Preoperative cardiac POCUS in high-risk non-cardiac surgery: A prospective study on anesthetic planning and outcomes

The role of preoperative cardiac point-of-care ultrasound (POCUS) in modifying anesthetic management and influencing perioperative outcomes in high-risk non-cardiac surgery patients is of interest. A total of 120 adults with Revised Cardiac Risk Index ≥2 or significant cardiac comorbidity underwent standardized preoperative focused transthoracic echocardiography. Clinically significant previously undiagnosed cardiac findings were detected in 31.7% of patients, leading to anesthesia plan modifications in 24.2%, including escalation to invasive monitoring, anesthesia technique changes and preoperative cardiology consultation. Patients whose plans were modified experienced fewer intraoperative hypotensive episodes and reduced unplanned intensive care admissions compared with those without plan changes. Thus, we show the integration of preoperative cardiac POCUS into perioperative assessment pathways for high-risk surgical patients to optimize management and improve hemodynamic stability.