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

Abstract 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) pro...

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Autores principales:	Stefan Schmidt, Jana-Katharina Dieks, Michael Quintel, Onnen Moerer
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Sonography Ultrasound General critical care ultrasound Whole-body ultrasound Critical care echocardiography Intensive care medicine Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/8feb553545f44b769faf6e01da5bacd3
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spelling	oai:doaj.org-article:8feb553545f44b769faf6e01da5bacd32021-11-28T12:03:52ZDevelopment and evaluation of the focused assessment of sonographic pathologies in the intensive care unit (FASP-ICU) protocol10.1186/s13054-021-03811-21364-8535https://doaj.org/article/8feb553545f44b769faf6e01da5bacd32021-11-01T00:00:00Zhttps://doi.org/10.1186/s13054-021-03811-2https://doaj.org/toc/1364-8535Abstract 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.Stefan SchmidtJana-Katharina DieksMichael QuintelOnnen MoererBMCarticleSonographyUltrasoundGeneral critical care ultrasoundWhole-body ultrasoundCritical care echocardiographyIntensive care medicineMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENCritical Care, Vol 25, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Sonography Ultrasound General critical care ultrasound Whole-body ultrasound Critical care echocardiography Intensive care medicine Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Sonography Ultrasound General critical care ultrasound Whole-body ultrasound Critical care echocardiography Intensive care medicine Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Stefan Schmidt Jana-Katharina Dieks Michael Quintel Onnen Moerer Development and evaluation of the focused assessment of sonographic pathologies in the intensive care unit (FASP-ICU) protocol
description	Abstract 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.
format	article
author	Stefan Schmidt Jana-Katharina Dieks Michael Quintel Onnen Moerer
author_facet	Stefan Schmidt Jana-Katharina Dieks Michael Quintel Onnen Moerer
author_sort	Stefan Schmidt
title	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_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_sort	development and evaluation of the focused assessment of sonographic pathologies in the intensive care unit (fasp-icu) protocol
publisher	BMC
publishDate	2021
url	https://doaj.org/article/8feb553545f44b769faf6e01da5bacd3
work_keys_str_mv	AT stefanschmidt developmentandevaluationofthefocusedassessmentofsonographicpathologiesintheintensivecareunitfaspicuprotocol AT janakatharinadieks developmentandevaluationofthefocusedassessmentofsonographicpathologiesintheintensivecareunitfaspicuprotocol AT michaelquintel developmentandevaluationofthefocusedassessmentofsonographicpathologiesintheintensivecareunitfaspicuprotocol AT onnenmoerer developmentandevaluationofthefocusedassessmentofsonographicpathologiesintheintensivecareunitfaspicuprotocol
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Development and evaluation of the focused assessment of sonographic pathologies in the intensive care unit (FASP-ICU) protocol

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