Top

Published in:

09-08-2022 | Transesophageal Echocardiography | Narrative Review

Machines that save lives in the intensive care unit: the ultrasonography machine

Authors: Paul H. Mayo, Michelle Chew, Ghislaine Douflé, Armand Mekontso-Dessap, Mangala Narasimhan, Antoine Vieillard-Baron

Published in: Intensive Care Medicine | Issue 10/2022

Abstract

This article highlights the ultrasonography machine as a machine that saves lives in the intensive care unit. We review its utility in the limited resource intensive care unit and some elements of machine design that are relevant to both the constrained operating environment and the well-resourced intensive care unit. As the ultrasonography machine can only save lives, if is operated by a competent intensivist; we discuss the challenges of training the frontline clinician to become competent in critical care ultrasonography followed by a review of research that supports its use.

Rudd KE, Johnson SC, Agesa KM et al (2020) Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. Lancet 395:200–211PubMedPubMedCentralCrossRef

Aziz S, Arabi YM, Alhazzani W et al (2020) Managing ICU surge during the COVID-19 crisis: rapid guidelines. Intensive Care Med 46:1303–1325PubMedPubMedCentralCrossRef

MekontsoDessap A (2019) Frugal innovation for critical care. Intensive Care Med 45:252–254CrossRef

Weyrauch T, Herstatt C (2017) What is frugal innovation? Three defining criteria. J Frugal Innov 2:1–7CrossRef

Laumer F, Di Vece D, Cammann VL et al (2022) Assessment of artificial intelligence in echocardiography diagnostics in differentiating Takotsubo Syndrome from myocardial infarction. JAMA Cardiol 7:494–503 PubMedCrossRef

Pham T, Beloncle F, Piquilloud L et al (2021) Assessment of a massive open online course (MOOC) incorporating interactive simulation videos on residents’ knowledge retention regarding mechanical ventilation. BMC Med Educ 21:1–11CrossRef

Shaddock L, Smith T (2022) Potential for use of portable ultrasound devices in rural and remote settings in australia and other developed countries: a systematic review. J Multidiscip Healthc 15:605PubMedPubMedCentralCrossRef

Riviello ED, Kiviri W, Twagirumugabe T et al (2016) Hospital incidence and outcomes of the acute respiratory distress syndrome using the Kigali modification of the Berlin definition. Am J Resp Crit Care Med 193:52–59PubMedCrossRef

Expert Round Table on Ultrasound in ICU (2011) International expert statement on training standards for critical care ultrasonography. Intensive Care Med 37:1077–1083CrossRef

10.

Wong A, Galarza L, Forni L, De Backer D et al (2020) Recommendations for core critical care ultrasound competencies as a part of specialist training in multidisciplinary intensive care: a framework proposed by the European Society of Intensive Care Medicine (ESICM). Crit Care 24:1–6CrossRef

11.

Rajamani A, Knudsen S, Huynh NBHK et al (2020) Basic echocardiography competence program in intensive care units: a multinational survey of intensive care units accredited by the College of Intensive Care Medicine. Anaesth Intensive Care 48:150–154PubMedCrossRef

12.

Gibson LE, White-Dzuro GA, Lindsay PJ et al (2020) Ensuring competency in focused cardiac ultrasound: a systematic review of training programs. J Intensive Care 8:1–16CrossRef

13.

Prat G, Charron C, Repesse X et al (2016) The use of computerized echocardiographic simulation improves the learning curve for transesophageal hemodynamic assessment in critically ill patients. Ann Intensive Care 6:1–8CrossRef

14.

Vignon P, Pegot B, Dalmay F et al (2018) Acceleration of the learning curve for mastering basic critical care echocardiography using computerized simulation. Intensive Care Med 44:1097–1105PubMedCrossRef

15.

Schott CK, Kode KR, Mader MJ (2020) Teaching vs learning: Impact of deliberate practice and formative feedback on developing point of care ultrasound skills. J Clin Ultrasound 48:437–442PubMedCrossRef

16.

Kirkpatrick JN, Grimm R, Johri AM et al (2020) Recommendations for echocardiography laboratories participating in cardiac point of care cardiac ultrasound (POCUS) and critical care echocardiography training: report from the American Society of Echocardiography. J Am Soc Echocardiogr 33:409–422PubMedCrossRef

17.

Charron C, Templier F, Goddet NS, Baer M et al (2015) Difficulties encountered by physicians in interpreting focused echocardiography using a pocket ultrasound machine in prehospital emergencies. Eur J Emerg Med 22:17–22PubMedCrossRef

18.

