Cardiac, cerebral, renal, optic nerve, and lung ultrasound study (CCROSS) protocol

Abstract

The use of echocardiography is very useful in the evaluation, treatment, and follow-up of the patient in critical condition. Along with clinic and the stethoscope, it is a tool that complements the act of the physician faced with the diversity of etiologies that determine the state of shock and increase morbidity and mortality, especially in post-cardiac surgery patients, in whom there are no management emergency post-surgical algorithms. In view of this situation, at the National Institute of Cardiology Ignacio Chávez, a management algorithm has been made and improved in cardiac post-surgical patients: through focused ultrasonography, including transthoracic echography, pulmonary ultrasound, optic nerve ultrasound, and renal ultrasound by evaluating renal resistive indices. Several societies have created their protocols for addressing patients in critical condition, so in the institute, specifically in cardiovascular intensive therapy, has created the cardiac, cerebral, renal, optic nerve, and lung ultrasound study (CCROSS) protocol for the initial approach of these patients, and a study is currently taking place for its validation, reproducibility, and efficacy.

Exploring the Use of Lung Ultrasonography to Assess Cardiac Surgery Patients: A Scoping Review

“…100 The earliest narrative review was published in 2016. 2 Countries of origin included Italy 2,92,94 ( n = 3), Russia 98 ( n = 1), Mexico 99 ( n = 1), and Saudi Arabia 100 ( n = 1).…”

“…All narrative reviews aimed to summarize LUS applications in cardiac surgery, with half focusing on the pediatric population (3.3%). The specific focus of the reviews varied from improving awareness of LUS among other specialists 98 to discussing the need for a new LUS protocol 99 to highlighting the role of LUS in weaning and extubation in pediatric cardiac patients. 100 The earliest narrative review was published in 2016.…”

“…91,95,102 Other reports carried a discussion between researchers regarding studies conducted using LUS, 96,105 including one letter to the editor 104 in which use of LUS in another included study 33 was questioned. Previously reported protocols (n = 25) Volpicelli 2012 107 9 The BLUE-protocoll 8 7 Acosta 2014 108 4 Lichtenstein 2012 109 2 Cantinotti 2018 30 1 Monastesse 2017 110 1 Bouhemad 2015 111 1 Volpicelli 2006 112 1 Lichtenstein 2004 113 1 Coiro 2015 114 1 Targhetta 1994 115 1 The FALLS protocol 8 1 Cattarossi 2013 116 1 Picano 2006 117 1 CCROSS 99 1 eFAST 118 1 FAST 118 1…”

The characteristics of echocardiography in ICU patients and its relationship with the outcomes

“…Later on, in 2013, the American Society of Echo decided that FOCUS should be used as an adjunct to the physical exam in an emergency setting [1] . Many different types of FOCUS exams for rapid evaluation of emergency or ICU patients have been introduced [2,3] , including the rapid ultrasound in shock (RUSH) protocol [4] , the focus-assessed transthoracic echocardiography (FATE) and the advanced FATE protocol [5] , the uid administration limited by lung sonography (FALLS) protocol [6] , the focused assessment with sonography for trauma (FAST) and extended FAST (eFAST) [7] , lung ultrasound study (CCROSS) protocol [8] , and the critical care chest ultrasonic examination (CCUE) protocol [9] , etc.. Most of these protocols use similar rapid echocardiography examinations including ve standard views.…”