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

Summary

This focused SCCM guideline update recommends using critical care ultrasonography to guide management in septic shock, acute dyspnea/respiratory failure, and cardiogenic shock, and supports CCUS for targeted volume management due to mortality benefit over usual care. Evidence remains insufficient to recommend CCUS over standard care in cardiac arrest.

Key Findings

• Recommends CCUS to guide management in adult septic shock, acute dyspnea/respiratory failure, and cardiogenic shock.
• Suggests CCUS-guided targeted volume management due to evidence of mortality improvement over usual care.
• Insufficient evidence to recommend CCUS over standard care for cardiac arrest management.

Clinical Implications

Implement CCUS-driven protocols for hemodynamic assessment and targeted volume management in septic shock, acute respiratory failure, and cardiogenic shock; invest in training, competency assessment, and workflow integration. Do not rely on CCUS alone to replace standard approaches in cardiac arrest.

Limitations

• Focused update addressing five PICO questions; not all CCUS applications covered.
• Some recommendations based on moderate-to-low certainty evidence; heterogeneity across studies.

Future Directions

Prospective, multicenter trials quantifying patient-centered outcomes with CCUS-driven protocols, standardized training/credentialing studies, and high-quality research in cardiac arrest.