Perioperative ultrasound‐assisted clinical evaluation – A case based review

Abstract

Ultrasound is increasingly being adopted into anaesthesia and intensive care practice. The range of ultrasound examination has also increased from transoesophageal echocardiography in cardiac surgery and ultrasound-guided nerve blocks and vascular access, to examination of the heart, lungs, abdomen and deep veins. Typically, the use of ultrasound is focused or basic, designed to be performed by the anaesthetist at the patient's bedside in real time to answer clinical questions and to direct therapy. Ultrasound is not performed in isolation, but used to complement clinical evaluation, and accordingly can be considered as 'ultrasoundassisted perioperative evaluation'. Whilst there is good evidence that ultrasound improves diagnostic accuracy and in turn alters management, there are few data examining whether ultrasound leads to improved clinical outcomes. This review will examine multiple uses of perioperative ultrasound with case studies to illustrate potential utility.

Perioperative Venous Excess Ultrasound Score (VExUS) to Guide Decongestion in a Dilated Cardiomyopathy Patient Presenting for Urgent Surgery

“…POCUS is an increasingly commonplace diagnostic modality that can provide important diagnostic information for the anesthesiologist [ 9 , 10 ]. The assessment of fluid status and venous congestion is usually done by assessing for IVC size and collapsibility with respiration [ 11 ].…”