Perioperative ultrasound applied to diagnosis and decision making in anesthesia.

Abstract:

INTRODUCTION:Ultrasound is a portable and safe technology that is increasingly used to assist anesthetic procedures and has been integrated into the routine practice of a wide range of invasive procedures. As a complementary diagnostic tool, publications related to perioperative support other than vascular access and nerve blocks are currently lacking. EVIDENCE ACQUISITION:Given the growing interest of anesthesiologists in acquisition of knowledge and skills of ultrasound, we propose a systematic review of the diagnosis, decision making or change in perioperative management of non-cardiac surgical patients derived from ultrasound practice. Of 1112 references found in electronic databases, 62 studies resulted from the screening process. EVIDENCE SYNTHESIS:A complete critical reading of 19 full-text publications was carried out with quantitative analysis of 1825 ultrasound examinations including echocardiography, neck and laryngeal ultrasound, pulmonary ultrasound and abdominal ultrasound, all of them performed by anesthesiologists. Diagnosis applied ultrasound and decision making during perioperative period resulted in change in the management of 31% with 95% CI of 21.06 to 42.04 and odds ratio of 2.68 (1.77 to 4.06) related to hemodynamic, airway and respiratory perioperative management. CONCLUSIONS:Since most of the articles included in this review are observational studies with inherent design concerns, there is an urgent requirement for randomized controlled trials in this area. As anesthesiologists become more comfortable and knowledgeable in ultrasound applied to the perioperative support, emergence of protocols with multidisciplinary ultrasound exploration is expected to allow an improvement in perioperative safety.

journal_name

Minerva Anestesiol

journal_title

Minerva anestesiologica

authors

Ferreira Albuquerque Costa NT,Gomar Sancho C

doi

10.23736/S0375-9393.17.12178-4

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

94-107

issue

1

eissn

0375-9393

issn

1827-1596

pii

S0375-9393.17.12178-4

journal_volume

84

pub_type

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