Role of point-of-care ultrasound in septic shock

Sepsis and septic shock are critical medical emergencies with high rates of morbidity and mortality. Point-of-care ultrasound (POCUS) has been demonstrated to be a vital instrument in the management of these patients, facilitating dynamic haemodynamic assessment and prompting immediate clinical decision-making. POCUS has been demonstrated to facilitate early identification of shock type, assessment of fluid response, and detection of infectious foci in unstable patients. It is evident that ultrasound protocols, including RUSH and VExUS, offer a systematic approach to the assessment of perfusion, venous congestion, and fluid overload. Recent studies have validated the usefulness of parameters such as left ventricular outflow tract velocity time integral (LVOT-VTI) and inferior vena cava (IVC) collapse to predict fluid response. However, it is imperative that its limitations be considered in the clinical context. In the context of etiological diagnosis, the use of pulmonary ultrasound has been shown to be superior to radiography in terms of the detection of pneumonia and pleural effusions. Concurrently, the use of abdominal and cardiac ultrasound has been demonstrated to enhance the identification of urological infections, biliary infections, abscesses, and indications of endocarditis. Despite its dependence on the operator, the extant evidence supports the systematic use of POCUS in the comprehensive assessment of the septic patient, being crucial for targeted and personalised resuscitation. Further research is necessary to standardise its application and demonstrate its benefits in clinical outcomes.