Work

Impact and Feasibility of Point-of-Care Ultrasound in Critically Ill Adults: Insights from a Resource-Limited Latin American ICU

Year: 2026

Type: article

Abstract: Hemodynamic monitoring in resource-limited ICUs often lacks advanced invasive tools, necessitating validated non-invasive alternatives. While Point-of-Care Ultrasound (POCUS) is promising, its quantitative impact on clinical trajectory and its diagnostic performance compared to gold standards in Latin American settings require rigorous validation. The objective of this article is to determine the clinical impact, diagnostic concordance, and procedural safety of POCUS, and to evaluate the discrimination and calibration of ultrasound-derived indices as predictors of fluid responsiveness in septic shock. This prospective cohort study (n=80) utilized a structured multi-organ POCUS protocol. Diagnostic concordance was assessed using weighted Cohen’s kappa (). Fluid responsiveness (defined by a ≥15% increase in stroke volume index via LVOT VTI) was modeled using multivariable logistic regression. Model performance was quantified using the Area Under the Receiver Operating Characteristic curve (AUROC) and the Youden Index to determine optimal cut-offs. POCUS-driven interventions occurred in 74% of cases, with a median time-to-decision of <45 minutes. Diagnostic concordance was near-perfect (=0.85; 92% agreement). POCUS-guided procedures demonstrated superior safety (98% success; OR for complications 0.15 vs. landmark technique). Early POCUS integration was an independent predictor of reduced ICU length of stay ( β = -1.5 days; 95% CI -2.4 to -0.6; p=0.02). In the septic shock subgroup, IVC distensibility index (AUROC 0.81; 95% CI 0.72–0.89) and LVOT VTI (AUROC 0.79; 95% CI 0.68–0.88) showed high discriminatory power. A combined model reached an AUROC of 0.82 with a sensitivity of 86% and specificity of 81% for predicting fluid responsiveness. POCUS is a high-precision diagnostic and therapeutic catalyst. Our data demonstrate that dynamic ultrasound indices are robust predictors of hemodynamic fluid-load capacity, enabling physiology-based resuscitation that significantly optimizes ICU resource utilization.

Source: Bionatura journal :

DOI: 10.70099/bj/2026.03.03.3

Authors: Rosali Santiago Roibal, Marlon Carbonell Gonzalez, Deborah Cabrera Rodríguez, Lhianella Ramos Escobedo

Institution: Central University of Ecuador

Language: English

Topic: Ultrasound in Clinical Applications

Subfield: Critical Care and Intensive Care Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Funder: Fakultet Medicinskih Nauka, Univerziteta U Kragujevcu