• Medical ultrasonography · Feb 2021

    Review

    A.B.C. approach proposal for POCUS in COVID-19 critically ill patients.

    • Robert Simon, Cristina Petrișor, Constantin Bodolea, Gabriela Csipak, Cristian Oancea, and Adela Golea.
    • 1 Clinical Emergency County Hospital Cluj-Napoca 2 "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca. simon.robert08@gmail.com.
    • Med Ultrason. 2021 Feb 18; 23 (1): 94-102.

    AbstractThe rapid spread of SARS-CoV-2 (COVID-19) since December 2019 forced Intensive Care Units to face high numbers of patients admitted simultaneously with limited resources. COVID-19 critically ill patients, especially those on mechanical ventilators, demand special attention as they can develop potential complications with critical hemodynamic and respiratory consequences. Point of Care Ultrasound (POCUS) might have important roles in assessing the critically ill SARS-CoV-2 patient. Mostly, lung ultrasound has been presented as having a role in diagnosis and monitoring, but airway examination and hemodynamic evaluation are of interest also. We propose an A.B.C. POCUS approach focusing on A-airway (orotracheal intubation), B-breathing (interstitial syn-dromes, pneumothorax, atelectasis, pneumonia), and C-circulation (cardiac function, pulmonary embolism, volume status, deep veins thrombosis). This A.B.C. approach has emerged during ICU care for 22 adult COVID-19 critically ill patients, along with the analysis of recent papers describing ultrasound in COVID-19 patients including the use of ultrasound that is currently applied in the management of the general critically ill population. This A.B.C- POCUS algorithm parallels the well-established clinical A.B.C. algorithms. There are few extensive ultrasonographic studies in COVID-19 critically ill patients up to now, but techniques extrapolated from non-COVID studies seem reasonable even though comparative studies are not available yet.

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