International Federation for Emergency Medicine Consensus Statement: Sonography in hypotension and cardiac arrest (SHoC): An international consensus on the use of point of care ultrasound for undifferentiated hypotension and during cardiac arrest

被引：71

作者：

Atkinson, Paul ^{[1
,2
]}

Bowra, Justin ^{[3
,4
]}

Milne, James ^{[5
]}

Lewis, David ^{[1
,2
]}

Lambert, Mike ^{[6
,11
]}

Jarman, Bob ^{[8
,12
]}

Noble, Vicki E. ^{[9
,10
]}

Lamprecht, Hein

Harris, Tim ^{[12
,13
]}

Connolly, Jim ^{[7
]}

机构：

[1] Dalhousie Univ, St John, NB, Canada

[2] St Johns Hosp, St John, NB, Canada

[3] Sydney Adventist Hosp, Wahroonga, Australia

[4] Univ Sydney, Sydney, NSW, Australia

[5] Fraser Hlth Author, Surrey, BC, Canada

[6] Advocate Christ Med Ctr, Oak Lawn, IL USA

[7] Royal Victoria Infirm, Newcastle Upon Tyne, Tyne & Wear, England

[8] Univ Teesside, Middlesbrough, Cleveland, England

[9] Univ Hosp Cleveland, Med Ctr, Cleveland, OH 44106 USA

[10] Case Western Reserve Univ, Sch Med, Cleveland, OH USA

[11] Stellenbosch Univ, Stellenbosch, South Africa

[12] Barts Hlth NHS Trust, London, England

[13] Queen Mary Univ London, London, England

来源：

CANADIAN JOURNAL OF EMERGENCY MEDICINE | 2017年 / 19卷 / 06期

关键词：

ultrasound; shock; hypotension; life support;

D O I：

10.1017/cem.2016.394

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Introduction: The International Federation for Emergency Medicine (IFEM) Ultrasound Special Interest Group (USIG) was tasked with development of a hierarchical consensus approach to the use of point of care ultrasound (PoCUS) in patients with hypotension and cardiac arrest. Methods: The IFEM USIG invited 24 recognized international leaders in PoCUS from emergency medicine and critical care to form an expert panel to develop the sonography in hypotension and cardiac arrest (SHoC) protocol. The panel was provided with reported disease incidence, along with a list of recommended PoCUS views from previously published protocols and guidelines. Using a modified Delphi methodology the panel was tasked with integrating the disease incidence, their clinical experience and their knowledge of the medical literature to evaluate what role each view should play in the proposed SHoC protocol. Results: Consensus on the SHoC protocols for hypotension and cardiac arrest was reached after three rounds of the modified Delphi process. The final SHoC protocol and operator checklist received over 80% consensus approval. The IFEM-approved final protocol, recommend Core, Supplementary, and Additional PoCUS views. SHoC-hypotension core views consist of cardiac, lung, and inferior vena vaca (IVC) views, with supplementary cardiac views, and additional views when clinically indicated. Subxiphoid or parasternal cardiac views, minimizing pauses in chest compressions, are recommended as core views for SHoC-cardiac arrest; supplementary views are lung and IVC, with additional views when clinically indicated. Both protocols recommend use of the "4 F" approach: fluid, form, function, filling. Conclusion: An international consensus on sonography in hypotension and cardiac arrest is presented. Future prospective validation is required.

引用

页码：459 / 470

页数：12

共 10 条

[1] Abdominal and Cardiac Evaluation with Sonography in Shock (ACES): an approach by emergency physicians for the use of ultrasound in patients with undifferentiated hypotension [J].