Development and evaluation of the focused assessment of sonographic pathologies in the intensive care unit (FASP-ICU) protocol

BACKGROUND: The use of ultrasonography in the intensive care unit (ICU) is steadily increasing but is usually restricted to examinations of single organs or organ systems. In this study, we combine the ultrasound approaches the most relevant to ICU to design a whole-body ultrasound (WBU) protocol. R...

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Autores principales: Schmidt, Stefan, Dieks, Jana-Katharina, Quintel, Michael, Moerer, Onnen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8611927/
https://www.ncbi.nlm.nih.gov/pubmed/34819132
http://dx.doi.org/10.1186/s13054-021-03811-2
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author Schmidt, Stefan
Dieks, Jana-Katharina
Quintel, Michael
Moerer, Onnen
author_facet Schmidt, Stefan
Dieks, Jana-Katharina
Quintel, Michael
Moerer, Onnen
author_sort Schmidt, Stefan
collection PubMed
description BACKGROUND: The use of ultrasonography in the intensive care unit (ICU) is steadily increasing but is usually restricted to examinations of single organs or organ systems. In this study, we combine the ultrasound approaches the most relevant to ICU to design a whole-body ultrasound (WBU) protocol. Recommendations and training schemes for WBU are sparse and lack conclusive evidence. Our aim was therefore to define the range and prevalence of abnormalities detectable by WBU to develop a simple and fast bedside examination protocol, and to evaluate the value of routine surveillance WBU in ICU patients. METHODS: A protocol for focused assessments of sonographic abnormalities of the ocular, vascular, pulmonary, cardiac and abdominal systems was developed to evaluate 99 predefined sonographic entities on the day of admission and on days 3, 6, 10 and 15 of the ICU admission. The study was a clinical prospective single-center trial in 111 consecutive patients admitted to the surgical ICUs of a tertiary university hospital. RESULTS: A total of 3003 abnormalities demonstrable by sonography were detected in 1275 individual scans of organ systems and 4395 individual single-organ examinations. The rate of previously undetected abnormalities ranged from 6.4 ± 4.2 on the day of admission to 2.9 ± 1.8 on day 15. Based on the sonographic findings, intensive care therapy was altered following 45.1% of examinations. Mean examination time was 18.7 ± 3.2 min, or 1.6 invested minutes per detected abnormality. CONCLUSIONS: Performing the WBU protocol led to therapy changes in 45.1% of the time. Detected sonographic abnormalities showed a high rate of change in the course of the serial assessments, underlining the value of routine ultrasound examinations in the ICU. Trial registration The study was registered in the German Clinical Trials Register (DRKS, 7 April 2017; retrospectively registered) under the identifier DRKS00010428. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-021-03811-2.
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spelling pubmed-86119272021-11-29 Development and evaluation of the focused assessment of sonographic pathologies in the intensive care unit (FASP-ICU) protocol Schmidt, Stefan Dieks, Jana-Katharina Quintel, Michael Moerer, Onnen Crit Care Research BACKGROUND: The use of ultrasonography in the intensive care unit (ICU) is steadily increasing but is usually restricted to examinations of single organs or organ systems. In this study, we combine the ultrasound approaches the most relevant to ICU to design a whole-body ultrasound (WBU) protocol. Recommendations and training schemes for WBU are sparse and lack conclusive evidence. Our aim was therefore to define the range and prevalence of abnormalities detectable by WBU to develop a simple and fast bedside examination protocol, and to evaluate the value of routine surveillance WBU in ICU patients. METHODS: A protocol for focused assessments of sonographic abnormalities of the ocular, vascular, pulmonary, cardiac and abdominal systems was developed to evaluate 99 predefined sonographic entities on the day of admission and on days 3, 6, 10 and 15 of the ICU admission. The study was a clinical prospective single-center trial in 111 consecutive patients admitted to the surgical ICUs of a tertiary university hospital. RESULTS: A total of 3003 abnormalities demonstrable by sonography were detected in 1275 individual scans of organ systems and 4395 individual single-organ examinations. The rate of previously undetected abnormalities ranged from 6.4 ± 4.2 on the day of admission to 2.9 ± 1.8 on day 15. Based on the sonographic findings, intensive care therapy was altered following 45.1% of examinations. Mean examination time was 18.7 ± 3.2 min, or 1.6 invested minutes per detected abnormality. CONCLUSIONS: Performing the WBU protocol led to therapy changes in 45.1% of the time. Detected sonographic abnormalities showed a high rate of change in the course of the serial assessments, underlining the value of routine ultrasound examinations in the ICU. Trial registration The study was registered in the German Clinical Trials Register (DRKS, 7 April 2017; retrospectively registered) under the identifier DRKS00010428. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-021-03811-2. BioMed Central 2021-11-24 /pmc/articles/PMC8611927/ /pubmed/34819132 http://dx.doi.org/10.1186/s13054-021-03811-2 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Schmidt, Stefan
Dieks, Jana-Katharina
Quintel, Michael
Moerer, Onnen
Development and evaluation of the focused assessment of sonographic pathologies in the intensive care unit (FASP-ICU) protocol
title Development and evaluation of the focused assessment of sonographic pathologies in the intensive care unit (FASP-ICU) protocol
title_full Development and evaluation of the focused assessment of sonographic pathologies in the intensive care unit (FASP-ICU) protocol
title_fullStr Development and evaluation of the focused assessment of sonographic pathologies in the intensive care unit (FASP-ICU) protocol
title_full_unstemmed Development and evaluation of the focused assessment of sonographic pathologies in the intensive care unit (FASP-ICU) protocol
title_short Development and evaluation of the focused assessment of sonographic pathologies in the intensive care unit (FASP-ICU) protocol
title_sort development and evaluation of the focused assessment of sonographic pathologies in the intensive care unit (fasp-icu) protocol
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8611927/
https://www.ncbi.nlm.nih.gov/pubmed/34819132
http://dx.doi.org/10.1186/s13054-021-03811-2
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