Table 1 POCUS protocol
Type of ultrasound | Instruments questions | Theoretic considerations |
|---|---|---|
Optical behavior | Diameter optic nerve: right eye (mm); left eye (mm) | A diameter > 5.7 is a noninvasive indication of intracranial hypertension |
Neck anatomy | Visualization of great vessels (jugular vein, carotid artery): normal or abnormal | Detection of patency (thrombosis) and anatomical variants or abnormalities |
Pulmonary | Lung ultrasound score, 0–36 points | Score increases as pulmonary water increases; indicates pulmonary edema |
Pleural | Presence of pleural occupation and estimation of pleural effusion (mL) | Confirmation of diagnosis, volume evaluation and follow-up |
Echocardiography overall function | Estimation of left-ventricular systolic function by LVEF (%) and right-ventricular systolic function by TAPSE (mm) | LVEF > 50% and TAPSE > 15 mm is considered normal |
Prediction of volume responsiveness | Distensibility index of inferior vena cava (%) | An index > 12% indicates response to intravenous fluid challenges |
Estimation of CO | CO (L/min) estimated by left ventricular outflow tract by velocity time integral and diameter | Normal values, 4–6 L/min |
Abdominal screening | FAST protocol for presence or absence of intraperitoneal free fluid | Presence of free fluid is abnormal |
Biliary | Presence of lithiasis or dilated biliary tract | Biliary tract pathology may be an incidental finding or the cause of critical illness |
Renal | Presence of urinary lithiasis or dilated urinary tract | Urinary tract pathology may be an incidental finding or the cause of critical illness |
Ultrasound-guided invasive procedures | Venous or arterial access, pleural or abdominal drainage | Ultrasound-guided invasive procedures are more secure, with fewer adverse effects |