• Micah L A Heldeweg, Jorge E Lopez Matta, Luigi Pisani, Stefanie Slot, Mark E Haaksma, Jasper M Smit, Amne Mousa, Giovanna Magnesa, Fabrizia Massaro, TouwHugo R WHRWAmsterdam Leiden Intensive care Focused Echography (ALIFE, www.alifeofpocus.com ), Amsterdam, The Netherlands.Department of Intensive Care Medicine, Radboud University Medical Hospital, Nijmegen, The Netherlands., Viviane Schouten, Carlos V Elzo Kraemer, David J van Westerloo, HeunksLeo M ALMADepartment of Intensive Care Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands., and Pieter R Tuinman.
• Department of Intensive Care Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
• Crit. Care Med. 2023 Mar 1; 51 (3): 357364357-364.

ObjectivesTo investigate the impact of thoracic ultrasound (TUS) examinations on clinical management in adult ICU patients.DesignA prospective international observational study.SettingFour centers in The Netherlands and Italy.PatientsAdult ICU patients (> 18 yr) that received a clinically indicated lung ultrasound examination.InterventionsNone.Measurements And Main ResultsClinicians performing TUS completed a pre- and post-examination case report form. Patient characteristics, TUS, and resulting clinical effects were recorded. First, change of management, defined as a TUS-induced change in clinical impression leading to a change in treatment plan, was reported. Second, execution of intended management changes within 8 hours was verified. Third, change in fluid balance after 8 hours was calculated. A total of 725 TUS performed by 111 operators across 534 patients (mean age 63 ± 15.0, 70% male) were included. Almost half of TUS caused a change in clinical impression, which resulted in change of management in 39% of cases. The remainder of TUS confirmed the clinical impression, while a minority (4%) did not contribute. Eighty-nine percent of management changes indicated by TUS were executed within 8 hours. TUS examinations that led to a change in fluid management also led to distinct and appropriate changes in patient's fluid balance.ConclusionsIn this international observational study in adult ICU patients, use of TUS had a major impact on clinical management. These results provide grounds for future randomized controlled trials to determine if TUS-induced changes in decision-making also lead to improved health outcomes.Copyright © 2023 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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