intensive care network. Crit Care Med. 2017;45(8):1325–36.CrossRefPubMed
12.
Burns KE, Duffett M, Kho ME, Meade MO, Adhikari NK, Sinuff T, et al. A guide for the design and conduct of self-administered surveys of clinicians. CMAJ. 2008;179(3):245–52.CrossRefPubMedPubMedCentral
13.
Lamperti M, Bodenham AR, Pittiruti M, Blaivas M, Augoustides JG, Elbarbary M, et al. International evidence-based recommendations on ultrasound-guided vascular access. Intensive Care Med. 2012;38(7):1105–17.CrossRefPubMed
14.
American Society of Anesthesiologists Task Force on Central Venous A, Rupp SM, Apfelbaum JL, Blitt C, Caplan RA, Connis RT, et al. Practice guidelines for central venous access: a report by the American Society of Anesthesiologists Task Force on Central Venous Access. Anesthesiology. 2012;116(3):539–73.CrossRef
15.
Troianos CA, Hartman GS, Glas KE, Skubas NJ, Eberhardt RT, Walker JD, et al. Special articles: guidelines for performing ultrasound guided vascular cannulation: recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. Anesth Analg. 2012;114(1):46–72.CrossRefPubMed
16.
Eisen LA, Leung S, Gallagher AE, Kvetan V. Barriers to ultrasound training in critical care medicine fellowships: a survey of program directors. Crit Care Med. 2010;38(10):1978–83.CrossRefPubMed
17.
Mayo PH, Beaulieu Y, Doelken P, Feller-Kopman D, Harrod C, Kaplan A, et al. American College of Chest Physicians/La Societe de Reanimation de Langue Francaise statement on competence in critical care ultrasonography. Chest. 2009;135(4):1050–60.CrossRefPubMed
18.
Expert Round Table on Echocardiography in ICU. International consensus statement on training standards for advanced critical care echocardiography. Intensive Care Med. 2014;40(5):654–66.CrossRef
19.
Jain MK, Heyland D, Dhaliwal R, Day AG, Drover J, Keefe L, et al. Dissemination of the Canadian clinical practice guidelines for nutrition support: results of a cluster randomized controlled trial. Crit Care Med. 2006;34(9):2362–9.CrossRefPubMed
20.
21.
Safdar N, Musuuza JS, Xie A, Hundt AS, Hall M, Wood K, et al. Management of ventilator-associated pneumonia in intensive care units: a mixed methods study assessing barriers and facilitators to guideline adherence. BMC Infect Dis. 2016;16:349.CrossRefPubMedPubMedCentral
22.
Peris A, Tutino L, Zagli G, Batacchi S, Cianchi G, Spina R, et al. The use of point-of-care bedside lung ultrasound significantly reduces the number of radiographs and computed tomography scans in critically ill patients. Anesth Analg. 2010;111(3):687–92.CrossRefPubMed
23.
Oks M, Cleven KL, Cardenas-Garcia J, Schaub JA, Koenig S, Cohen RI, et al. The effect of point-of-care ultrasonography on imaging studies in the medical ICU: a comparative study. Chest. 2014;146(6):1574–7.CrossRefPubMed
24.
Brunkhorst FM, Engel C, Ragaller M, Welte T, Rossaint R, Gerlach H, et al. Practice and perception—a nationwide survey of therapy habits in sepsis. Crit Care Med. 2008;36(10):2719–22.CrossRefPubMed
25.
Crawford SDCM, Lamias MJ. Web surveys: perceptions of burden. Soc Sci Comput Rev. 2001;19:146–62.CrossRef
Metadata
Title
Point-of-care ultrasonography in Brazilian intensive care units: a national survey
Authors
José Augusto Santos Pellegrini
Ricardo Luiz Cordioli
Ana Cristina Burigo Grumann
Patrícia Klarmann Ziegelmann
Leandro Utino Taniguchi
Publication date
01-12-2018
Publisher
Springer International Publishing
Published in
Annals of Intensive Care / Issue 1/2018
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-018-0397-3

Other articles of this Issue 1/2018

Annals of Intensive Care 1/2018 Go to the issue

Research

Fluid therapy and outcome: a prospective observational study in 65 German intensive care units between 2010 and 2011

Research

Hemodynamic effects of extended prone position sessions in ARDS

Letter to the Editor

Defending a mean arterial pressure in the intensive care unit: Are we there yet?

Research

High-flow nasal oxygen versus noninvasive ventilation in adult patients with cystic fibrosis: a randomized crossover physiological study

Research

The effect of a medication reconciliation program in two intensive care units in the Netherlands: a prospective intervention study with a before and after design

Review

Perioperative statin therapy in cardiac and non-cardiac surgery: a systematic review and meta-analysis of randomized controlled trials