Using point-of-care ultrasound to assess volume status.

Abstract

Abstract: Determining volume status at the bedside is an essential skill clinicians must possess. Unfortunately, traditional bedside assessments, including measuring vital signs, obtaining a history, and performing a physical examination, are often unreliable and limited by patient body habitus. Point-of-care ultrasound (POCUS) is a valuable and accurate adjunct to aid in determination of a patient's volume status. POCUS of the lungs, heart, inferior vena cava, and internal jugular vein can add valuable data for clinicians when determining volume status. Specifically, lung ultrasound is more accurate than physical examination and chest radiography in detecting pulmonary edema and pleural effusions; cardiac POCUS allows for qualitative estimations of left ventricle and right ventricle function and can confirm the presence or absence of clinically significant pericardial effusions; and POCUS of the inferior vena cava and internal jugular vein can estimate right atrial pressure, and in the appropriate clinical context, help to determine intravascular volume status.