Arntfield RT (2015) The utility of remote supervision with feedback as a method to deliver high-volume critical care ultrasound training. J Crit Care 30:441.e441-446CrossRef

19.

Carver TW (2018) Ultrasound training in surgical critical care fellowship: a survey of program directors. J Surg Educ 12:1250–1255CrossRef

20.

Brady AK, Spitzer CR, Kelm D, Brosnahan SB, Latifi M, Burkart KM (2021) Pulmonary critical care fellows’ use of and self-reported barriers to learning bedside ultrasound during training: results of a national survey. Chest 160:231–237PubMedCrossRef

21.

Smith MJ, Hayward SA, Innes SM (2020) Point-of-care ultrasound in respiratory and critical care: consolidation and expansion of imaging skills. Anaesthesia 75:1115–1116PubMedPubMedCentralCrossRef

22.

Price S, Via G, Sloth E et al (2008) Echocardiography practice, training and accreditation in the intensive care: document for the World Interactive Network Focused on Critical Ultrasound (WINFOCUS). Cardiovasc Ultrasound 6:1–35CrossRef

23.

Clunie M, O’Brien J, Olszynski P et al (2021) Competence of anesthesiology residents following a longitudinal point-of-care ultrasound curriculum. Can J Anaesth 29:1–12

24.

Vignon P, Mucke F, Bellec F et al (2011) Basic critical care echocardiography: validation of a curriculum dedicated to noncardiologist residents. Crit Care Med 39:636–642PubMedCrossRef

25.

Arbelot C, DexheimerNeto FL, Gao Y et al (2020) Lung ultrasound in emergency and critically ill patients: number of supervised exams to reach basic competence. Anesthesiology 132:899–907PubMedCrossRef

26.

Arntfield R, Millington SJ, Ainsworth CD et al (2014) Canadian recommendations for critical care ultrasound training and competency. Can Resp J 21:341–345

27.

Mahmood N, Souleymane M, Rajendram R et al (2020) Focused cardiac ultrasound is applicable to internal medicine and critical care but skill gaps currently limit use. J Saudi Heart Assoc 32:464–471PubMedPubMedCentralCrossRef

28.

Yamamoto R, Clanton D, Willis RE et al (2018) Rapid decay of transthoracic echocardiography skills at 1 month: a prospective observational study. J Surg Educ 75:503–509PubMedCrossRef

29.

Schott CK, LoPresti CM, Boyd JS et al (2021) Retention of point-of-care ultrasound skills among practicing physicians: findings of the VA Nationa POCUS Training Program. Am J Med 134(391–399):398

30.

International consensus statement on training standards for advanced critical care echocardiography (2014) Expert Round Table on Echocardiography in ICU. Intensive Care Med 40:654–66

31.

European Society of Intensive Care Medicine, European Diploma of Echocardiography. https://www.esicm.org/education/edec-2/. Accessed 23 Apr 2022.

32.

The National Board of Echocardiography https://www.echoboards.org/EchoBoards/News/2019_Adult_Critical_Care_Echocardiography_Exam.aspx. Accessed 23 Apr 2022.

33.

Panebianco NL, Mayo PH, Arntfield RT et al (2021) Assessing competence in critical care echocardiography: development and initial results of an examination and certification processes. Crit Care Med 49:1285–1292PubMed

34.

Mayo P, Arntfield R, Balik M et al (2017) The ICM research agenda on critical care ultrasonography. Intensive Care Med 43:1257–1269PubMedCrossRef

35.

Vincent JL, Rhodes A, Perel A et al (2011) Clinical review: update on hemodynamic monitoring-a consensus of 16. Crit Care 15:1–8CrossRef

36.

Lanspa M, Burk R, Wilson E et al (2018) Echocardiogram-guided resuscitation versus early goal-directed therapy in the treatment of septic shock: a randomized, controlled, feasibility trial. J Intensive Care 6:50PubMedPubMedCentralCrossRef

37.

Stengel D, Rademacher G, Ekkernkamp A et al (2015) Emergency ultrasoundbased algorithms for diagnosing blunt abdominal trauma. Cochrane Database Syst Rev 2015:CD004446PubMedCentral

38.

Clattenburg E, Wroe P, Brown S et al (2018) Point-of-care ultrasound use in patients with cardiac arrest is associated prolonged cardiopulmonary resuscitation pauses: a prospective cohort study. Resuscitation 122:65–68PubMedCrossRef

39.

