Department of Anesthesia, Imeldaziekenhuis, Imeldalaan, Bonheiden.
Department of Anesthesia, University Hospital Antwerpen, Wilrijkstraat, Edegem.
Curr Opin Anaesthesiol. 2020 Jun;33(3):277-283. doi: 10.1097/ACO.0000000000000846.
This review focuses on the use of point-of-care ultrasound (PoCUS) in the obstetric context for airway management and assessment of aspiration risk, the placement of neuraxial blocks and the diagnosis and follow-up of cardiorespiratory dysfunction.
Gastric ultrasound is a useful aspiration risk assessment tool in pregnant patients. Total gastric fluid assessment models and specific cut-offs between high-risk and low-risk stomachs are presented. Airway assessment is useful to detect specific changes in pregnancy and to guide airway management. Handheld ultrasound devices with automated neuraxial landmark detection capabilities could facilitate needle placement in the future. Lung and cardiac ultrasonography is useful in the management of preeclampsia, pulmonary arterial hypertension and peripartum cardiomyopathy.
Owing to its noninvasiveness, ease of accessibility and lack of exposure to radiation, PoCUS plays an increasing and essential role in aspiration risk assessment, airway management, neuraxial anaesthesia and cardiorespiratory diagnosis and decision-making during pregnancy.
本文重点介绍了床旁超声(POCUS)在产科环境下用于气道管理和评估误吸风险、神经轴阻滞的放置以及心肺功能障碍的诊断和随访中的应用。
胃超声是一种有用的孕妇误吸风险评估工具。目前提出了总胃液评估模型和高风险胃与低风险胃之间的具体分界值。气道评估有助于发现妊娠时的特定变化,并指导气道管理。具有自动神经轴地标检测功能的手持式超声设备将来可能会便于置针。肺部和心脏超声在子痫前期、肺动脉高压和围产期心肌病的治疗中具有一定作用。
由于其无创性、易于获得性和无辐射暴露,POCUS 在评估误吸风险、气道管理、神经轴麻醉以及妊娠期间心肺诊断和决策方面发挥着越来越重要的作用。