Bryan Boling is Nurse Practitioner, Department of Anesthesiology, Division of Critical Care Medicine, University of Kentucky, 531 Southbend Dr, Lexington, KY 40503 (
Abbye Solis is Nurse Practitioner, Weinberg Surgical Intensive Care Unit, Johns Hopkins Hospital, Baltimore, Maryland; and Adjunct Faculty, Adult-Gerontology Acute Care Nurse Practitioner Program, Georgetown University, Washington, DC.
AACN Adv Crit Care. 2023 Sep 15;34(3):216-227. doi: 10.4037/aacnacc2023298.
Point-of-care ultrasonography is becoming standard practice for diagnosis and management of patients in the critical care setting. When using point-of-care ultrasonography for evaluation of the abdomen, most providers will immediately think of the Focused Assessment with Sonography for Trauma examination. However, there are a number of important abdominal applications for the nontrauma patient, including evaluation of the function of abdominal organs, differentiation of shock states, and identification of sources of sepsis. This article covers basic approaches to an abdominal point-of-care ultrasonography examination of the biliary tract, liver, kidneys, bladder, and appendix, as well as identification and management of intra-abdominal free fluid.
床边超声检查在重症监护患者的诊断和治疗中已成为标准操作。在使用床边超声检查评估腹部时,大多数医生会立即想到创伤重点评估超声检查。然而,对于非创伤患者,有许多重要的腹部应用,包括评估腹部器官的功能、区分休克状态以及确定脓毒症的来源。本文涵盖了胆道、肝脏、肾脏、膀胱和阑尾的床边超声检查的基本方法,以及腹腔游离液体的识别和处理。