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Erschienen in:

08.05.2024 | REVIEW

Cardiac Point-of-Care Ultrasound in Critical Care: Evolution, Current State, and Future Prospects

verfasst von: Ricardo Diaz Milian, Govind Pandompatam, Pablo Moreno Franco

Erschienen in: Current Pulmonology Reports | Ausgabe 3/2024

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As of 2024, Cardiac Point-of-Care Ultrasonography (CPOCUS) has become an essential tool in intensive care units around the world. Technological advancements have significantly enhanced the quality of images obtained, streamlined the processing through improved software, and facilitated more efficient storage and sharing solutions. These improvements have collectively enhanced the diagnostic efficiency for critical illness. Furthermore, innovative techniques such as Venous Excess Ultrasound Score (VEXUS) [1], an emerging tool for volume assessment, are being developed and tested to address complex clinical questions where reliable tests are currently lacking. Perhaps the most significant advancement in CPOCUS over the past decade has been the increased emphasis on education, equipping a new generation of clinicians with proficiency in this critical technology. For example, the integration of CPOCUS into medical school, residency, and fellowship curriculums marks a significant shift from specialized technicians acquiring imaging and physician specialists providing the interpretation. This expansion reflects a growing recognition of its value in diverse clinical settings, enhancing diagnostic accuracy and patient care across multiple disciplines. It also enables real-time diagnosis and implementation of specific therapies which are often critical in intensive care units. Despite the transformative potential of CPOCUS, its integration into clinical practice has been gradual, with some clinicians still favoring traditional invasive monitoring methods. Addressing the barriers to adoption, quality control and credentialing can further unlock the benefits of this non-invasive technology. …
Literatur
1.
Zurück zum Zitat Wong A, Olusanya O, Watchorn J, Bramham K, Hutchings S. Utility of the Venous Excess Ultrasound (VEXUS) score to track dynamic change in volume status in patients undergoing fluid removal during haemodialysis - the ACUVEX study. Ultrasound J. 2024;16(1):23.CrossRefPubMedPubMedCentral Wong A, Olusanya O, Watchorn J, Bramham K, Hutchings S. Utility of the Venous Excess Ultrasound (VEXUS) score to track dynamic change in volume status in patients undergoing fluid removal during haemodialysis - the ACUVEX study. Ultrasound J. 2024;16(1):23.CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Jardin F, Farcot JC, Gueret P, Prost JF, Ozier Y, Bourdarias JP. Cyclic changes in arterial pulse during respiratory support. Circulation. 1983;68(2):266–74.CrossRefPubMed Jardin F, Farcot JC, Gueret P, Prost JF, Ozier Y, Bourdarias JP. Cyclic changes in arterial pulse during respiratory support. Circulation. 1983;68(2):266–74.CrossRefPubMed
3.
Zurück zum Zitat Xie J, Xu L, Peng K, Chen J, Wan JJ. Comparison between changes in systolic-pressure variation and pulse-pressure variation after passive leg raising to predict fluid responsiveness in postoperative critically Ill patients. J Cardiothor Vasc An. 2024;38(2):459–65.CrossRef Xie J, Xu L, Peng K, Chen J, Wan JJ. Comparison between changes in systolic-pressure variation and pulse-pressure variation after passive leg raising to predict fluid responsiveness in postoperative critically Ill patients. J Cardiothor Vasc An. 2024;38(2):459–65.CrossRef
4.
Zurück zum Zitat Chatterjee K. The Swan-Ganz catheters: past, present, and future A viewpoint. Circulation. 2009;119(1):147–52.CrossRefPubMed Chatterjee K. The Swan-Ganz catheters: past, present, and future A viewpoint. Circulation. 2009;119(1):147–52.CrossRefPubMed
5.
