Ultraschall Med 2023; 44(01): 36-49
DOI: 10.1055/a-1882-6116
Guidelines & Recommendations

EFSUMB Clinical Practice Guidelines for Point-of-Care Ultrasound: Part One (Common Heart and Pulmonary Applications) SHORT VERSION

EFSUMB-Leitlinien für die klinische Praxis des Point-of-Care-Ultraschalls: Teil 1 (Allgemeine Herz- und Lungenanwendungen) KURZFASSUNG
1   Emergency Department, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
2   School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom of Great Britain and Northern Ireland
,
3   Emergency Medicine, University Hospital Lewisham, London, United Kingdom of Great Britain and Northern Ireland
,
4   Emergency Medicine, Mater Hospital School, Dublin, Ireland
,
Morten Bøtker
5   Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
6   Prehospital Emergency Medical Services, Central Denmark Region, Viborg, Denmark
,
Lars Knudsen
7   Department of Anaesthesia, Aarhus University Hospital, Aarhus, Denmark
,
Tim Harris
8   Emergency Medicine, Queen Mary University of London, United Kingdom of Great Britain and Northern Ireland
9   Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
,
Bilal Albaroudi
9   Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
,
Omar Albaroudi
9   Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
,
9   Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
,
Robert Darke
10   Emergency Medicine and Intensive Care Medicine, Health Education England North East, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
,
Edward Berry
11   Emergency Medicine, Torbay Hospital, Torquay, United Kingdom of Great Britain and Northern Ireland
,
Tomas Breslin
12   Emergency Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
13   School of Medicine, University College Dublin, Ireland
,
Gareth Fitzpatrick
14   Emergency Medicine, St Vincentʼs University Hospital, Dublin, Ireland
,
Leah Flanagan
12   Emergency Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
,
Olusegun Olusanya
15   Intensive Care Medicine, University College Hospital, London, United Kingdom of Great Britain and Northern Ireland
,
Dominic Craver
16   Emergency Medicine, The Royal London Hospital, London, United Kingdom of Great Britain and Northern Ireland
,
Adhnan Omar
17   Respiratory Medicine, University Hospital Lewisham, London, United Kingdom of Great Britain and Northern Ireland
,
Thomas Simpson
18   Respiratory Medicine, Lewisham and Greenwich NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
,
Nishant Cherian
19   Emergency Department, The Alfred Emergency & Trauma Centre, Melbourne, Australia
2   School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom of Great Britain and Northern Ireland
,
Martin Dore
20   Emergency Medicine, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom of Great Britain and Northern Ireland
,
Gregor Prosen
21   Center for Emergency Medicine, University Medical Centre Maribor, Slovenia
,
Sharon Kay
22   Cardiac Physiology and Echocardiography, The University of Sydney, Australia
,
Tomás Villén-Villegas
23   Department of Medicine, Francisco de Vitoria University, Pozuelo de Alarcon, Spain
,
Luna Gargani
24   Cardiology, Institute of Clinical Physiology National Research Council, Pisa, Italy
,
Simon Carley
25   Emergency Medicine, Manchester University NHS Foundation Trust, Manchester, United Kingdom of Great Britain and Northern Ireland
26   Emergency Medicine, Manchester Metropolitan University, Manchester, United Kingdom of Great Britain and Northern Ireland
,
Michael Woo
27   Emergency Medicine, University of Ottawa, Canada
28   Emergency Medicine, Ottawa Hospital Research Institute, Ottawa, Canada
,
Florence Dupriez
29   Emergency Medicine, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
,
Arif Hussain
30   Cardiac Critical Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
,
Gabriele Via
31   Istituto Cardio Centro, EOC, Lugano, Switzerland
,
James Anthony Connolly
32   Emergency Medicine, Royal Victoria Infirmary, Newcastle-upon-Tyne, United Kingdom of Great Britain and Northern Ireland
,
Marcus Peck
33   Anaesthesia and Intensive Care, Frimley Park Hospital NHS Trust, Frimley, United Kingdom of Great Britain and Northern Ireland
,
Larry Melniker
