Sekiguchi Hiroshi
Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota.
Semin Respir Crit Care Med. 2016 Feb;37(1):68-87. doi: 10.1055/s-0035-1570353. Epub 2016 Feb 4.
Since the advent of portable ultrasonography machines, many providers, including intensivists and pulmonologists, have been trained in point-of-care ultrasonography. When point-of-care ultrasonography is performed with focused clinical question and goal in mind, it serves as a valuable adjunct to physical examination and facilitates patient care and disease management. Its clinical application is now wider than that of a stethoscope in the intensive care unit where the noise level is high. In this review article, crucial ultrasonographic findings, their clinical implication, and their limitations are discussed in the most commonly targeted organ systems: cardiac, thoracic, abdominal, and vascular. In addition, recent studies on the use of multiorgan system point-of-care ultrasonography in diagnoses and management of acutely ill patients are described. As new clinical applications have been identified, a conventional approach to the critical illness must be modified to a new approach that incorporates ultrasonographic information. Clinicians should not only be trained in image acquisition and interpretation but also be up to date on the new ultrasonography-guided diagnosis, therapy, and management.
自从便携式超声检查仪问世以来，包括重症医学专家和肺科医生在内的许多医疗服务提供者都接受了床旁超声检查的培训。当带着明确的临床问题和目标进行床旁超声检查时，它可作为体格检查的宝贵辅助手段，促进患者护理和疾病管理。在重症监护病房噪音水平较高的情况下，其临床应用范围现在比听诊器更广。在这篇综述文章中，将在最常针对的器官系统（心脏、胸部、腹部和血管）中讨论关键的超声检查结果、它们的临床意义及其局限性。此外，还描述了关于在急性病患者的诊断和管理中使用多器官系统床旁超声检查的最新研究。随着新的临床应用被发现，对危重病的传统处理方法必须改为纳入超声检查信息的新方法。临床医生不仅应接受图像采集和解读方面的培训，还应跟上超声引导下的新诊断、治疗和管理方法。
