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Table 1 POCUS protocol

From: Impact of an ultrasound-driven diagnostic protocol at early intensive-care stay: a randomized-controlled trial

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


Lung ultrasound score, 0–36 points

Score increases as pulmonary water increases; indicates pulmonary edema


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


Presence of lithiasis or dilated biliary tract

Biliary tract pathology may be an incidental finding or the cause of critical illness


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

  1. CO cardiac output, FAST focused assessment with sonography in trauma, IH intracranial hypertension, LVEF left-ventricular ejection fraction, POCUS point-of-care ultrasound, TAPSE tricuspid annular plane systolic excursion