Developing a comprehensive haemodynamic ultrasound assessment for critical care: Rationale and methodology from the...

Area of Science:

• Critical Care Medicine
• Cardiovascular Imaging
• Point-of-Care Ultrasound

Background:

• Hemodynamic ultrasound is crucial for assessing circulatory failure in intensive care.
• The original Focused UltraSound in Intensive Care HaemoDynamics (FUSIC HD) program provided a framework for physiologically focused ultrasound.
• Experience indicated a need to expand the scope of parameters assessed in routine practice.

Purpose of the Study:

• To outline the rationale and development of the revised FUSIC HD dataset.
• To incorporate additional hemodynamic parameters into the FUSIC HD framework.
• To support integrated hemodynamic interpretation in critically ill patients.

Main Methods:

• Revision of the FUSIC HD dataset based on training cohort experience and logbook review.
• Incorporation of assessments for left ventricular performance, right ventricular function, and pulmonary vascular loading.
• Refinement of left atrial pressure estimation techniques.

Main Results:

• An updated FUSIC HD framework has been developed.
• The revised framework includes expanded assessments while maintaining focus on physiological coherence and bedside feasibility.
• The update aims to enhance, not replace, comprehensive echocardiography.

Conclusions:

• The revised FUSIC HD dataset offers a more comprehensive approach to bedside hemodynamic assessment.
• The updated framework supports integrated interpretation of hemodynamic data in critically ill patients.
• The FUSIC HD program continues to provide a structured training and governance approach for critical care ultrasound.