How we do Multiorgan Integrated Critical Care Ultrasonology (MICCUS): An Approach for Patient Evaluation

Abstract

The point-of-care ultrasonography (POCUS) has become integral for physicians working in critical care set-ups. It has been used for acute and crisis management, ongoing care of the patient, real-time guidance for performing procedures, diagnostic and screening aids, etc. Interestingly, the use of POCUS is increasing daily, and intensivists and critical care physicians are routinely scanning the lung, heart, vascular structure, abdomen, optic nerves, etc. Presently, literature for the routine and emergency use of ultrasound for protocolized assessment for differentiating and diagnosing acute respiratory failure, acute shock, and undifferentiated shock is available. Although there is some overlap, most of the protocolized approach primarily aims at respiratory or circulatory failure. On the other hand, the respiratory and cardiovascular system is well integrated. Moreover, critically ill patients also suffer other organ insufficiencies because of cardiorespiratory insufficiencies or vice versa. Nevertheless, POCUS is now considered the visual stethoscope of critical care physicians. Therefore, a multiorgan integrated approach is justified for assessing the patient right from the first clinical evaluation on admission. This article is intended to provide brief information related to the use and current practice of ultrasonology for critical care patient management by the residents and provide a technical framework for multiorgan integrated critical care ultrasonology (MICCUS) approach for evaluating patients having a new or ongoing acute cardiorespiratory insufficiencies with particular emphasize on the respiratory, cardiac, and vascular systems and integrating the evaluation of the abdomen and urological system. Nevertheless, the MICCUS is just an approach (how critical care ultrasonology can be integrated), not a protocol. It is developed by using existing and validated protocols on topics.  

Bangladesh Journal of Medical Science Vol. 23 No. 03 July’24 Page : 610-616