International Evidence-Based Recommendations for Focused Cardiac Ultrasound - 19/06/14
, Arif Hussain, MD b, Mike Wells, MD, BSc, BSc Hons, MBBCh, FCEM, Dip PEC c, Robert Reardon, MD d, Mahmoud ElBarbary, MD e, Vicki E. Noble, MD f, James W. Tsung, MD, MPH g, h, Aleksandar N. Neskovic, MD, PhD, FESC, FACC i, Susanna Price, MD, MBBS, BSc, MRCP, EDICM, PhD, FFICM, FESC j, Achikam Oren-Grinberg, MD, MS k, Andrew Liteplo, MD, RDMS l, Ricardo Cordioli, MD m, Nitha Naqvi, MD, MSc, MRCPCH n, Philippe Rola, MD o, Jan Poelaert, MD, PhD p, Tatjana Golob Guliĉ, MD q, Erik Sloth, MD, PhD, DMSc r, Arthur Labovitz, MD, FACC s, Bruce Kimura, MD, FACC t, Raoul Breitkreutz, MD u, Navroz Masani, MBBS, FRCP v, Justin Bowra, FACEM, CCPU w, Daniel Talmor, MD, MPH k, Fabio Guarracino, MD x, Adrian Goudie, BMedSci(Hons), MBBS, FACEM DDU y, Wang Xiaoting, MD z, Rajesh Chawla, MD, FCCM aa, Maurizio Galderisi, MD bb, Micheal Blaivas, MD, FACEP, FAIUM cc, Tomislav Petrovic, MD dd, Enrico Storti, MD ee, Luca Neri, MD ff, Lawrence Melniker, MD, MS gg, hhInternational Liaison Committee on Focused Cardiac UltraSound (ILC-FoCUS)
for theInternational Conference on Focused Cardiac UltraSound (IC-FoCUS)
Abstract |
Background |
Focused cardiac ultrasound (FoCUS) is a simplified, clinician-performed application of echocardiography that is rapidly expanding in use, especially in emergency and critical care medicine. Performed by appropriately trained clinicians, typically not cardiologists, FoCUS ascertains the essential information needed in critical scenarios for time-sensitive clinical decision making. A need exists for quality evidence-based review and clinical recommendations on its use.
Methods |
The World Interactive Network Focused on Critical UltraSound conducted an international, multispecialty, evidence-based, methodologically rigorous consensus process on FoCUS. Thirty-three experts from 16 countries were involved. A systematic multiple-database, double-track literature search (January 1980 to September 2013) was performed. The Grading of Recommendation, Assessment, Development and Evaluation method was used to determine the quality of available evidence and subsequent development of the recommendations. Evidence-based panel judgment and consensus was collected and analyzed by means of the RAND appropriateness method.
Results |
During four conferences (in New Delhi, Milan, Boston, and Barcelona), 108 statements were elaborated and discussed. Face-to-face debates were held in two rounds using the modified Delphi technique. Disagreement occurred for 10 statements. Weak or conditional recommendations were made for two statements and strong or very strong recommendations for 96. These recommendations delineate the nature, applications, technique, potential benefits, clinical integration, education, and certification principles for FoCUS, both for adults and pediatric patients.
Conclusions |
This document presents the results of the first International Conference on FoCUS. For the first time, evidence-based clinical recommendations comprehensively address this branch of point-of-care ultrasound, providing a framework for FoCUS to standardize its application in different clinical settings around the world.
Le texte complet de cet article est disponible en PDF.Keywords : Cardiac sonography, Echocardiography, Cardiac ultrasound, Crit Care echocardiography, Emergency ultrasound, Critical ultrasound, Point-of-care ultrasound, Guideline, RAND, GRADE, Evidence-based medicine
Abbreviations : ALS, ASE, ECG, ED, ESM, FAST, FoCUS, GRADE, ICU, IVC, LV, 2D, WINFOCUS
Plan
| Dr Bowra is a member of the Medical Advisory Board of Signostics Pty Ltd. Dr Neskovic is an advisor to Medtronic and AstraZeneca and has received consultative honoraria from these companies. Dr Neskovic has received honoraria from Merck and research funds from GE Healthcare. Dr Sloth is an uncompensated member of the Medical Advisory Board of GE Vscan and an uncompensated lecturer for Philips. All other members declared no conflict of interest. No direct sponsorship of any kind has been provided by any commercial or industrial source. No honoraria have been given to any of the panel members. |
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| Promoted by the World Interactive Network Focused on Critical UltraSound (WINFOCUS). Endorsed by the American Society of Echocardiography (ASE), the European Association of Cardiovascular Imaging (EACVI), the British Society of Echocardiography (BSE), the Indian Society of Critical Care Medicine (ISCCM), the Chinese Society of Critical Care Medicine (CSCCM), the International Pan-Arab Critical Care Medicine Society (IPACCS), Associação do Medicina Intensiva Brasileira (AMIB), the European Society of Emergency Medicine (EuSEM), the American College of Emergency Physicians (ACEP), the Australasian College for Emergency Medicine (ACEM), the Asian Society for Emergency Medicine (ASEM), the Emergency Medicine Society of South Africa (EMSSA), the Society for Ultrasound in Medical Education (SUSME), the Australian Society for Ultrasound in Medicine (ASUM), the Saudi Heart Association (SHA), and the Pediatricians with Expertise in Cardiology Special Interest Group (PECSIG). |
Vol 27 - N° 7
P. 683.e1-683.e33 - juillet 2014 Retour au numéro
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