title: Point-of-care ultrasound in intensive care units: assessment of 1073 procedures in a multicentric, prospective, observational study.
abstract: OBJECTIVE
  To describe current use and diagnostic and therapeutic impacts of point-of-care ultrasound (POCUS) in the intensive care unit (ICU).
  
  
  BACKGROUND
  POCUS is of growing importance in the ICU. Several guidelines recommend its use for procedural guidance and diagnostic assessment. Nevertheless, its current use and clinical impact remain unknown.
  
  
  METHODS
  Prospective multicentric study in 142 ICUs in France, Belgium, and Switzerland. All the POCUS procedures performed during a 24-h period were prospectively analyzed. Data regarding patient condition and the POCUS procedures were collected. Factors associated with diagnostic and therapeutic impacts were identified.
  
  
  RESULTS
  Among 1954 patients hospitalized during the study period, 1073 (55%) POCUS/day were performed in 709 (36%) patients. POCUS served for diagnostic assessment in 932 (87%) cases and procedural guidance in 141 (13%) cases. Transthoracic echocardiography, lung ultrasound, and transcranial Doppler accounted for 51, 17, and 16% of procedures, respectively. Diagnostic and therapeutic impacts of diagnostic POCUS examinations were 84 and 69%, respectively. Ultrasound guidance was used in 54 and 15% of cases for central venous line and arterial catheter placement, respectively. Hemodynamic instability, emergency conditions, transthoracic echocardiography, and ultrasounds performed by certified intensivists themselves were independent factors affecting diagnostic or therapeutic impacts.
  
  
  CONCLUSIONS
  With regard to guidelines, POCUS utilization for procedural guidance remains insufficient. In contrast, POCUS for diagnostic assessment is of extensive use. Its impact on both diagnosis and treatment of ICU patients seems critical. This study identified factors associated with an improved clinical value of POCUS.
authors.affiliation: Service d'anesthésie et de réanimation, Hôpital Nord, Assistance Publique Hôpitaux de Marseille, Aix Marseille Université, Chemin des Bourrely, 13015, Marseille, France.
authors.forename: Laurent
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authors.forename: Samir
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authors.lastname: Langeron
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authors.lastname: Mahjoub
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authors.lastname: Perbet
authors.forename: Hervé
authors.initials: H
authors.lastname: Quintard
authors.forename: Béatrice
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authors.lastname: Riu
authors.forename: Coralie
authors.initials: C
authors.lastname: Vigne
authors.forename: Kathia
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authors.lastname: Chaumoitre
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mesh_terms: D006801:Humans; D007362:Intensive Care Units; D019095:Point-of-Care Systems; D011446:Prospective Studies; D014464:Ultrasonic Therapy / Q000706:statistics & numerical data*; D014463:Ultrasonography / Q000706:statistics & numerical data*