Interventional Ultrasound in Adult Critically Ill Patient in Surgical ICU

Abstract

Ultrasonography in the intensive care unit (ICU) has become a valuable tool for expeditiously, safely and effectively diagnosing and treating a myriad of conditions commonly encountered in this setting. Most intensivists are familiar with focused assessment with sonography in trauma (FAST) and can readily grasp the fundamentals of a limited or directed ultrasonographic exam. Thus, with appropriate training and practice, intensivists can utilize this tool in visualizing, characterizing and treating life-threatening conditions in their role as intensivists in the surgical ICU (SICU). In this review we will discuss the different uses of ultrasonography in general critical care for assessing as well as intervention in the thoracic, abdominal and vascular systems. Vascular ultrasonography for central venous line placement has been shown to significantly increase the overall chances for successful placement on the first attempt and to reduce the rate of complications. The data were most compelling for internal jugular vein central venous line placement over subclavian vein cannulations. Thus, this technique has been recommended in the United States by the Agency for Healthcare Research and Quality for all central venous line insertions and in the United Kingdom by the National Institute for Clinical Excellence (NICE). Keywords: Interventional Ultrasound, Surgical ICU