Basic ultrasound head-to-toe skills for intensivists in the general and neuro intensive care unit population: consensus and expert recommendations of the European Society of Intensive Care Medicine

Chiara Robba (1, 2) , Adrian Wong (3) , Daniele Poole (4) , Ashraf Al Tayar , Robert T. Arntfield (5) , Michelle S. Chew (6) , Francesco Corradi (7, 8) , Ghislaine Doufle (9) , Alberto Goffi (10) , Massimo Lamperti (11) , Paul Mayo (12) , Antonio Messina (13) , Silvia Mongodi (14) , Mangala Narasimhan (12) , Corina Puppo (15) , Aarti Sarwal (16) , Michel Slama (17, 18) , Fabio S. Taccone (19) , Philippe Vignon (20, 21) , Antoine Vieillard-Baron (22, 23)

1 Ospedale Policlinico San Martino [Genoa]
2 UniGe - Università degli studi di Genova = University of Genoa
3 KCH - King's College Hospital
4 San Martino Hospital
5 Western University [London, ON, Canada]
6 LIU - Linköping University
7 University of Pisa - Università di Pisa
8 E.O. Ospedali Galliera
9 University of Toronto
10 St. Michael's Hospital
11 Cleveland Clinic Abu Dhabi [Abou Dabi, Émirats arabes unis]
12 Donald and Barbara Zucker School of Medicine at Hofstra/Northwell [Hempstead, NY, USA]
13 Humanitas Clinical and Research Center [Rozzano, Milan, Italy]
14 IRCCS "San Matteo" Hospital Foundation [Pavie, Italie]
15 University of the Republic, Montevideo
16 Wake Forest Baptist Medical Center
17 CHU Amiens-Picardie
18 MP3CV - Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517
19 ULB - Université libre de Bruxelles
20 CIC1435 - Centre d'Investigation Clinique de Limoges
21 CHU Limoges
22 Hôpital Ambroise Paré [AP-HP]
23 CESP - Centre de recherche en épidémiologie et santé des populations

Purpose To provide consensus, and a list of experts' recommendations regarding the basic skills for head-to-toe ultrasonography in the intensive care setting. Methods The Executive Committee of the European Society of Intensive Care (ESICM) commissioned the project and supervised the methodology and structure of the consensus. We selected an international panel of 19 expert clinicians-researchers in intensive care unit (ICU) with expertise in critical care ultrasonography (US), plus a non-voting methodologist. The panel was divided into five subgroups (brain, lung, heart, abdomen and vascular ultrasound) which identified the domains and generated a list of questions to be addressed by the panel. A Delphi process based on an iterative approach was used to obtain the final consensus statements. Statements were classified as a strong recommendation (84% of agreement), weak recommendation (74% of agreement), and no recommendation (less than 74%), in favor or against. Results This consensus produced a total of 74 statements (7 for brain, 20 for lung, 20 for heart, 20 for abdomen, 7 for vascular Ultrasound). We obtained strong agreement in favor for 49 statements (66.2%), 8 weak in favor (10.8%), 3 weak against (4.1%), and no consensus in 14 cases (19.9%). In most cases when consensus was not obtained, it was felt that the skills were considered as too advanced. A research agenda and discussion on training programs were implemented from the results of the consensus. Conclusions This consensus provides guidance for the basic use of critical care US and paves the way for the development of training and research projects.

Mots clés: Abdominal ultrasound; Brain ultrasound; Consensus; Echocardiography; Intensive care unit; Lung ultrasound; Ultrasonography; Vascular ultrasound

Domaines: Sciences du Vivant [q-bio]

Chiara Robba, Adrian Wong, Daniele Poole, Ashraf Al Tayar, Robert T. Arntfield, et al.. Basic ultrasound head-to-toe skills for intensivists in the general and neuro intensive care unit population: consensus and expert recommendations of the European Society of Intensive Care Medicine. Intensive Care Medicine, 2021, 47 (12), pp.1347-1367. ⟨10.1007/s00134-021-06486-z⟩. ⟨hal-03584064⟩