title: The Diagnostic and Therapeutic Impact of Point-of-Care Ultrasonography in the Intensive Care Unit.
abstract: OBJECTIVE
  In light of point-of-care ultrasonography's (POCUS) recent rise in popularity, assessment of its impact on diagnosis and treatment in the intensive care unit (ICU) is of key importance.
  
  
  METHODS
  Ultrasound examinations were collected through an ultrasound reporting software in 6 multidisciplinary ICU units from 3 university hospitals in Canada and the United States. This database included a self-reporting questionnaire to assess the impact of the ultrasound findings on diagnosis and treatment. We retrieved the results of these questionnaires and analyzed them in relation to which organs were assessed during the ultrasound examination.
  
  
  RESULTS
  One thousand two hundred and fifteen ultrasound studies were performed on 968 patients. Intensivists considered the image quality of cardiac ultrasound to be adequate in 94.7% compared to 99.7% for general ultrasound ( P < .001). The median duration of a cardiac examination was 10 (interquartile range [IQR] 10) minutes compared to 5 (IQR 8) minutes for a general examination ( P < .001). Overall, ultrasound findings led to a change in diagnosis in 302 studies (24.9%) and to a change in management in 534 studies (44.0%). A change in diagnosis or management was reported more frequently for cardiac ultrasound than for general ultrasound (108 [37.1%] vs 127 [16.5%], P < .001) and (170 [58.4%] vs 270 [35.1%], P < .001). Assessment of the inferior vena cava for fluid status emerged as the critical care ultrasound application associated with the greatest impact on management.
  
  
  CONCLUSIONS
  Point-of-care ultrasonography has the potential to optimize care of the critically ill patients when added to the clinical armamentarium of the intensive care physician.
authors.affiliation: 1 Hôpital du Sacré-Coeur de Montréal, University of Montreal, Montreal, Canada.
authors.forename: Amélie
authors.initials: A
authors.lastname: Bernier-Jean
authors.affiliation: 2 Hôpital du Sacré-Coeur de Montréal Research Center, University of Montreal, Montreal, Canada.
authors.forename: Martin
authors.initials: M
authors.lastname: Albert
authors.affiliation: 3 Division of Critical Care Medicine, Department of Medicine, Albert Einstein College of Medicine, J.B. Langner Critical Care Service, Montefiore Medical Center, New York, NY, USA.
authors.forename: Ariel L
authors.initials: AL
authors.lastname: Shiloh
authors.affiliation: 3 Division of Critical Care Medicine, Department of Medicine, Albert Einstein College of Medicine, J.B. Langner Critical Care Service, Montefiore Medical Center, New York, NY, USA.
authors.forename: Lewis A
authors.initials: LA
authors.lastname: Eisen
authors.affiliation: 4 Pharmacy Department, Hôpital du Sacré-Coeur de Montréal, Faculty de Pharmacy, University of Montreal, Montreal, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Williamson
authors.affiliation: 1 Hôpital du Sacré-Coeur de Montréal, University of Montreal, Montreal, Canada.
authors.forename: Yanick
authors.initials: Y
authors.lastname: Beaulieu
mesh_terms: D002170:Canada; D003422:Critical Care / Q000592:standards* / Q000706:statistics & numerical data; D016638:Critical Illness / Q000628:therapy*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000592:standards / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems / Q000639:trends; D011787:Quality of Health Care / Q000592:standards* / Q000639:trends; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional / Q000639:trends; D014481:United States
keywords: critical care; diagnostic techniques and procedures; echocardiography; point-of-care systems; ultrasonography