Point-of-Care Ultrasound Applications in Critical Care

Point-of-care ultrasound (POCUS) has transformed critical care by enabling real-time, bedside imaging that informs rapid clinical decision-making. Its applications span cardiovascular assessment, respiratory evaluation, fluid management and procedural guidance. In haemodynamic instability, simple cardiac views permit estimation of intravascular volume status and ventricular function, guiding fluid resuscitation and inotropic support. In acute respiratory failure, lung ultrasound detects pneumothorax, pulmonary oedema, consolidation and interstitial syndromes more sensitively than conventional radiography, reducing diagnostic delay and radiation exposure. POCUS has also been adopted to steer vascular access, thoracic drainage and pericardial interventions, improving safety and efficiency. Advances in portable technology, probe miniaturisation and artificial intelligence–assisted interpretation promise to widen accessibility, particularly in resource-limited and prehospital settings. Training initiatives and consensus-based protocols are fostering standardisation and competency among multidisciplinary teams, enhancing global applicability.

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Point-of-Care Ultrasound Applications in Critical Care publication trend

The graph below shows the total number of articles in point-of-care ultrasound applications in critical care across all publications each year (not limited to Nature Index journals).

Technical terms

Point-of-care ultrasound (POCUS): Bedside ultrasonographic examination performed and interpreted by the treating clinician for immediate diagnostic or therapeutic decision-making.
Focused cardiac ultrasound (FoCUS): Targeted echocardiographic protocol assessing ventricular function, volume status and pericardial effusion without full Doppler interrogation.
B-lines: Vertical, laser-like reverberation artefacts that arise from the pleural line, indicating interstitial syndrome or pulmonary congestion.
Pleural line: Bright horizontal echo that represents the interface between chest wall tissues and aerated lung.
Lung sliding: Rhythmic shimmering of the pleural line with respiration, signifying normal apposition of visceral and parietal pleura.
A-lines: Horizontal repetition artefacts parallel to the pleural line, indicative of normal air-filled lung fields.

References

1. Diagnostic accuracy of point-of-care ultrasound with artificial intelligence-assisted assessment of left ventricular ejection fraction. npj Digital Medicine (2023).
2. International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC). Critical Care (2020).
3. Lung ultrasound in the critically ill. Annals of Intensive Care (2014).
4. Diagnostic Accuracy of Point-of-Care Lung Ultrasonography and Chest Radiography in Adults With Symptoms Suggestive of Acute Decompensated Heart Failure. JAMA Network Open (2019).