Abstract
BACKGROUND: Point of care ultrasound (POCUS) use has become ubiquitous in the ICU setting. Despite this, there remains a paucity of data regarding how its use impacts patient outcomes. We sought to determine if physician attitudes toward and use of POCUS impact patient outcomes. OBJECTIVES: To evaluate the impact of physician use of POCUS in the medical intensive care unit (MICU) on patient care outcomes. METHODS: A longitudinal, single-center retrospective study of adult patients in a tertiary care center MICU was conducted between 2016 and 2017. A total of 512 patient encounters were analyzed for: number of ventilator days, number of vasopressor days, and MICU length of stay. The outcomes were then compared between attending physicians who showed high, medium, and low self-reported POCUS implementation and confidence scores by questionnaire. RESULTS: Patients of physicians in the low POCUS confidence group had a statistically significant increase in MICU length of stay (IRR = 1.19, 95% CI: 1.06-1.32, p = 0.0022) and ventilator days (IRR = 1.18, 95% CI: 1.03-1.36, p = 0.0197) compared to the medium confidence group. CONCLUSIONS: Our investigation found a statistically significant relationship between self-reported confidence in POCUS by MICU physicians and MICU length of stay as well as total days spent on mechanical ventilation. Increased self-reported use of POCUS by physicians did not impact patient outcomes in this population. There was similarly no evidence of increased harm or adverse outcomes in high-POCUS implementation groups.