Intensive Care Medicine

, Volume 37, Issue 7, pp 1077–1083 | Cite as

International expert statement on training standards for critical care ultrasonography

  • Expert Round Table on Ultrasound in ICU
Expert Panel


Training in ultrasound techniques for intensive care medicine physicians should aim at achieving competencies in three main areas: (1) general critical care ultrasound (GCCUS), (2) “basic” critical care echocardiography (CCE), and (3) advanced CCE. A group of 29 experts representing the European Society of Intensive Care Medicine (ESICM) and 11 other critical care societies worldwide worked on a potential framework for organizing training adapted to each area of competence. This framework is mainly aimed at defining minimal requirements but is by no means rigid or restrictive: each training organization can be adapted according to resources available. There was 100% agreement among the participants that general critical care ultrasound and “basic” critical care echocardiography should be mandatory in the curriculum of intensive care unit (ICU) physicians. It is the role of each critical care society to support the implementation of training in GCCUS and basic CCE in its own country.


Ultrasound techniques Echocardiography Training Competence 



The participants and the organizing committee are indebted to Mrs. Cindy Martinez and to Pr. Jean-Daniel Chiche for their invaluable help with practical organization of this round table.

Conflict of interest

B. Cholley has worked as a consultant or lecturer for Philips Healthcare (fees being paid to his department) but has no conflict of interest related to the topic of this conference. A. Vieillard Baron has received honoraria as a lecturer at ultrasound symposia, and funding from various industrial partners to develop a website in critical care ultrasound. P. Vignon has worked as a consultant or lecturer for Philips Healthcare but has no conflict of interest related to the topic of this conference. Y. Beaulieu declares to work part-time as director of ultrasound education for a company called CAE Healthcare, providing training solutions on bedside ultrasound including e-learning curriculum and an ultrasound simulator. He receives a salary for that role from CAE Healthcare. R.C. McDermid has received honoraria from ICCU Imaging, a company involved in ultrasound training. S. Alhamid, M. Balik, R. Breitkreutz, J.-L. Canivet, P. Doelken, H. Flaatten, H. Frankel, M. Haney, A. Hilton, E. Maury, P.H. Mayo, A.S. McLean, C. Mendes, M.R Pinsky, J. Poelaert, S. Price, D. Schmidlin, M. Slama, D. Talmor, J. M. Teles, G. Via, G.Voga, P. Wouters, and T. Yamamoto have no financial conflicts of interest to declare.


