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  • Title: Merging ultrasound in the intensive care routine.
    Author: Jakobson DJ, Shemesh I.
    Journal: Isr Med Assoc J; 2013 Nov; 15(11):688-92. PubMed ID: 24511649.
    Abstract:
    BACKGROUND: Goal-oriented ultrasound examination is gaining a place in the intensive care unit. Some protocols have been proposed but the applicability of ultrasound as part of a routine has not been studied. OBJECTIVES: To assess the influence of ultrasound performed by intensive care physicians. METHODS: This retrospective descriptive clinical study was performed in a medical-surgical intensive care unit of a university-affiliated general hospital. Data were collected from patients undergoing ultrasound examinations performed by a critical care physician during the period 2010 to June 2011. RESULTS: A total of 299 ultrasound exams were performed in 113 mechanically ventilated patients (70 males, mean age 65 years). Exams included trans-cranial Doppler (n = 24), neck evaluation before tracheostomy (n = 15), chest exam (n = 83), focuse cardiac echocardiography (n = 60), abdominal exam (n = 41), and comprehensive screening at patient admission (n = 30). Ultrasound was used to guide invasive procedures for vascular catheter insertion (n = 42), pleural fluid drainage (n = 24), and peritoneal fluid drainage (n = 7). One pneumothorax was seen during central venous line insertion but no complications were observed after pleural or abdominal drainage. The ultrasound study provided good quality visualization in 86% (258 of 299 exams) and was a diagnostic tool that induced a change in treatment in 58% (132 of 226 exams). CONCLUSIONS: Bedside ultrasound examinations performed by critical care physicians provide an important adjunct to diagnostic and therapeutic performance, improving quality of care and patient safety.
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