Point-of-care ultrasound in obstetric anesthesia clinical practice

医学 下腔静脉 麻醉学 羊水栓塞 重症监护医学 超声波 注意事项 放射科 麻醉 怀孕 遗传学 生物 护理部
作者
Pedram Aleshi,Clemens M. Ortner,Alexander J. Butwick
出处
期刊:Current Opinion in Anesthesiology [Lippincott Williams & Wilkins]
标识
DOI:10.1097/aco.0000000000001501
摘要

Purpose of the review Point-of-care ultrasound (POCUS) is increasingly recognized as a valuable tool in obstetric anesthesia. This review synthesizes key studies and reviews published within the last 2 years on its application in clinical practice with relevant supporting literature. Recent findings Handheld ultrasound-assisted neuraxial block placement modestly reduces periprocedure time compared with landmark-based techniques. Devices with integrated three-dimensional or artificial intelligence-guided software may improve first-attempt success, particularly in obese patients. Focused cardiac ultrasound has gained interest as a potential tool for predicting postspinal hypotension through predelivery inferior vena cava collapsibility assessment. POCUS is also valuable for evaluating shock and cardiovascular compromise, aiding in the diagnosis and clinical management of amniotic fluid embolism and maternal cardiomyopathy. Gastric ultrasound can be performed qualitatively, aids aspiration risk assessment, and can be used in studies evaluating drug effects on gastric contents and antral cross-sectional area. Robust training programs are essential to equip obstetric anesthesiologists with sustainable POCUS skill sets. Summary POCUS is associated with reduced neuraxial block placement times, provides critical hemodynamic data in patients with amniotic fluid embolism and cardiomyopathy, and allows gastric content evaluation for aspiration risk assessment. Expanding structured training and research is crucial to maximizing its clinical utility.

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