Miller Ashley, Peck Marcus, Clark Tom, Conway Hannah, Olusanya Segun, Fletcher Nick, Coleman Nick, Parulekar Prashant, Aron Jonathan, Kirk-Bayley Justin, Wilkinson Jonathan Nicholas, Wong Adrian, Stephens Jennie, Rubino Antonio, Attwood Ben, Walden Andrew, Breen Andrew, Waraich Manprit, Nix Catherine, Hayward Simon
Department of Intensive Care, Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, UK.
Department of Intensive Care, Frimley Park Hospital NHS Foundation Trust, Surrey, UK.
J Intensive Care Soc. 2022 Aug;23(3):325-333. doi: 10.1177/17511437211010032. Epub 2021 Apr 23.
FUSIC haemodynamics (HD) - the latest Focused Ultrasound in Intensive Care (FUSIC) module created by the Intensive Care Society (ICS) - describes a complete haemodynamic assessment with ultrasound based on ten key clinical questions: 1. Is stroke volume abnormal? 2. Is stroke volume responsive to fluid, vasopressors or inotropes? 3. Is the aorta abnormal? 4. Is the aortic valve, mitral valve or tricuspid valve severely abnormal? 5. Is there systolic anterior motion of the mitral valve? 6. Is there a regional wall motion abnormality? 7. Are there features of raised left atrial pressure? 8. Are there features of right ventricular impairment or raised pulmonary artery pressure? 9. Are there features of tamponade? 10. Is there venous congestion? FUSIC HD is the first system of its kind to interrogate major cardiac, arterial and venous structures to direct time-critical interventions in acutely unwell patients. This article explains the rationale for this accreditation, outlines the training pathway and summarises the ten clinical questions. Further details are included in an online supplementary appendix.
聚焦超声血流动力学(HD)——由重症监护协会(ICS)创建的最新重症监护聚焦超声(FUSIC)模块——描述了基于十个关键临床问题的超声血流动力学全面评估:1. 每搏输出量是否异常?2. 每搏输出量对液体、血管加压药或正性肌力药物是否有反应?3. 主动脉是否异常?4. 主动脉瓣、二尖瓣或三尖瓣是否严重异常?5. 二尖瓣是否有收缩期前向运动?6. 是否存在节段性室壁运动异常?7. 是否有左心房压力升高的特征?8. 是否有右心室功能障碍或肺动脉压力升高的特征?9. 是否有心脏压塞的特征?10. 是否有静脉淤血?FUSIC HD是首个此类系统,可对主要心脏、动脉和静脉结构进行检查,以指导对急性不适患者进行时间紧迫的干预。本文解释了此项认证的基本原理,概述了培训途径并总结了十个临床问题。更多详细信息包含在在线补充附录中。