| Autor: |
Chambers, Michael G, Garrett, Britton, Cancio, Leopoldo C |
| Předmět: |
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| Zdroj: |
Journal of Burn Care & Research; 2021 Supplement, Vol. 42, pS103-S103, 1p |
| Abstrakt: |
Introduction Point-of-Care Ultrasound (POCUS) has been shown to be a useful adjunct in assessment of various shock states and utilized to guide resuscitative and post-resuscitation de-escalation efforts. POCUS use for guiding resuscitation in burn injured patient has not be described. Objectives characterize the use of bedside ultrasound examinations performed by advance practice providers and treating physicians in a regional burn intensive care unit Methods Daily beside ultrasound examinations were performed utilizing a bedside ultrasound device by an advanced practice provider prior to rounds POCUS examinations consist of: Focused transthoracic echocardiographic exam Parasternal long Parasternal short Apical 4 chamber Subcostal Pulmonary exam Inferior vena cava measurement Data Recorded Left ventricular systolic function (Qualitative) Right ventricular systolic function (TAPSE) Significant (>50%) valvular regurgitation B-lines present Inferior vena cava diameter, dispensability, collapsibility Volume assessment made based on US Hypovolemic Euvolemic Hypervolemic Ultrasound images were archived to a centralized image repository and reviewed daily during multi-disciplinary rounds. Ultrasonographic volume assessment compared to clinical volume assessment made during daily multidisciplinary rounds. Results 100 examinations were performed of those 32 were within the initial 72 hour window: 94.1 % of examinations demonstrated findings that supported clinical assessment (physical, laboratory, and radiographic findings) and contributed positively to medical decision making. 5.9% of examination findings either did not contribute to medical decision making or conflicted with physical exam, radiographic, or laboratory findings Conclusions Our results demonstrate that bedside ultrasound aides in guidance of both resuscitative and post-resuscitative efforts. We identified a cohort of patients who appeared hypervolemic clinically but US findings supported hypovolemia, we refer to as pseudohypervolemia US volume assessment provides information that changes management. We believe point of care ultrasound is a viable tool in preventing over-resuscitation as well as to guide post-resuscitative diuresis. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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