Zurück zum Zitat Yoo TK, Miyashita S, Davoudi F, Imahira U, Al-Obaidi A, Chweich H, et al. Clinical impact of pulmonary artery catheter in patients with cardiogenic shock: A systematic review and meta-analysis. Cardiovasc Revasc Med. 2023;55:58–65.CrossRefPubMed Yoo TK, Miyashita S, Davoudi F, Imahira U, Al-Obaidi A, Chweich H, et al. Clinical impact of pulmonary artery catheter in patients with cardiogenic shock: A systematic review and meta-analysis. Cardiovasc Revasc Med. 2023;55:58–65.CrossRefPubMed
6.
Zurück zum Zitat Panebianco NL, Mayo PH, Arntfield RT, Brown SM, Diaz-Gomez J, Hernandez A, et al. Assessing competence in critical care echocardiography: Development and initial results of an examination and certification processes. Crit Care Med. 2021;49(8):1285–92.CrossRefPubMed Panebianco NL, Mayo PH, Arntfield RT, Brown SM, Diaz-Gomez J, Hernandez A, et al. Assessing competence in critical care echocardiography: Development and initial results of an examination and certification processes. Crit Care Med. 2021;49(8):1285–92.CrossRefPubMed
7.
Zurück zum Zitat Cholley B. Echocardiography in the intensive care unit: beyond “eyeballing”. A plea for the broader use of the aortic velocity-time integral measurement. Intensive Care Med. 2019;45(6):898–901.CrossRefPubMed Cholley B. Echocardiography in the intensive care unit: beyond “eyeballing”. A plea for the broader use of the aortic velocity-time integral measurement. Intensive Care Med. 2019;45(6):898–901.CrossRefPubMed
8.
Zurück zum Zitat Diaz-Gomez JL, Mayo PH, Koenig SJ. Point-of-care ultrasonography. N Engl J Med. 2021;385(17):1593–602.CrossRefPubMed Diaz-Gomez JL, Mayo PH, Koenig SJ. Point-of-care ultrasonography. N Engl J Med. 2021;385(17):1593–602.CrossRefPubMed
10.
Zurück zum Zitat Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23(7):685–713; quiz 86–8. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23(7):685–713; quiz 86–8.
11.
Zurück zum Zitat Kane CJ, Salama AA, Pislaru C, Kane GC, Pislaru SV, Lin G. Low pulmonary artery pulsatility index by echocardiography is associated with increased mortality in pulmonary hypertension. J Am Soc Echocardiogr. 2023;36(2):189–95.CrossRefPubMed Kane CJ, Salama AA, Pislaru C, Kane GC, Pislaru SV, Lin G. Low pulmonary artery pulsatility index by echocardiography is associated with increased mortality in pulmonary hypertension. J Am Soc Echocardiogr. 2023;36(2):189–95.CrossRefPubMed
12.
Zurück zum Zitat Kayarian F, Patel D, O’Brien JR, Schraft EK, Gottlieb M. Artificial intelligence and point-of-care ultrasound: Benefits, limitations, and implications for the future. Am J Emerg Med. 2024;80:119–22.CrossRefPubMed Kayarian F, Patel D, O’Brien JR, Schraft EK, Gottlieb M. Artificial intelligence and point-of-care ultrasound: Benefits, limitations, and implications for the future. Am J Emerg Med. 2024;80:119–22.CrossRefPubMed
13.
Zurück zum Zitat Wang YC, Chen KW, Tsai BY, Wu MY, Hsieh PH, Wei JT, et al. Implementation of an all-day artificial intelligence-based triage system to accelerate door-to-balloon times. Mayo Clin Proc. 2022;97(12):2291–303.CrossRefPubMed Wang YC, Chen KW, Tsai BY, Wu MY, Hsieh PH, Wei JT, et al. Implementation of an all-day artificial intelligence-based triage system to accelerate door-to-balloon times. Mayo Clin Proc. 2022;97(12):2291–303.CrossRefPubMed
14.
Zurück zum Zitat Yu J, Tasken AA, Flade HM, Skogvoll E, Berg EAR, Grenne B, et al. Automatic assessment of left ventricular function for hemodynamic monitoring using artificial intelligence and transesophageal echocardiography. J Clin Monit Comput. 2024;38(2):281–91.CrossRefPubMed Yu J, Tasken AA, Flade HM, Skogvoll E, Berg EAR, Grenne B, et al. Automatic assessment of left ventricular function for hemodynamic monitoring using artificial intelligence and transesophageal echocardiography. J Clin Monit Comput. 2024;38(2):281–91.CrossRefPubMed
Metadaten
Titel
Cardiac Point-of-Care Ultrasound in Critical Care: Evolution, Current State, and Future Prospects
verfasst von
Ricardo Diaz Milian
Govind Pandompatam
Pablo Moreno Franco
Publikationsdatum
08.05.2024
Verlag
Springer US
Erschienen in
Current Pulmonology Reports / Ausgabe 3/2024
Elektronische ISSN: 2199-2428
DOI
https://doi.org/10.1007/s13665-024-00353-0

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