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Perioperative Use of Focused Transthoracic Cardiac Ultrasound: A Survey of Current Practice and Opinion

Conlin, Frederick MD*†; Connelly, Neil R. MD*†; Eaton, Michael P. MD; Broderick, Patrick J. DO*†; Friderici, Jennifer MSPH; Adler, Adam C. MS, MD, FAAP

doi: 10.1213/ANE.0000000000002089
Hemostasis: Original Clinical Research Report

BACKGROUND: The advent of portable ultrasound machines in recent years has led to greater availability of focused cardiac ultrasound (FoCUS) in the perioperative and critical care setting. To our knowledge, its use in the perioperative setting among anesthesiologists remains undefined. We sought to assess the use of FoCUS by members of the Society of Cardiovascular Anesthesiologists (SCA) in clinical practice, to identify variations in its application, to outline limits to its use, and to understand the level of training of physicians using this technology.

METHODS: A 26-question anonymous and voluntary online survey assessing the participants’ training level with FoCUS, frequency of use, and opinions regarding incorporating it into residency training and developing a pathway to basic certification. The survey was distributed to the members of the SCA via email.

RESULTS: The survey was completed by 379 of 3660 members of the SCA (10%). Of the respondents, the majority (67%) had completed a cardiovascular anesthesiology fellowship with 58% identifying their practice as academic, while 37% stated they were in private practice, and 6% were military/Veterans Administration. Most (84%) of the respondents practiced in North America. Eighty-one percent reported familiarity with FoCUS, while 47% stated they use it in their clinical practice. Those practicing in North America were significantly less likely to utilize FoCUS in their practice as compared to other respondents. With regard to training and certification, 88% believe FoCUS education should be integrated into residency training programs and 74% believe there should be a pathway to basic certification for FoCUS.

CONCLUSIONS: While most cardiovascular anesthesiologists are familiar with FoCUS, a minority have integrated it into their practice. Roadblocks such as lack of training, the fear of missing diagnoses, lack of resources, and the lack of a formal certification process must be addressed to allow for more widespread use of perioperative cardiac ultrasound.

Supplemental Digital Content is available in the text.Published ahead of print May 19, 2017.

From the *Department of Anesthesiology, Baystate Medical Center, Springfield, Massachusetts; Department of Anesthesiology, University of Massachusetts Medical School-Baystate, Springfield, Massachusetts; Department of Anesthesiology; University of Rochester School of Medicine and Dentistry, Rochester, New York; §Department of Biostatistics and Epidemiology, Baystate Medical Center, Springfield, Massachusetts; and Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiovascular Anesthesiology, Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas.

Published ahead of print May 19, 2017.

Accepted for publication February 24, 2017.

Funding: None.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website.

The results presented in this article have been submitted for presentation at the Society for Cardiovascular Anesthesiologists meeting, Orlando, FL, April 2017.

Reprints will not be available from the authors.

Address correspondence to Frederick Conlin, MD, Department of Anesthesiology, Baystate Medical Center, 759 Chestnut St, Springfield, MA 01199. Address e-mail to Frederick.Conlin@baystatehealth.org.

© 2017 International Anesthesia Research Society
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