Society of Critical Care Medicine Guidelines on Adult Critical Care Ultrasonography: Focused Update 2024

  • José L. Díaz-Gómez
  • , Sameer Sharif
  • , Enyo Ablordeppey
  • , Michael J. Lanspa
  • , John Basmaji
  • , Thomas Carver
  • , Jayne Chirdo Taylor
  • , Luna Gargani
  • , Alberto Goffi
  • , Allyson M. Hynes
  • , Antonio Hernandez
  • , Jan Kasal
  • , Abhilash Koratala
  • , Smadar Kort
  • , Peter Lindbloom
  • , Rachel Liu
  • , Pete Livezey
  • , Viveta Lobo
  • , Susan Malone
  • , Paul Mayo
  • Carol Mitchell, Ng Niu, Nova Panebianco, Madhavi Parekh, Susana Price, Aarti Sarwal, Felipe Teran, Gabriele Via, Antoine Vieillard-Baron, Anthony Weekes, Brandon Wiley, Kimberley Lewis, Sara Nikravan

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

RATIONALE: Critical care ultrasonography (CCUS) is rapidly evolving with new evidence being published since the prior 2016 guideline. OBJECTIVES: To identify and assess the best evidence regarding the clinical outcomes associated with five CCUS applications in adult patients since the publication of the previous guidelines. PANEL DESIGN: An interprofessional, multidisciplinary, and diverse expert panel of 36 individuals including two patient/family representatives was assembled via an intentional approach. Conflict-of-interest policies were strictly followed in all phases of the guidelines, including task force selection and voting. METHODS: Focused research questions based on Population, Intervention, Control, and Outcomes (PICO) for adult CCUS application were developed. Panelists applied the guidelines revision process described in the Standard Operating Procedures Manual to analyze supporting literature and to develop evidence-based recommendations as a focused update. The evidence was statistically summarized and assessed for quality using the Grading of Recommendations, Assessment, Development, and Evaluation approach. The evidence-to-decision framework was used to formulate recommendations as strong or conditional. RESULTS: The Adult CCUS Focused Update Guidelines panel aimed to understand the current impact of CCUS on patient important outcomes as they related to five PICO questions in critically ill adults. A rigorous systematic review of evidence to date informed the panel's recommendations. In adult patients with septic shock, acute dyspnea/respiratory failure, or cardiogenic shock, we suggest using CCUS to guide management. Given evidence supporting an improvement in mortality, we suggest the use of CCUS for targeted volume management as opposed to usual care without CCUS. Last, there was insufficient data to determine if CCUS should be used over standard care without CCUS in the management of patients with cardiac arrest. CONCLUSIONS: The guidelines panel achieved strong agreement regarding the recommendations for CCUS to improve patient outcomes. These recommendations are intended for consideration along with the patient's existing clinical status.

Original languageEnglish
Pages (from-to)e447-e458
JournalCritical care medicine
Volume53
Issue number2
DOIs
StatePublished - Feb 1 2025

Keywords

  • acute respiratory failure
  • cardiogenic shock
  • critical care ultrasonography
  • guidelines
  • point-of-care ultrasound
  • septic shock

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