Date: 21 May 2013

Focused ultrasound is the next step in perioperative care

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In this issue of the Journal, two different investigators report the use of bedside ultrasound for focused cardiac examination as well as for focused thoracic and abdominal examinations in patients undergoing non-cardiac surgery.1,2 These ultrasound observations led to a change in patient management, and it is expected that more widespread use of this tool in our practice will likely have a significant impact on perioperative care. This paradigm change implies that consideration should be given to incorporating an ultrasound curriculum within our anesthesiology training programs.3

The first case1 involves a previously healthy 29-yr-old pregnant woman who developed preeclampsia complicated by HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome. Following Cesarean delivery, the patient remained anuric and was transferred to the intensive care unit. A bedside cardiac ultrasound was performed using a validated pulsed wave tissue Doppler technique to estimate filling p