Bedside Endoscopic Ultrasound in Critically Ill patients

Area of Science:

• Gastroenterology
• Critical Care Medicine
• Diagnostic Imaging

Background:

• Critically ill patients often present complex diagnostic challenges.
• Endoscopic ultrasound (EUS) offers a minimally invasive approach for evaluating various conditions.

Purpose of the Study:

• To evaluate the role and impact of bedside endoscopic ultrasound (EUS) in managing critically ill patients.
• To assess the safety and feasibility of performing EUS at the patient's bedside.

Main Methods:

• Retrospective review of patients undergoing bedside EUS over a 68-month period.
• EUS considered impactful if it led to a new diagnosis or altered clinical management.
• Included EUS-Fine Needle Aspiration (EUS-FNA) in 80% of cases.

Main Results:

• Fifteen critically ill patients underwent bedside EUS without complications.
• EUS-FNA yielded diagnoses including malignant mediastinal masses, pancreatic abscesses, and benign gastric folds.
• EUS correctly excluded conditions like choledocholithiasis and cholangiocarcinoma.
• Overall, EUS had a significant impact on management in 87% of patients.

Conclusions:

• Bedside EUS is technically feasible and safe in critically ill patients.
• EUS demonstrated a major impact on clinical management for the majority of patients studied.
• EUS is a valuable tool for diagnosis and management in the intensive care setting.