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床旁超声(POCUS)在麻醉学中的应用:一篇叙述性综述。

The Use of Point-of-Care Ultrasound (POCUS) in Anesthesiology: A Narrative Review.

作者信息

Gohad Rutuja, Jain Sudha

机构信息

Department of Anesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Sep 23;16(9):e70039. doi: 10.7759/cureus.70039. eCollection 2024 Sep.

Abstract

Point-of-care ultrasound (POCUS) has become an essential tool in modern anesthesiology, offering real-time imaging that aids in diagnosis, treatment, and procedural guidance. Its applications have expanded significantly, from routine assessments to complex perioperative management, enhancing patient care across various domains. This study aimed to review and summarize the current literature on the applications of POCUS in anesthesiology, focusing on its utility in airway management, cardiac assessment, lung ultrasound (LUS), and abdominopelvic evaluations. Additionally, it discusses the challenges and strategies for overcoming barriers to its widespread adoption. A narrative literature review was conducted, encompassing studies on using POCUS in anesthesiology. Key databases were searched for relevant articles ("Point-of-care ultrasound," "Focused cardiac ultrasound," "Lung ultrasound)and studies were selected based on their relevance to the main topics of interest: airway management, cardiac ultrasound, LUS, and abdominopelvic and gastric ultrasound. Both observational studies and randomized controlled trials were included. POCUS improves the safety and accuracy of regional anesthesia and airway procedures, enhancing patient outcomes by providing real-time visualization. Focused cardiac ultrasound is valuable in preoperative, intraoperative, and postoperative care, allowing for tailored anesthesia plans and timely interventions based on cardiac function. The US is an effective diagnostic tool for assessing pulmonary conditions, with specific signs and artifacts aiding in identifying pathologies such as pneumothorax, pleural effusions, and pulmonary congestion. Despite its benefits, POCUS faces barriers such as limited access to training, the need for standardized protocols, and the high equipment cost, especially in low-resource settings. While its integration into clinical practice continues to grow, overcoming challenges related to training, standardization, and equipment access is essential to realize its full potential. Continued efforts in education and research are needed to support the widespread adoption of POCUS in anesthesiology.

摘要

床旁超声(POCUS)已成为现代麻醉学中的一项重要工具,可提供实时成像,有助于诊断、治疗和操作指导。其应用范围已大幅扩展,从常规评估到复杂的围手术期管理,在各个领域提升了患者护理水平。本研究旨在回顾和总结当前关于POCUS在麻醉学中应用的文献,重点关注其在气道管理、心脏评估、肺部超声(LUS)和腹部盆腔评估中的效用。此外,还讨论了其广泛应用面临的挑战及克服障碍的策略。我们进行了一项叙述性文献综述,涵盖了关于在麻醉学中使用POCUS的研究。在主要数据库中搜索相关文章(“床旁超声”“聚焦心脏超声”“肺部超声”),并根据与主要感兴趣主题的相关性选择研究:气道管理、心脏超声、LUS以及腹部盆腔和胃部超声。纳入了观察性研究和随机对照试验。POCUS提高了区域麻醉和气道操作的安全性和准确性,通过提供实时可视化改善了患者预后。聚焦心脏超声在术前、术中和术后护理中都很有价值,可根据心功能制定个性化的麻醉计划并及时进行干预。超声是评估肺部疾病的有效诊断工具,特定的征象和伪像有助于识别气胸、胸腔积液和肺充血等病理情况。尽管有诸多益处,但POCUS面临一些障碍,如培训机会有限、需要标准化方案以及设备成本高昂,尤其是在资源匮乏的环境中。虽然其在临床实践中的整合不断增加,但克服与培训、标准化和设备获取相关的挑战对于充分发挥其潜力至关重要。需要在教育和研究方面持续努力,以支持POCUS在麻醉学中的广泛应用。

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Point-of-care ultrasound (POCUS) of the upper airway.床旁超声在上呼吸道中的应用。
Can J Anaesth. 2018 Apr;65(4):473-484. doi: 10.1007/s12630-018-1064-8. Epub 2018 Jan 18.

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