Intensive use of general ultrasound in the intensive care unit. Prospective study of 150 consecutive patients

Abstract

Objective: To assess the impact of systematic ultrasound (US) examination in patients admitted to the ICU.

Design: An observational study of 150 consecutive patients.

Setting: A medical ICU of a University-affiliated hospital.

Patients: All consecutively admitted patients were examined, but patients discharged within < 48 h were excluded from the analysis.

Interventions: A systematic examination of the abdomen, pleural space, cervical and femoral vein, was performed at the bedside by the same investigator.

Measurements: Results of US examinations were compared to findings from CT-scan, surgery, endoscopic procedures, autopsy, or other diagnostic tests. The impact of U.S. findings on immediate patients management was evaluated.

Results: In 33 of 150 patients (22%), U.S. findings influenced the diagnosis, work up of the patients, and had a direct impact on the therapeutic plan. In 30/33 cases, confirmation of diagnosis was obtained by another diagnostic and/or therapeutic procedure.

Conclusions: Routine US examination may alter therapeutic plans in up to 1/4 of critically ill patients admitted to the ICU. US examination should be liberally performed on such patients.