Routine pre-operative focused ultrasonography by anesthesiologists in patients undergoing urgent surgical procedures

Acta Anaesthesiol Scand. 2014 Aug;58(7):807-14. doi: 10.1111/aas.12343. Epub 2014 May 28.


Background: Unexpected cardiopulmonary complications are well described during surgery and anesthesia. Pre-operative evaluation by focused cardiopulmonary ultrasonography may prevent such mishaps. The aim of this study was to determine the frequency of unexpected cardiopulmonary pathology with focused ultrasonography in patients undergoing urgent surgical procedures.

Methods: We performed pre-operative focused cardiopulmonary ultrasonography in patients aged 18 years or above undergoing urgent surgical procedures at pre-defined study days. Known and unexpected cardiopulmonary pathology was recorded, and subsequent changes in the anesthesia technique or supportive actions were registered.

Results: A total of 112 patients scheduled for urgent surgical procedures were included. Their mean age (standard deviation) was 62 (21) years. Of these patients, 24% were American Society of Anesthesiologists (ASA) class 1, 39% were ASA class 2, 32% were ASA class 3, and 4% were ASA class 4. Unexpected cardiopulmonary pathology was disclosed in 27% [95% confidence interval (CI) 19-36] of the patients and led to a change in anesthesia technique or supportive actions in 43% (95% CI 25-63) of these. Unexpected pathology leading to changes in anesthesia technique or supportive actions was only disclosed in a group of patients above the age of 60 years and/or in ASA class ≥ 3.

Conclusion: Focused cardiopulmonary ultrasonography disclosed unexpected pathology in patients undergoing urgent surgical procedures and induced changes in the anesthesia technique or supportive actions. Pre-operative focused ultrasonography seems feasible in patients above 60 year and/or with physical limitations but not in young, healthy individuals.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesiology / methods*
  • Denmark / epidemiology
  • Diagnostic Tests, Routine*
  • Echocardiography* / methods
  • Echocardiography* / statistics & numerical data
  • Emergencies*
  • Female
  • Heart Diseases / diagnostic imaging
  • Heart Diseases / epidemiology
  • Heart Diseases / prevention & control
  • Hospital Mortality
  • Humans
  • Intraoperative Complications / prevention & control*
  • Laparotomy*
  • Lung Diseases / diagnostic imaging
  • Lung Diseases / epidemiology
  • Lung Diseases / prevention & control
  • Male
  • Middle Aged
  • Orthopedic Procedures*
  • Pericardial Effusion / diagnostic imaging
  • Pericardial Effusion / epidemiology
  • Pleural Effusion / diagnostic imaging
  • Pleural Effusion / epidemiology
  • Preoperative Care / methods*
  • Prospective Studies