ROLE OF ULTRASOUND IN THE MANAGEMENT OF PATIENTS IN INTENSIVE CARE: A ONE-YEAR PROSPECTIVE STUDY.

Médical science

Summary Objective: To evaluate the usefulness of clinical ultrasound in intensive care. Patients and methods: This is a descriptive prospective study, conducted on patients admitted to an intensive care unit who underwent clinical ultrasound at a university hospital center “Aristide Le Dantec” in Dakar from February 1, 2021, to January 31, 2022. Results: In this study, 211 ultrasounds were performed on 114 patients. The median age is 46 years, and the majority of patients are females (59%). 24.5% of patients presented with shock. The echocardiography was the most frequent ultrasound exam performed (41.7%). Hypovolemia was the most frequent anomaly found on echocardiography (46.7%). In 81% of cases, performing echocardiography had an impact on the ongoing treatment. 38 patients performed pulmonary ultrasound (18%).The anomalies found were dominated by interstitial syndrome (37%) and pleural effusion (21%). Non-invasive ventilation was the most common therapeutic decision after pulmonary ultrasound (18%). Ultrasound-guided central venous catheterization was performed in 53 patients, and the most commonly used site was the internal jugular vein (89%). The complication rate was 17%, consisting of hematoma (9.5%) or arterial puncture (7.5%). 24 patients performed abdominal ultrasound (11.3%). Peritoneal effusions were objectified in 14 patients (59%). The therapeutic impact was 44.5% (10 exploratory laparotomies (41%) and one haemostasis hysterectomy). Conclusion: Targeted ultrasound in intensive care unit represents an extension of clinical examination in various pathological situations. We have demonstrated the feasibility and effectiveness of this technique in our unit. Keywords: Ultrasound, POCUS, intensive care, emergency

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