Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2020.06.006
Brazilian Journal of Anesthesiology
Narrative Review

Focused cardiac US in anesthetic practice: technique and indications

Ultrassom cardíaco focado na prática anestésica: técnica e indicações

Fabio de Vasconcelos Papa

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Abstract

The use of ultrasonography is well established in several anesthesia sub-specialties. Recently, there has been a major expansion of the POC (Point-Of-Care) ultrasound technique in intensive care, surgery, and emergency medicine, corroborating that USPOC in perioperative medicine has a much more comprehensive capability for both providing improved hemodynamic monitoring and early diagnosis of complications. The objective of the present article was to describe the use of a USPOC modality (focused cardiac US) that can be used for bedside assessment of unstable patients. Within a specific list of diagnoses, clinical treatment for a given situation can be tailored according to ultrasound findings, and by using binary and simple questions. Perioperative focused cardiac US use by the anesthesiologist has been related to lower rates of complications and mortality in high-risk patients.

Keywords

Point of care ultrasound,  Cardiac ultrasound,  Hemodynamic instability

Resumo

O uso da ultrassonografia na prática anestésica já é bem estabelecido com a sua utilização em diversas sub-especialidades. Recentemente houve uma grande disseminação da técnica de ultrassonografia POC (point-of-care) nas áreas de medicina intensiva, cirurgia e medicina de urgência confirmando que o seu uso em medicina perioperatória tem um potencial muito mais abrangente tanto para melhor monitorização hemodinâmica, como também para diagnóstico precoce de complicações. O objetivo desse artigo é descrever a utilização de uma modalidade de USPOC (US cardíaco focado) que pode ser utilizado à beira do leito com o objetivo de avaliar o paciente instável e dentro de uma lista específica de diagnósticos individualizar o tratamento clínico para determinada situação baseado nos achados ultrassonográficos utilizando-se de questões de caráter binário e simples sendo o seu uso pelo anestesiologista no período perioperatório relacionado a menores taxas de complicações e mortalidade em pacientes de alto risco.

Palavras-chave

Ultrassonografia point of care,  Ultrassom cardíaco,  Instabilidade hemodinâmica

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