Focused cardiac ultrasound is emerging as a vital tool in the armamentarium of the modern intensivist and critical care practitioner. From assessment of the patient in shock (1) to assessment of fluid status (2,3), focused echocardiography permits a deeper understanding of complex physiology in the critically ill patient. Focused cardiac ultrasound exists on the spectrum of care alongside comprehensive echocardiography, a sentiment echoed by the American Society of Echocardiography and endorsed by guidelines (4,5). A number of expert recommendations and consensus documents provide a template for which to base educational infrastructure in focused cardiac ultrasound (4,6–8). The general principles of CCUS are intertwined with focused cardiac ultrasound including:
- Complementary or as an extension to clinical exam
- Repeatable and non-invasive
- Available 24/7 at the bedside
- Goal-directed to facilitate bedside decision-making
- Collaborative along the spectrum of care with comprehensive imaging
- Integrated directly into the clinical context
- Facilitate timely diagnosis and management of life-threatening pathology
- Jones AE, Tayal VS, Sullivan DM, Kline J a. Randomized, controlled trial of immediate versus delayed goal-directed ultrasound to identify the cause of nontraumatic hypotension in emergency department patients. Crit Care Med. 2004;32(8):1703-1708.
- Kanji HD, McCallum J, Sirounis D, MacRedmond R, Moss R, Boyd JH. Limited echocardiography-guided therapy in subacute shock is associated with change in management and improved outcomes. J Crit Care. 2014;29(5):700-705.
- Barbier C, Loubières Y, Schmit C, et al. Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patients. Intensive Care Med. 2004;30:1740-1746.
- Via G, Hussain A, Wells M, et al. International evidence-based recommendations for focused cardiac ultrasound. J Am Soc Echocardiogr. 2014;27:1-33.
- Weigers S. President’s Message: Point of Care. Am Soc Echocardiogr News. 2016.
- Cholley BP. International expert statement on training standards for critical care ultrasonography. Intensive Care Med. 2011;37:1077-1083.
- Mayo PH. American College of Chest Physicians Statement on Competence in Critical Care Ultrasonography. CHEST J. 2009;135(4):1050.
- Arntfield R, Millington S, Ainsworth C, et al. Canadian recommendations for critical care ultrasound training and competency. Can Respir J. 2014;21(6):341-345.