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  • Pocus in Icu

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    Isnaini Naini
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    Point of care ultrasound (POCUS) has become a standard of care in the intensive care unit (ICU). POCUS is a modern "stethoscope" that is non-radiating, portable, low cost, and can be performed repeatedly at the bedside. In the ICU, POCUS can detect free intraperitoneal fluid, cholelithiasis and acute cholecystitis, renal hypoperfusion and dysfunction, small bowel obstruction, gastrointestinal perforation, and abdominal aortic aneurysm. The use of POCUS by non-radiologist clinicians has changed the current paradigm for timely diagnosis and management of critically ill patients.

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    POCUS IN ICU (1)

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    Point of care ultrasound (POCUS) has become a standard of care in the intensive care unit (ICU). POCUS is a modern "stethoscope" that is non-radiating, portable, low cost, and can be performed repeatedly at the bedside. In the ICU, POCUS can detect free intraperitoneal fluid, cholelithiasis and acute cholecystitis, renal hypoperfusion and dysfunction, small bowel obstruction, gastrointestinal perforation, and abdominal aortic aneurysm. The use of POCUS by non-radiologist clinicians has changed the current paradigm for timely diagnosis and management of critically ill patients.

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    15 views15 pages

    Pocus in Icu

    Uploaded by

    Isnaini Naini
    Point of care ultrasound (POCUS) has become a standard of care in the intensive care unit (ICU). POCUS is a modern "stethoscope" that is non-radiating, portable, low cost, and can be performed repeatedly at the bedside. In the ICU, POCUS can detect free intraperitoneal fluid, cholelithiasis and acute cholecystitis, renal hypoperfusion and dysfunction, small bowel obstruction, gastrointestinal perforation, and abdominal aortic aneurysm. The use of POCUS by non-radiologist clinicians has changed the current paradigm for timely diagnosis and management of critically ill patients.

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    of 15

    POINT OF CARE ULTRASOUND

    DI INTENSIVE CARE UNIT (ICU)

    Nurhayani Dwi Susanti


    Radiologist Consultant
    Introduksi
    • Point of care ultrasound (POCUS)  standar
    perawatan di ICU

    Ultrasound :
    • “Stetoskop” modern
    • Bedside tool non radiasi
    • Low cost
    • Portable >> ; handheld unit
    • Bisa dilakukan berulang kali pemeriksaan terhadap
    pasien
    POCUS - Abdominal di ICU

    Mendeteksi adanya :
     Cairan bebas intraperitoneal
     Cholelithiasis and Acute Cholecystitis
     Hypoperfusion & Renal dysfunction
     Small Bowel Obstruction
     Gastrointestinal Perforation
     Abdominal Aortic Aneurysm
    Cairan bebas intraabdominal
    • Sensitivitas 64 – 98 % ; Spesifisitas 86 – 100%
    • Evaluasi spontaneous hemoperitoneum pada pasien non trauma misalnya :
    - ruptur gestational sac pada kehamilan ektopik
    - ruptur kista ovarium
    Cholelithiasis and Acute Cholecystitis

    Cholelithiasis Acute Cholecystitis


    Renal Hypoperfusion

    Renal Resistive Index :

    Normal Renal Resistive Index (RI) < 0.68


    Diukur pada arteri Arcuata atau arteri Lobularis
    7 Renal Hypoperfusion…

    presentation title 20XX


    Renal Hypoperfusion…

    AKI disebabkan
    Hepatorenal Syndrome
    9 Renal Hypoperfusion…

    Severe Acute Tubular Necrosis

    presentation title 20XX


    Renal dysfunction

     Peningkatan echogenicity
    parenkim ginjal
    Small Bowel Obstruction

    Dilatasi kaliber usus > 3 cm disertai penebalan dinding usus


    Gastrointestinal Perforation

     Posisi LLD
     Reverberation artefacts on
    the ventral surface of the
    liver
    Abdominal Aortic Aneurysm

     Normal diameter Aorta Abdominalis


    < 3cm
     Sering dijumpai trombus
    Kesimpulan

     Penggunaan POCUS oleh Klinisi non Radiologist telah


    mengubah paradigma saat ini tentang manajemen
    perawatan pasien kritis terutama untuk mendiagnosis
    cepat adanya akumulasi cairan bebas, penyakit-
    penyakit akut abdomen (Acute Cholecystitis, Small
    Bowel Obstruction, Gastrointestinal Perforation), Renal
    dysfunction dan renal hypoperfusion, Abdominal Aortic
    Aneurysm
    Terima kasih

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