34   Emergency Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, United States
,
Andrew Walden
35   Acute and Intensive Care Medicine, Royal Berkshire Hospital, Reading, United Kingdom of Great Britain and Northern Ireland
36   Acute Medicine and Intensive Care Medicine, University of Oxford, United Kingdom of Great Britain and Northern Ireland
,
Mark Anthony Attard Biancardi
37   Emergency Medicine, Mater Dei Hospital, Msida, Malta
,
Olga Żmijewska-Kaczor
38   Emergency Medicine, Royal Cornwall Hospital, Truro, United Kingdom of Great Britain and Northern Ireland
,
Elizabeth Lalande
39   Emergency Medicine, Centre Hospitalier de l’Université Laval, Sainte-Foy, Canada
,
Paul Geukens
40   Intensive Care Medicine, Hopital de Jolimont, Haine-Saint-Paul, Belgium
,
Russell McLaughlin
41   Emergency Medicine, Royal Victoria Hospital, Belfast, United Kingdom of Great Britain and Northern Ireland
42   Medical Director, Northern Ireland Ambulance Service, Belfast, United Kingdom of Great Britain and Northern Ireland
,
Paul Olszynski
43   Emergency Medicine, University of Saskatchewan, Saskatoon, Canada
,
Beatrice Hoffmann
44   Emergency Department, Harvard Medical School Department of Emergency Medicine Beth Israel Deaconess Medical Center, Boston, United States
,
Eric Chin
45   Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, United States
,
Christopher Muhr
46   Emergency Medicine and Internal Medicine, Capio Sankt Gorans Sjukhus, Stockholm, Sweden
,
47   Emergency Medicine, The University of British Columbia, Vancouver, Canada
48   Emergency Medicine, Vancouver General Hospital, Vancouver, Canada
,
Andre Mercieca
37   Emergency Medicine, Mater Dei Hospital, Msida, Malta
,
Dharmesh Shukla
9   Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
,
Simon Hayward
49   Physiotherapy, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom of Great Britain and Northern Ireland
,
Michael Smith
50   School of Healthcare Sciences, Cardiff University College of Biomedical and Life Sciences, Cardiff, United Kingdom of Great Britain and Northern Ireland
,
Romolo Gaspari
51   Emergency Medicine, UMass Memorial Medical Center, Worcester, United States
52   Emergency Medicine, UMass Medical School, Worcester, United States
,
Nick Smallwood
53   Acute Medicine, East Surrey Hospital, Redhill, United Kingdom of Great Britain and Northern Ireland
,
Philippe Pes
54   Emergency Medicine, University Hospital Centre Nantes, France
,
Guido Tavazzi
55   Anesthesia and Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
56   Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, Università degli Studi di Pavia Facoltà di Medicina e Chirurgia, Pavia, Italy
,
Francesco Corradi
57   Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Italy
,
Michael Lambert
58   Emergency Medicine, Advocate Christ Medical Center, Oak Lawn, United States
,
Craig Morris
59   Intensive Care, Royal Derby Hospital, Derby, United Kingdom of Great Britain and Northern Ireland
,
Michael Trauer
60   Emergency Medicine, St Thomas’ Hospital, London, United Kingdom of Great Britain and Northern Ireland
,
Kylie Baker
61   Emergency Medicine, Ipswich Hospital, Ipswich, Australia
62   Faculty of Medicine, The University of Queensland, Saint Lucia, Australia
,
Adam Bystrzycki
63   Emergency Medicine, The Alfred Emergency & Trauma Centre, Melbourne, Australia
64   Department of Epidemiology & Preventive Medicine, Monash University, Clayton, Australia
,
Adrian Goudie
65   Emergency Medicine, Fiona Stanley Hospital, Murdoch, Australia
,
Rachel Liu
66   Emergency Medicine, Yale School of Medicine, New Haven, United States
,
Lynne Rudd
67   General Secretary, European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB), London, United Kingdom of Great Britain and Northern Ireland
,
68   Department Allgemeine Innere Medizin, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
,
Christian Jenssen
69   Klinik für Innere Medizin, Krankenhaus Märkisch Oderland, Strausberg/Wriezen, Germany
,
70   Radiology, Kingʼs College London, United Kingdom of Great Britain and Northern Ireland
› Author Affiliations

Abstract

Objective To evaluate the evidence and produce a summary and recommendations for the most common heart and lung point-of-care ultrasound (PoCUS).

