Skip to main content
Log in

International expert statement on training standards for critical care ultrasonography

  • Expert Panel
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Cholley BP, Vieillard-Baron A, Mebazaa A (2006) Echocardiography in the ICU: time for widespread use!. Intensive Care Med 32:9–10

    Article  PubMed  Google Scholar 

  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–S161

    Article  PubMed  Google Scholar 

  3. Beaulieu Y (2007) Bedside echocardiography in the assessment of the critically ill. Crit Care Med 35:S235–S249

    Article  PubMed  Google Scholar 

  4. Beaulieu Y (2007) Specific skill set and goals of focused echocardiography for critical care clinicians. Crit Care Med 35:S144–S149

    Article  PubMed  Google Scholar 

  5. Kaplan A, Mayo PH (2009) Echocardiography performed by the pulmonary/critical care medicine physician. Chest 135:529–535

    Article  PubMed  Google Scholar 

  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 127:1363–1371

    Article  PubMed  CAS  Google Scholar 

  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 26:152–158

    Article  PubMed  CAS  Google Scholar 

  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 107:774–779

    Article  PubMed  CAS  Google Scholar 

  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 48:827–836

    Article  PubMed  CAS  Google Scholar 

  10. Beaulieu Y, Marik PE (2005) Bedside ultrasonography in the ICU: part 2. Chest 128:1766–1781

    Article  PubMed  Google Scholar 

  11. Beaulieu Y, Marik PE (2005) Bedside ultrasonography in the ICU: part 1. Chest 128:881–895

    Article  PubMed  Google Scholar 

  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 33:492–496

    PubMed  CAS  Google Scholar 

  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 102:340–344

    Article  PubMed  Google Scholar 

  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 135:1050–1060

    Article  PubMed  Google Scholar 

  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 35:1767–1771

    Article  PubMed  Google Scholar 

  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 19:155–159

    Article  PubMed  Google Scholar 

  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 33:1795–1799

    Article  PubMed  Google Scholar 

  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 6:49

    PubMed  Google Scholar 

  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 75:285–292

    PubMed  CAS  Google Scholar 

  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 12:10–15

    Article  PubMed  CAS  Google Scholar 

  21. Melamed R, Sprenkle MD, Ulstad VK, Herzog CA, Leatherman JW (2009) Assessment of left ventricular function by intensivists using hand-held echocardiography. Chest 135:1416–1420

    Article  PubMed  Google Scholar 

  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]

  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 33:1712–1718

    Article  PubMed  Google Scholar 

  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 51:361–367

    Article  PubMed  Google Scholar 

  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 41:687–708

    Article  PubMed  Google Scholar 

  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 

Download references

Acknowledgments

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.

Author information

Authors and Affiliations

Consortia

Additional information

Round table participants and affiliations are given in Appendix

Appendices

Appendix

Organizing Society:

European Society of Intensive Care Medicine (ESICM)

Participating Societies:

American College of Chest Physicians (ACCP); American Thoracic Society (ATS); Asia Pacific Association of Critical Care Medicine (APACCM); Australia and New Zealand Intensive Care Society (ANZICS); Brazilian Association of Intensive Care Medicine (AMIB); Canadian Critical Care Society (CCCS); European Society of Anaesthesiology (ESA); European Society of Intensive Care Medicine (ESICM); Japanese Society of Intensive Care Medicine (JSICM); Pan Arab Federation of Societies of Anaesthesia, Intensive Care and Pain Medicine (PAFSA); Société de Réanimation de Langue Française (SRLF); Society of Critical Care Medicine (SCCM).

Round table participants and affiliations

Round table organization:

B.P. Cholley (AP-HP, Hôpital Européen Georges Pompidou, Service d’Anesthésie-Réanimation, Paris and Université Paris Descartes, France)

Working subgroups leaders:

P.H. Mayo (Long Island Jewish Medical Center, New York, USA)

J. Poelaert (Flemish University Hospital, Brussels, Belgium)

A. Vieillard-Baron (AP-HP, Hôpital Ambroise Paré, Boulogne and Université Paris-Versailles-Saint Quentin, France)

P. Vignon (CHU Limoges, Réanimation Polyvalente, Limoges, F-87042 and INSERM 0801, Limoges, F-87042 and Université de Limoges, Limoges, F-87000)

Round table participants:

S. Alhamid (King Abdul-Aziz Medical City National Guard, College of Medicine, King Saud Bin Abdul-Aziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia)

M. Balik (First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic)

Y. Beaulieu (Hôpital Sacré-Coeur de Montréal, Université de Montréal, Montréal, Québec, Canada)

R. Breitkreutz (Department of Anesthesiology, Intensive Care and Pain Therapy, University Hospital and Medical Faculty of the Saarland, Homburg (Saar), Germany)

J.-L. Canivet (University Hospital Centre, University of Liege, Liege, Belgium)

P. Doelken (Medical University of South Carolina, Charleston, SC, USA)

H. Flaatten (Haukeland Universitetssykehus, Bergen, Norway)

H. Frankel (University of Texas Southwestern Medical Center, Dallas, USA)

M. Haney (Umeå University and University Hospital of Umeå, Umeå, Sweden)

A. Hilton (Alfred Hospital, Melbourne, Australia)

E. Maury (AP-HP, Hôpital Saint-Antoine, Paris & Université Pierre et Marie Curie, France)

R.C. McDermid (University of Alberta Hospital, University of Alberta, Edmonton, Alberta, Canada)

A.S. McLean (University of Sydney Medical School, Nepean Sydney, Australia)

C. Mendes (Intensive Care Unit, Hospital Universitário UFPB, João Pessoa, Paraíba, Brasil)

M.R. Pinsky (University of Pittsburgh School of Medicine, Pittsburgh, PA, USA)

S. Price (Royal Brompton & Harefield NHS Foundation Trust, UK)

D. Schmidlin (Intensive Care Medicine, Klinik Im Park, Zurich, Switzerland)

M. Slama (CHU Amiens, Amiens & INSERM ERI 12, France)

D. Talmor (Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA)

J. M. Teles (Intensive Care Unit-Hospital da Bahia-Salvador-Bahia-Brasil)

G. Via (IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy)

G.Voga (General Hospital Celje, Celje, Slovenia)

P. Wouters (Department of Anesthesiology, Ghent University Hospital, Ghent, Belgium)

T. Yamamoto (Nippon Medical School Hospital, Tokyo, Japan)

Endorsement

The content of this manuscript has been officially endorsed by the following societies:

American College of Chest Physicians (ACCP)

American Thoracic Society (ATS)

Australia and New Zealand Intensive Care Society (ANZICS)

Asia Pacific Association of Critical Care Medicine (APACCM)

Brazilian Association of Intensive Care Medicine (AMIB)

Canadian Critical Care Society (CCCS)

Czech Society of Anaesthesiology and Intensive Care Medicine (ČSARIM)

European Association of Cardiothoracic Anaesthesiologists (EACTA)

European Society of Anaesthesiology (ESA)

European Society of Intensive Care Medicine (ESICM)

Japanese Society of Intensive Care Medicine (JSICM)

Société Française d’Anesthésie-Réanimation (SFAR)

Société de Réanimation de Langue Française (SRLF)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Expert Round Table on Ultrasound in ICU. International expert statement on training standards for critical care ultrasonography. Intensive Care Med 37, 1077–1083 (2011). https://doi.org/10.1007/s00134-011-2246-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00134-011-2246-9

Keywords

Navigation