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

Abstract

To assess the impact of systematic ultrasound (US) examination in patients admitted to the ICU. An observational study of 150 consecutive patients. A medical ICU of a University-affiliated hospital. All consecutively admitted patients were examined, but patients discharged within < 48 h were excluded from the analysis. A systematic examination of the abdomen, pleural space, cervical and femoral vein, was performed at the bedside by the same investigator. 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. 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. 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.