POCUS en cirugía cardíaca: revisión de la evidencia y experiencia institucional
CRITICAL CARE & EMERGENGY MEDICINE VOL. 5
POCUS in Cardiac Surgery: Review of Evidence and Institutional Experience
- 8 enero, 2026
- Revisión narrativa, Volumen 5
Gabriela Ramírez G. 1 
, Dante Vizcayno Soto 2 , Alberto Hernández Guijosa 3 .
1 Anestesiólogo cardiovascular. Hospital Lic. Adolfo López Mateos, ISSSTE, Ciudad de México, México.
2 Médico Anestesiólogo. Hospital San Angelin. Ciudad de México. México.
3 Médico Anestesiólogo-Algólogo. IMSS HGM. Ciudad de México. México.
Editor
Manuel Alberto Guerrero Gutierrez , Liliana Catalina Galeana Gonzalez .
Chair
Diego Escarraman Martinez .
Abstract
Abstract: Point-of-care ultrasound (POCUS) has become an essential tool in the perioperative management of patients undergoing cardiac surgery. This narrative review analyzes recent
evidence and institutional experience regarding the impact of POCUS on patient safety optimization, hemodynamic assessment, and real-time clinical decision-making. It explores the integration of POCUS with transesophageal (TEE) and transthoracic echocardiography (TTE), emphasizing its diagnostic and therapeutic value throughout the perioperative process. Significant clinical benefits are highlighted, including early detection of cardiovascular dysfunction and guidance in invasive procedures, as well as ongoing challenges related to standardization, operator training, and incorporation into complex surgical protocols. Strengthening perioperative ultrasound skills offers an opportunity to enhance patient safety, diagnostic accuracy, and overall efficiency in cardiovascular care.
Resumen
Resumen: El ultrasonido en el punto de atención (POCUS) se ha consolidado como una herramienta esencial en el manejo perioperatorio de pacientes sometidos a cirugía cardíaca. Esta revisión narrativa analiza la evidencia reciente y la experiencia institucional sobre el impacto del POCUS en la optimización de la seguridad del paciente, la evaluación hemodinámica y la toma de decisiones clínicas en tiempo real. Se examina la integración del POCUS con la ecocardiografía transesofágica (TEE) y transtorácica (TTE), destacando su utilidad diagnóstica y terapéutica durante todo el proceso perioperatorio. Además, se identifican beneficios clínicos significativos, como la detección temprana de alteraciones cardiovasculares y la guía en procedimientos invasivos, así como desafíos relacionados con la estandarización, la capacitación y la implementación de esta tecnología en protocolos quirúrgicos complejos. El fortalecimiento de las competencias en ultrasonido perioperatorio representa una oportunidad para mejorar la seguridad y la eficiencia en la atención del paciente cardiovascular.
Keywords
Ultrasonography; Echocardiography, Transesophageal; Echocardiography, Transthoracic; Cardiac Surgical Procedures; Perioperative Care.
Biografias de autores
Gabriela Ramírez G.
Anestesiólogo cardiovascular. Hospital Lic. Adolfo López Mateos, ISSSTE, Ciudad de México, México.
Dante Vizcayno Soto.
Médico Anestesiólogo. Hospital San Angelin. Ciudad de México. México.
Alberto Hernández Guijosa.
Médico Anestesiólogo-Algólogo. IMSS HGM. Ciudad de México. México.
Referencias
Nicoara A, Skubas N, Ad N, Finley A, Hahn RT, Mahmood F, et al; American Society of Echocardiography, Society of Cardiovascular Anesthesiologists & Society of Thoracic Surgeons. Guidelines for the use of transesophageal echocardiography to assist with surgical decision-making in the operating room: a surgery-based approach. J Am Soc Echocardiogr. 2020 Jun;33(6):692–734. doi: 10.1016/j.echo.2020.03.0022.
2.- De Marchi L, Meineri M. POCUS in perioperative medicine: a North American perspective. Crit Ultrasound J. 2017;9:15. doi: 10.1186/s13089-017-0066-7.
3.- Cowie B. Three years’ experience of focused cardiovascular ultrasound in the peri-operative period. Anaesthesia. 2011 Apr;66(4):268–273. doi: 10.1111/j.1365-2044.2011.06622.x.
4.- Naji A, Chappidi M, Ahmed A, Monga A, Sanders J. Perioperative point-of-care ultrasound use by anesthesiologists. Cureus. 2021 May 24;13(5):e15217. doi: 10.7759/cureus.15217.
5.- Efrimescu CI, Moorthy A, Griffin M. Rescue transesophageal echocardiography: a narrative review of current knowledge and practice. J Cardiothorac Vasc Anesth. 2023 Apr;37(4):584–600. doi: 10.1053/j.jvca.2022.12.031.
6.- Verreet T, Defosse J, Verschueren J, Desruelles D, Deloof T, Vanden Eynde J, et al. Ensuring competency in focused cardiac ultrasound: a systematic review of training programs. J Intensive Care. 2020;8:57. doi: 10.1186/s40560-020-00503-x.
7.- Via G, Hussain A, Wells M, Reardon R, ElBarbary M, Noble VE, et al. International evidence-based recommendations for focused cardiac ultrasound. J Am Soc Echocardiogr. 2014 Jul;27(7):683.e1–683.e33. doi: 10.1016/j.echo.2014.05.001.
8.- Maheshwari S, Dagor H. Evolving the scope of cardiac point-of-care ultrasound in the current era. Cureus. 2024 Feb 10;16(2):e53985. doi: 10.7759/cureus.53985.
