A.B.C. approach proposal for POCUS in COVID-19 critically ill patients

Area of Science:

• Critical Care Medicine
• Medical Imaging
• Infectious Diseases

Background:

• Intensive Care Units (ICUs) faced unprecedented patient surges during the COVID-19 pandemic.
• Critically ill COVID-19 patients, particularly those on mechanical ventilation, are prone to severe hemodynamic and respiratory complications.
• Limited resources in ICUs necessitate efficient patient assessment tools.

Purpose of the Study:

• To propose and evaluate a structured Point of Care Ultrasound (POCUS) approach for critically ill COVID-19 patients.
• To integrate airway, breathing, and circulation assessments using POCUS in the ICU setting.
• To provide a framework for ultrasound application in managing severe SARS-CoV-2 infections.

Main Methods:

• Development of an A.B.C. POCUS algorithm: A-Airway (orotracheal intubation), B-Breathing (lung assessment), C-Circulation (hemodynamic assessment).
• Application of the A.B.C. POCUS approach in 22 adult critically ill COVID-19 patients.
• Review of existing literature on ultrasound use in COVID-19 and general critical care.

Main Results:

• The A.B.C. POCUS approach was applied to assess airway, breathing, and circulation in critically ill COVID-19 patients.
• Lung ultrasound demonstrated utility in diagnosing and monitoring respiratory conditions.
• The algorithm parallels established clinical A.B.C. assessment protocols.

Conclusions:

• The A.B.C. POCUS approach provides a systematic method for evaluating critically ill COVID-19 patients.
• While extensive studies are limited, POCUS techniques extrapolated from non-COVID critical care appear feasible.
• Further comparative studies are needed to validate POCUS efficacy in COVID-19 management.