Society of Critical Care Medicine Guidelines on Adult Critical Care Ultrasonography: Focused Update 2024

Summary

SCCM reviewed adult critical-care ultrasonography (CCUS) in cardiac arrest, septic shock, acute dyspnea or respiratory failure, volume management, and cardiogenic shock. It conditionally suggests CCUS for shock, respiratory failure and volume management, generally with low or very-low certainty. In cardiac arrest it suggests either CCUS or usual care without CCUS; superiority is not established.

Why it matters

Use CCUS as an adjunct to clinical assessment when trained operators are available, especially in shock or dyspnea. Do not interrupt CPR for scanning or claim that ultrasound improves arrest outcomes.

Key recommendations

• Conditional low-certainty suggestions for CCUS in septic shock, respiratory failure and targeted volume management.
• Conditional very-low-certainty suggestion for CCUS in cardiogenic shock.
• For cardiac arrest either CCUS or usual care without CCUS is suggested with very-low certainty.

Limitations

These critical-care recommendations are conditional and supported largely by low- or very-low-certainty evidence rather than an ED outcomes trial. The official SCCM recommendations and PubMed abstract, not complete paywalled guideline text, were reviewed.

Recommendation strength

Conditional recommendations with low/very-low certainty; cardiac arrest does not favor CCUS over usual care.