Mosier J, Stolz U, Milligan R et al (2019) Impact of point-of-care ultrasound in the emergency department on care processes and outcomes in critically nontraumatic patients. Crit Care Explor 1:e0019PubMedPubMedCentralCrossRef

40.

Huang S, Sanfilippo F, Herpain A et al (2020) Systematic review and literature appraisal on methodology of conducting and reporting critical care echocardiography studies: a report from the European Society of Intensive Care Medicine PRICES expert panel. Ann Intensive Care 10:49PubMedPubMedCentralCrossRef

41.

Sanfilippo F, Huang S, Herpain A et al (2021) The PRICES statement: an ESICM expert consensus on methodology for conducting and reporting critical care echocardiography research studies. Intensive Care Med 47:1–13PubMedCrossRef

42.

Zieleskiewicz L, Lopez A, Hraiech S et al (2021) Bedside POCUS during ward emergencies is associated with improved diagnosis and outcome: an observational, prospective, controlled study. Crit Care 25:34PubMedPubMedCentralCrossRef

43.

Zoccali C, Torino C, Mallamaci F et al (2021) A randomized multicenter trial on a lung ultrasound-guided treatment strategy in patients on chronic hemodialysis with high cardiovascular risk. Kidney Int 100:1325–1333PubMedCrossRef

44.

Rivas-Lasarte M, Alvarez-Garcia J, Fernandez-Martinez J (2019) Lung ultrasound guided treatment in ambulatory patients with heart failure: a randomized controlled clinical trial (LUS-HF study). Eur J Heart Fail 21:1605–1613PubMedCrossRef

45.

Gartlehner G, Wagner G, Affengruber L et al (2021) Point-of-Care ultrasonography in patients with acute dyspnea: an evidence report for clinical practice guideline by the American College of Physicians. Ann Intern Med 174:967–976PubMedCrossRef

46.

Oulego-Erroz I, Gonzalez-Cortes R, Garcia-Soler P et al (2018) Ultrasound guided or landmark techniques for central venous catheter placement in critically ill children. Intensive Care Med 44:61–72PubMedCrossRef

47.

Goudelin M, Champy P, Amiel JB et al (2020) Left ventricular overloading identified by critical care echocardiography is key in weaning-induced pulmonary edema. Intensive Care Med 46:1371–1381PubMedPubMedCentralCrossRef

48.

Feng M, McSparron J, TrungKien D et al (2018) Transthoracic echocardiography and mortality in sepsis: analysis of the MIMIC-III database. Intensive Care Med 44:884–892PubMedCrossRef

49.

Papolos A, Narula J, Bavishi C et al (2016) U.S. hospital use of echocardiography: insights from the Nationwide Inpatient Sample. J Am Coll Cardiol 67:502–511PubMedCrossRef

50.

El-Nawawy AA, Abdelmohsen AM, Hassouna HM (2018) Role of echocardiography in reducing shock reversal time in pediatric septic shock: a randomized controlled trial. J Pediatr (Rio J) 94:31–39CrossRef

51.

Merz T, Cioccari L, Frey PM et al (2019) Continual hemodynamic hemodynamic monitoring with a single-use transesophageal echocardiography probe in critically ill patients with shock: a randomized controlled clinical trial. Intensive Care Med 45:1093–1102PubMedCrossRef

52.

Yu K, Zhang S, Chen N et al (2022) Critical care ultrasound goal-directed versus early goal-directed therapy in septic shock. Intensive Care Med 48:121–123PubMedCrossRef

Title: Machines that save lives in the intensive care unit: the ultrasonography machine
Authors: Paul H. Mayo
Michelle Chew
Ghislaine Douflé
Armand Mekontso-Dessap
Mangala Narasimhan
Antoine Vieillard-Baron
Publication date: 09-08-2022
Publisher: Springer Berlin Heidelberg
Keywords: Transesophageal Echocardiography
Echocardiography
Care
Echocardiography
Published in: Intensive Care Medicine / Issue 10/2022
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-022-06804-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Machines that save lives in the intensive care unit: the ultrasonography machine

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 10/2022

Central venous pressure (CVP)

Update on prevention of intra-vascular accesses complications

Manipulating temperature: devices for targeted temperature management (TTM) in brain injury

Intracranial pressure: current perspectives on physiology and monitoring

Timing of early mobilization to optimize outcomes in mechanically ventilated ICU patients

Lung and diaphragm protective ventilation guided by the esophageal pressure