Point-of-Care Ultrasound for Oncologic Critical Care
In this chapter, we will focus our limited review of point-of-care ultrasonography (POCUS) specifically on those components arguably most pertinent to the care of the oncologic patient. A more thorough review of some topics, such as the FAST exam for the detection of intraperitoneal fluid, can be found elsewhere. In the presence of systemic morbidity and an expanding differential diagnosis, rapid and accurate assessment of these patients can be challenging. POCUS can potentially narrow the differential and avoid significant delays in treatment. The foundation of ultrasonography is a practical understanding of ultrasound physics, equipment, and artifacts. POCUS of the heart and IVC can help guide the resuscitation of the hemodynamically unstable patient. Lung sonography can suggest the etiology of the dyspnea and guide weaning from mechanical ventilation. Routine use of POCUS can potentially avoid significant delays in treatment for many conditions, from intracranial hypertension to VTE. Despite the enormous potential of POCUS, it is important to remember that guided training and continued research are requisites if patient care is to be improved and iatrogenic injury avoided.
KeywordsPoint-of-care ultrasound (POCUS) Echocardiography Goal-directed resuscitation Transthoracic Venous thromboembolism Intracranial hypertension
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