The Value of Bedside Ultrasound in Improving Treatment in ICU_West China Medical Journal

Authors：

YIN Wanhong , SHU Aiya , CHEN Yao , WANG Bo , ZUO Yanyan

Intensive care unit, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

Keywords：

床旁超声; 重症医学; 诊断

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的　探讨床旁超声在重症监护治疗决策中的价值及应用方案。方法　回顾2010年6月－2012年2月期间床旁超声应用情况及提供的信息对治疗决策的影响及临床效果，总结重症诊治临床实践中可行的应用方案。结果　研究期间共使用床旁超声219例次，其中血流动力学监测（评估心脏前负荷、收缩力）41例次，低氧原因检查45例次，血栓筛查19例次，胎心监测22例次，引导深静脉穿刺48例次，引导胸、腹腔穿刺及置管37例次，引导动脉置管4例次，气道情况检查3例次。循环监测中经验判断容量准确性为63.4%，床旁超声能提供85.4%的正确信息，其中纠正了13例临床经验判断错误（31.7%），明显提高了诊断正确率（P＜0.05）；低氧原因判断中临床判断正确率62.2%，超声检查能提供86.7%的正确信息，发现16例临床经验判断错误，纠正错误判断35.6% （P＜0.05）。结论　床旁超声能很好地协助重症医学科医生提高临床判断准确性，控制医疗风险。

Citation： YIN Wanhong,SHU Aiya,CHEN Yao,WANG Bo,ZUO Yanyan. The Value of Bedside Ultrasound in Improving Treatment in ICU. West China Medical Journal, 2012, 27(9): 1315-1318. doi: Copy

1.	Beaulieu Y, Marik PE. Bedside ultrasonography in the ICU: part 1[J].Chest, 2005, 128(2): 1766-1781.
2.	Beaulieu Y, Bedside echocardiography in the assessment of the critically ill[J]. Crit Care Med, 2007, 35(5 suppl 1): 235-249.
3.	Stefanidis K, Dimopoumos S, Nanas S. Basic principles and current applications of lung ultrasonography in the intensive care unit[J]. Respirology, 2011, 16(2): 249-256.
4.	Salem R, Vallee F, Rusca M, et al. Hemodynamic monitoring by echocardiography in the ICU: the role of the new echo techniques[J]. Curr Opin Criti Care, 2008, 14(5): 561-568.
5.	Vieillard-Baron A. Assessment of right ventricular function[J]. Curr Opin Crit Care, 2009, 15(3): 254-260.
6.	Vieillard-Baron A, Jardin F. Why protect the right ventricle in patients with acute respiratory distress syndrome?[J]. Curr Opin Crit Care, 2003, 9(1): 15-21.
7.	于大兴, 翁利, 彭劲民, 等. 生理指标对容量负荷试验结果的预测价值[J].中华医学杂志, 2010, 90(41): 2935-2938.
8.	Fernandes CJ, Akamine N, Knobel E. Myocardial depression in sepsis[J]. Shock, 2008, 30(Suppl 1): 14-17.
9.	Alsous F, Khamiees M, DeGirolamo A, et al. Negative fluid balance predicts survival in patients with septic shock: a retrospective pilot study[J]. Chest, 2000, 117(6): 1749-1754.
10.	于大兴, 翁利, 彭劲民, 等. 血管外肺水对危重病患者预后的预测价值[J]. 中华内科杂志, 2011, 50(3): 251-253.
11.	李晓君. 床旁超声对气胸的诊断价值[J].中国医疗设备, 2009, 24(7): 95-96.
12.	张茂, 干建新, 游向东, 等. 床旁胸部超声在危重患者中应用的进展[J]. 中国急救医学, 2006, 26(3): 213-215.
13.	Vignon P, Chastagner C, Berkane V, et al. Quantitative assessment of pleural effusion in critically ill patients by means of ultrasonography[J]. Crit Care Med, 2005, 33(8): 1757-1763.
14.	王小亭，刘大为. 重视心脏多普勒超声在重症医学领域中的应用[J].中华内科杂志, 2011, 50(7): 539-540.

1. 　Beaulieu Y, Marik PE. Bedside ultrasonography in the ICU: part 1[J].Chest, 2005, 128(2): 1766-1781.
2. 　Beaulieu Y, Bedside echocardiography in the assessment of the critically ill[J]. Crit Care Med, 2007, 35(5 suppl 1): 235-249.
3. 　Stefanidis K, Dimopoumos S, Nanas S. Basic principles and current applications of lung ultrasonography in the intensive care unit[J]. Respirology, 2011, 16(2): 249-256.
4. 　Salem R, Vallee F, Rusca M, et al. Hemodynamic monitoring by echocardiography in the ICU: the role of the new echo techniques[J]. Curr Opin Criti Care, 2008, 14(5): 561-568.
5. 　Vieillard-Baron A. Assessment of right ventricular function[J]. Curr Opin Crit Care, 2009, 15(3): 254-260.
6. 　Vieillard-Baron A, Jardin F. Why protect the right ventricle in patients with acute respiratory distress syndrome?[J]. Curr Opin Crit Care, 2003, 9(1): 15-21.
7. 　于大兴, 翁利, 彭劲民, 等. 生理指标对容量负荷试验结果的预测价值[J].中华医学杂志, 2010, 90(41): 2935-2938.
8. 　Fernandes CJ, Akamine N, Knobel E. Myocardial depression in sepsis[J]. Shock, 2008, 30(Suppl 1): 14-17.
9. 　Alsous F, Khamiees M, DeGirolamo A, et al. Negative fluid balance predicts survival in patients with septic shock: a retrospective pilot study[J]. Chest, 2000, 117(6): 1749-1754.
10. 　于大兴, 翁利, 彭劲民, 等. 血管外肺水对危重病患者预后的预测价值[J]. 中华内科杂志, 2011, 50(3): 251-253.
11. 　李晓君. 床旁超声对气胸的诊断价值[J].中国医疗设备, 2009, 24(7): 95-96.
12. 　张茂, 干建新, 游向东, 等. 床旁胸部超声在危重患者中应用的进展[J]. 中国急救医学, 2006, 26(3): 213-215.
13. 　Vignon P, Chastagner C, Berkane V, et al. Quantitative assessment of pleural effusion in critically ill patients by means of ultrasonography[J]. Crit Care Med, 2005, 33(8): 1757-1763.
14. 　王小亭，刘大为. 重视心脏多普勒超声在重症医学领域中的应用[J].中华内科杂志, 2011, 50(7): 539-540.

West China Medical Journal

The Value of Bedside Ultrasound in Improving Treatment in ICU

Abstract Full text Figures/Tables Video References Cited by

Format

Content