Ultrasound In Critical Care: A Holistic Discipline

Abstract

In this review, ultrasound is presented as a tool for visual medicine, of major help in critical care first. This evolution was possible since at last 1982, ideally 1992 due to the size and mobility of the machines. Holistic ultrasound includes first the heart, which can be simplified in light of other fields. It assesses the whole body, i.e., not only the abdomen, but several targets (optic nerve, venous network, interventional procedures such as venous line insertion). The lung, main vital organ, is possibly the main part of holistic ultrasound, because protocols have been designed for current settings, i.e., acute respiratory failure (BLUE-protocol), acute circulatory failure (FALLS-protocol), cardiac arrest (SESAME-protocol), and request for limiting irradiation (LUCI-FLR project). Lung ultrasound can be performed in ARDS, bariatric patients, neonates, with the same standardized approach. Lung ultrasound is part of holistic ultrasound, since it simplifies the approach of echocardiography to a real-time analysis, using one and single probe, suitable for the whole body (veins, abdomen), and a simple unit. Lung ultrasound provides so fast data that SESAME-protocol (cardiac arrest) begins by lung views, since suitable windocs are always provided. Lung ultrasound is holistic, again, when it provides a direct parameter of clinical volemia, through the transformation from dry lung to wet lung, occuring at an early step of pulmonary edema. CEURF trains intensivists to this holistic approach since 1989.