Methods We reviewed 10 clinical domains/questions related to common heart and lung applications of PoCUS. Following review of the evidence, a summary and recommendations were produced, including assigning levels of evidence (LoE) and grading of recommendation, assessment, development, and evaluation (GRADE). 38 international experts, the expert review group (ERG), were invited to review the evidence presented for each question. A level of agreement of over 75 % was required to progress to the next section. The ERG then reviewed and indicated their level of agreement of the summary and recommendation for each question (using a 5-point Likert scale), which was approved in the case of a level of agreement of greater than 75 %. A level of agreement was defined as a summary of “strongly agree” and “agree” on the Likert scale responses.

Findings and Recommendations One question achieved a strong consensus for an assigned LoE of 3 and a weak GRADE recommendation (question 1), the remaining 9 questions achieved broad agreement with an assigned LoE of 4 and a weak GRADE recommendation (question 2), three achieved an LoE of 3 with a weak GRADE recommendation (questions 3–5), three achieved an LoE of 3 with a strong GRADE recommendation (questions 6–8) and the remaining two were assigned an LoE of 2 with a strong GRADE recommendation (questions 9 and 10).

Conclusion These consensus-derived recommendations should aid clinical practice and highlight areas of further research for PoCUS in acute settings.

Zusammenfassung

Ziel Bewertung der Evidenz und Erstellung einer Zusammenfassung sowie von Empfehlungen für die häufigsten Herz- und Lungenanwendungen des Point-of-Care-Ultraschalls (PoCUS).

Methoden Wir überprüften 10 klinische Bereiche bzw. Fragen im Zusammenhang mit den häufigsten Herz- und Lungenanwendungen des PoCUS. Nach der Überprüfung der Evidenz wurden eine Zusammenfassung und Empfehlungen erstellt, einschließlich der Zuordnung von Evidenzgraden (“Level of Evidence” LoE) und der Einstufung der Empfehlung, Bewertung, Entwicklung und Evaluierung (GRADE). Die Expert Review Group (ERG), bestehend aus 38 internationale Experten, wurde aufgefordert, die für jede Fragestellung vorgelegte Evidenz zu überprüfen. Eine Zustimmung von über 75 % war erforderlich, um zum nächsten Teilbereich überzugehen. Anschließend überprüfte die ERG die Ergebnisse und gab den Grad der Zustimmung (mittels 5-stufiger Likert-Skala) bezüglich der Zusammenfassung und Empfehlung für jede Fragestellung an. Diese wurde anerkannt, wenn der Grad der Zustimmung – definiert als Summe der Antworten „stimme voll zu“ und „stimme zu“ auf der Likert-Skala – mehr als 75 % betrug.

Ergebnisse und Empfehlungen Bei einer Frage wurde ein starker Konsens bei einem zugeordneten LoE von 3 und einer schwachen GRADE-Empfehlung erzielt (Frage 1). Die übrigen 9 Fragen erzielten eine breite Zustimmung, wobei eine Frage einen LoE von 4 und eine schwache GRADE-Empfehlung erhielt (Frage 2), 3 Fragen erreichten einen LoE von 3 mit schwacher GRADE-Empfehlung (Fragen 3–5), 3 Fragen erreichten einen LoE von 3 mit starker GRADE-Empfehlung (Fragen 6–8) und die verbleibenden 2 Fragen erhielten einen LoE von 2 mit einer starken GRADE-Empfehlung (Fragen 9 und 10).

Schlussfolgerung Diese konsensbasierten Empfehlungen sollen die klinische Praxis unterstützen und Bereiche für weitere Forschung hinsichtlich des PoCUS in der Akutversorgung aufzeigen.



Publication History

Received: 22 December 2021

Accepted: 07 June 2022

Article published online:
13 October 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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