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2019, vol. 41, iss. 7-8, pp. 189-193
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Focused cardiac ultrasound: FoCUS
Fokusirani ultrazvuk srca - FoCUS
aClinical Center of Serbia, Clinic for Cardiology, Belgrade bClinical Center of Serbia, Center for Anesthesiology, Belgrade cClinical Center of Serbia, Center for Radiology and Magnetic Resonance Imaging, Belgrade dClinical Center of Serbia, Center for Radiology and Magnetic Resonance Imaging, Belgrade + University of Belgrade, Faculty of Medicine eClinical Center of Serbia, Emergency Center, Belgrade fClinical Center of Serbia, Center for Anesthesiology, Belgrade + University of Belgrade, Faculty of Medicine
email: opetrovic1976@gmail.com
Abstract
Focused cardiac ultrasound (FoCUS) is defined as pointof-care ultrasound examination, preformed according to a standardized, but restricted, scanning protocol in order to quickly determine the etiologies of cardiac dysfunction. The use of focused cardiac ultrasound has grown over recent years, and is increasingly being performed by intensivists, anesthesiologists and emergency medicine doctors appropriately trained in FoCUS, not necessarily trained in comprehensive echocardiography. While classic echocardiography uses a set of measurements, the main goal of focused cardiac ultrasound based on rapid orientation is to answer on urgent clinical questions - if there is pericardial effusion and threatening tamponade, whether cardiac function is impaired, normal or enhanced, if the circulating volume is adequate. In addition, FoCUS is suitable in urgent conditions where a clinical decision needs to be made quickly, such as trauma, chest pain, hypotension, and dyspnea. Focused cardiac ultrasound is integrated in the advanced cardiovascular life support algorithm. Unlike the basic FoCUS, advanced FoCUS involves a more detailed examination and provides data on valvular dysfunction, segmental kinetics failure, signs of right heart loading, thoracic aortic dissection. The basic FoCUS does not involve measuring or using Doppler.
Sažetak
Fokusirani ultrazvuk srca (Focused cardiac ultrasound - FoCUS) definiše se kao point-of-care ultrazvučni pregled srca koji se izvodi prema standardizovanom, ali restriktivnom protokolu, a sa ciljem brzog utvrđivanja etiologije srčane disfunkcije. Poslednjih godina je upotreba fokusirane ehokardiografije sve više zastupljena među lekarima različitih specijalnosti, posebno intenzivne medicine, anesteziologije i urgentne medicine, jer za njeno izvođenje nije neophodna praksa specijalizovanog ultrazvuka srca, već je dovoljan adekvatan FoCUS trening. Dok se kod klasičnog ultrazvučnog pregleda srca obavlja set merenja, osnovi cilj FoCUS pregleda je da na osnovu brze orijentacije da odgovor na hitna klinička pitanja - da li postoji perikardni izliv i preteća tamponada, da li je srčana funkcija oslabljena, normalna ili pojačana, da li je cirkulišući volumen adekvatan? Upravo zato je pogodan u urgentnim stanjima kod kojih je potrebno brzo donošenje kliničke odluke, kao što su trauma, bol u grudima, hipotenzija, dispnea. Fokusirani ultrazvuk srca je integrisan u algoritam naprednih mera kardiopulmonalne reanimacije. Za razliku od osnovnog FoCUS pregleda, napredni FoCUS podrazumeva detaljniji pregled i daje podatke o disfunkciji valvula, segmentnom ispadu kinetike, znacima opterećenja desnog srca, disekciji grudne aorte. Osnovni FoCUS pregled ne podrazumeva ni merenja ni korišćenje doplera.
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