Review of Point-of-Care (POC) Ultrasound for the 21st Century Perioperative Physician

Abstract

Point-of-care (POC) ultrasonography can be defined as ultrasonography brought to the patient and performed by the provider in real time. Anesthesiologists commonly use this modality to aid regional anesthesia and central vascular access. However, as POC ultrasonography has been further developed, utility of this technology has increased in the areas of hemodynamic monitoring, cardiopulmonary function, and other areas that are relevant for the perioperative physician. This manuscript seeks to provide a review of the literature of point-of-care ultrasound topics that are relevant for the anesthesiologist. These topics will include (I) assessment of preload and fluid responsiveness, (II) assessment of mechanisms of hypotension and shock, (III) evaluation of pulmonary function, (IV) advanced vascular access, and (V) additional areas of POC ultrasound for perioperative improvement. Finally, this manuscript will suggest a novel POC ultrasound curriculum that integrates the components of this review into a comprehensive perioperative ultrasound examination, abbreviated as FORESIGHT (focused, perioperative, risk, evaluation, sonography, involving, gastro-abdominal, hemodynamic, and trans-thoracic ultrasound) exam.