  1. 1.
    Cholley BP, Vieillard-Baron A, Mebazaa A (2006) Echocardiography in the ICU: time for widespread use!. Intensive Care Med 32:9–10PubMedCrossRefGoogle Scholar
  2. 2.
    Breitkreutz R, Walcher F, Seeger FH (2007) Focused echocardiographic evaluation in resuscitation management: concept of an advanced life support-conformed algorithm. Crit Care Med 35:S150–S161PubMedCrossRefGoogle Scholar
  3. 3.
    Beaulieu Y (2007) Bedside echocardiography in the assessment of the critically ill. Crit Care Med 35:S235–S249PubMedCrossRefGoogle Scholar
  4. 4.
    Beaulieu Y (2007) Specific skill set and goals of focused echocardiography for critical care clinicians. Crit Care Med 35:S144–S149PubMedCrossRefGoogle Scholar
  5. 5.
    Kaplan A, Mayo PH (2009) Echocardiography performed by the pulmonary/critical care medicine physician. Chest 135:529–535PubMedCrossRefGoogle Scholar
  6. 6.
    Khoury AF, Afridi I, Quinones MA, Zoghbi WA (1994) Transesophageal echocardiography in critically ill patients: feasibility, safety, and impact on management. Am Heart J 127:1363–1371PubMedCrossRefGoogle Scholar
  7. 7.
    Heidenreich PA, Stainback RF, Redberg RF, Schiller NB, Cohen NH, Foster E (1995) Transesophageal echocardiography predicts mortality in critically ill patients with unexplained hypotension. J Am Coll Cardiol 26:152–158PubMedCrossRefGoogle Scholar
  8. 8.
    Poelaert JI, Trouerbach J, De Buyzere M, Everaert J, Colardyn FA (1995) Evaluation of transesophageal echocardiography as a diagnostic and therapeutic aid in a critical care setting. Chest 107:774–779PubMedCrossRefGoogle Scholar
  9. 9.
    Huttemann E, Schelenz C, Kara F, Chatzinikolaou K, Reinhart K (2004) The use and safety of transoesophageal echocardiography in the general ICU—a minireview. Acta Anaesthesiol Scand 48:827–836PubMedCrossRefGoogle Scholar
  10. 10.
    Beaulieu Y, Marik PE (2005) Bedside ultrasonography in the ICU: part 2. Chest 128:1766–1781PubMedCrossRefGoogle Scholar
  11. 11.
    Beaulieu Y, Marik PE (2005) Bedside ultrasonography in the ICU: part 1. Chest 128:881–895PubMedCrossRefGoogle Scholar
  12. 12.
    Stanko LK, Jacobsohn E, Tam JW, De Wet CJ, Avidan M (2005) Transthoracic echocardiography: impact on diagnosis and management in tertiary care intensive care units. Anaesth Intensive Care 33:492–496PubMedGoogle Scholar
  13. 13.
    Orme RM, Oram MP, McKinstry CE (2009) Impact of echocardiography on patient management in the intensive care unit: an audit of district general hospital practice. Br J Anaesth 102:340–344PubMedCrossRefGoogle Scholar
  14. 14.
    Mayo PH, Beaulieu Y, Doelken P, Feller-Kopman D, Harrod C, Kaplan A, Oropello J, Vieillard-Baron A, Axler O, Lichtenstein D, Maury E, Slama M, Vignon P (2009) American College of Chest Physicians/La Societe de Reanimation de Langue Francaise statement on competence in critical care ultrasonography. Chest 135:1050–1060PubMedCrossRefGoogle Scholar
  15. 15.
    Chalumeau-Lemoine L, Baudel JL, Das V, Arrive L, Noblinski B, Guidet B, Offenstadt G, Maury E, Maury E, Guglielminotti J, Alzieu M, Guidet B, Offenstadt G (2009) Results of short-term training of naive physicians in focused general ultrasonography in an intensive-care unit. Ultrasonic examination: an alternative to chest radiography after central venous catheter insertion? Intensive Care Med 35:1767–1771PubMedCrossRefGoogle Scholar
  16. 16.
    Manasia AR, Nagaraj HM, Kodali RB, Croft LB, Oropello JM, Kohli-Seth R, Leibowitz AB, DelGiudice R, Hufanda JF, Benjamin E, Goldman ME (2005) Feasibility and potential clinical utility of goal-directed transthoracic echocardiography performed by noncardiologist intensivists using a small hand-carried device (SonoHeart) in critically ill patients. J Cardiothorac Vasc Anesth 19:155–159PubMedCrossRefGoogle Scholar
  17. 17.
    Vignon P, Dugard A, Abraham J, Belcour D, Gondran G, Pepino F, Marin B, Francois B, Gastinne H (2007) Focused training for goal-oriented hand-held echocardiography performed by noncardiologist residents in the intensive care unit. Intensive Care Med 33:1795–1799PubMedCrossRefGoogle Scholar
  18. 18.
    Price S, Via G, Sloth E, Guarracino F, Breitkreutz R, Catena E, Talmor D (2008) Echocardiography practice, training and accreditation in the intensive care: document for the World Interactive Network Focused on Critical Ultrasound (WINFOCUS). Cardiovasc Ultrasound 6:49PubMedGoogle Scholar
  19. 19.
    Breitkreutz R, Uddin S, Steiger H, Ilper H, Steche M, Walcher F, Via G, Price S (2009) Focused echocardiography entry level: new concept of a 1 day training course. Minerva Anestesiol 75:285–292PubMedGoogle Scholar
  20. 20.
    Benjamin E, Griffin K, Leibowitz AB, Manasia A, Oropello JM, Geffroy V, DelGiudice R, Hufanda J, Rosen S, Goldman M (1998) Goal-directed transesophageal echocardiography performed by intensivists to assess left ventricular function: comparison with pulmonary artery catheterization. J Cardiothorac Vasc Anesth 12:10–15PubMedCrossRefGoogle Scholar
  21. 21.
    Melamed R, Sprenkle MD, Ulstad VK, Herzog CA, Leatherman JW (2009) Assessment of left ventricular function by intensivists using hand-held echocardiography. Chest 135:1416–1420PubMedCrossRefGoogle Scholar
  22. 22.
    Vignon P, Mücke F, Bellec F, Marin B, Croce J, Brouqui T, Palobart C, Senges P, Truffy C, Wachmann A, Dugard A, Amiel J-B (2011) Basic critical care echocardiography: validation of a curriculum dedicated to noncardiologist residents. Crit Care Med 7 [Epub ahead of print]Google Scholar
  23. 23.
    Charron C, Prat G, Caille V, Belliard G, Lefevre M, Aegerter P, Boles JM, Jardin F, Vieillard-Baron A (2007) Validation of a skills assessment scoring system for transesophageal echocardiographic monitoring of hemodynamics. Intensive Care Med 33:1712–1718PubMedCrossRefGoogle Scholar
  24. 24.
    Ryan T, Armstrong WF, Khandheria BK (2008) Task force 4: training in echocardiography endorsed by the American Society of Echocardiography. J Am Coll Cardiol 51:361–367PubMedCrossRefGoogle Scholar
  25. 25.
    Quinones MA, Douglas PS, Foster E, Gorcsan J 3rd, Lewis JF, Pearlman AS, Rychik J, Salcedo EE, Seward JB, Stevenson JG, Thys DM, Weitz HH, Zoghbi WA (2003) ACC/AHA clinical competence statement on echocardiography: a report of the American College of Cardiology/American Heart Association/American College of Physicians-American Society of Internal Medicine Task Force on Clinical Competence. J Am Coll Cardiol 41:687–708PubMedCrossRefGoogle Scholar
  26. 26.
    Huang SJ, McLean AS (2010) Do we need a critical care ultrasound certification program? Implications from an Australian medical-legal perspective. Crit Care 14:313 [Epub ahead of print]Google Scholar

Copyright information

© Copyright jointly held by Springer and ESICM 2011

Authors and Affiliations

  1. 1.B. P. Cholley, Service d’Anesthésie-RéanimationHôpital Européen Georges PompidouParis Cedex 15France

Personalised recommendations