9.- Chisholm CB, Dodge WR, Balise RR, Williams SR, Gharahbaghian L, Beraud AS. Focused cardiac ultrasound training: how much is enough? J Emerg Med. 2013 Apr;44(4):818–822. doi: 10.1016/j.jemermed.2012.07.092.
10.- Russell FM, Herbert A, Zakeri B, Blaha M, Ferre RM, Sarmiento EJ, et al. Training the trainer: faculty from across multiple specialties show improved confidence, knowledge and skill in point-of-care ultrasound after a short intervention. Cureus. 2020 Dec 1;12(12):e11821. doi: 10.7759/cureus.11821.
11.- Mor-Avi V, Lang RM, Badano LP, Belohlavek M, Cardim NM, Derumeaux G, et al. Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EACVI consensus. J Am Soc Echocardiogr. 2021 Feb;34(2):136–165. doi: 10.1016/j.echo.2020.10.024.
12.- Kalagara H, Coker B, Gerstein NS, Kukreja P, Deriy L, Pierce A, Townsley MM. Point-of-care ultrasound (POCUS) for the cardiothoracic anesthesiologist. J Cardiothorac Vasc Anesth. 2021 Oct;35(10):3054–3071. doi: 10.1053/j.jvca.2021.01.018.
13.- Johri AM, Glass C, Hill B, Jensen T, Puentes W, Olusanya O, et al. The evolution of cardiovascular ultrasound: a review of cardiac point-of-care ultrasound (POCUS) across specialties. Am J Med. 2023 Jul;136(7):621–628. doi: 10.1016/j.amjmed.2023.02.020.
14.- Gu Y, Panda K, Spelde A, Jelly CA, Crowley J, Gutsche J, et al. Modernization of cardiac advanced life support: role and value of cardiothoracic anesthesiologist intensivist in post-cardiac surgery arrest resuscitation. J Cardiothorac Vasc Anesth. 2024 Nov;38(11):3005–3017. doi: 10.1053/j.jvca.2024.09.019.
15.- Rao VV, DellaValle J, Zierler RE, Wang H, Parshall CG, Day J, et al. POCUS25: top 25 point-of-care ultrasound (POCUS) community-defined practice domains. J Radiol Nurs. 2024;43(1):52–59. doi: 10.1016/j.jradnu.2023.09.011.
16.- Resnyk J, Weichold A. Barriers to learning and performing point-of-care ultrasound (POCUS): an integrative review. J Prof Nurs. 2024;54:54–62. doi: 10.1016/j.profnurs.2024.06.007.
17.- Moka E, Paladini A, Rekatsina M, Urits I, Viswanath O, Kaye AD, et al. Best practice in cardiac anesthesia during the COVID-19 pandemic: practical recommendations. Best Pract Res Clin Anaesthesiol. 2020 Dec;34(4):569–582. doi: 10.1016/j.bpa.2020.06.008.
18.- Subramaniam K, Subramanian H, Knight J, Mandell D, McHugh SM. An approach to standard perioperative transthoracic echocardiography practice for anesthesiologists—perioperative transthoracic echocardiography protocols. J Cardiothorac Vasc Anesth. 2022 Feb;36(2):367–386. doi: 10.1053/j.jvca.2021.08.100.
19.- Bouchez S, De Backer D, Fraipont V, Momeni M, Rex S, De Hert S. Perioperative hemodynamic monitoring techniques: a narrative review. Acta Anaesthesiol Belg. 2024;75(2):125–138.
20.- Meineri M, Bryson GL, Arellano R, Skubas N. Core point-of-care ultrasound curriculum: what does every anesthesiologist need to know? Can J Anesth. 2018 Apr;65(4):417–426. doi: 10.1007/s12630-018-1063-9.
How to Cite / Como citar
[1] Gabriela Ramírez G., Dante Vizcayno Soto, and Alberto Hernández Guijosa. 2026. POCUS en cirugía cardíaca: revisión de la evidencia y experiencia institucional. CRITICAL CARE & EMERGENGY MEDICINE 5, (January 2026), 44–49. https://doi.org/10.58281/ccem060126-rev-nar-07
Licencia
© 2025 Critical Care & Emergency Medicine by Ediciones Prado. This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0) .
The copyrights of the articles published in Critical Care & Emergency Medicine belong to Ediciones Prado. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Critical Care & Emergency Medicine without prior authorization for non-commercial use.
ISSN
2992-6785
eISSN: 2992-6785
DOI: 10.3989/ccem
Indexación
Patrocinadores
- 8 enero, 2026
- Revisión narrativa, Volumen 5
Gabriela Ramírez G. 1 , Dante Vizcayno Soto 2 , Alberto Hernández Guijosa 3 .
1 Anestesiólogo cardiovascular. Hospital Lic. Adolfo López Mateos, ISSSTE, Ciudad de México, México.
2 Médico Anestesiólogo. Hospital San Angelin. Ciudad de México. México.
3 Médico Anestesiólogo-Algólogo. IMSS HGM. Ciudad de México. México.
Editor
Manuel Alberto Guerrero Gutierrez , Liliana Catalina Galeana Gonzalez .
Chair
Diego Escarraman Martinez .
Abstract
Abstract: Point-of-care ultrasound (POCUS) has become an essential tool in the perioperative management of patients undergoing cardiac surgery. This narrative review analyzes recent
evidence and institutional experience regarding the impact of POCUS on patient safety optimization, hemodynamic assessment, and real-time clinical decision-making. It explores the integration of POCUS with transesophageal (TEE) and transthoracic echocardiography (TTE), emphasizing its diagnostic and therapeutic value throughout the perioperative process. Significant clinical benefits are highlighted, including early detection of cardiovascular dysfunction and guidance in invasive procedures, as well as ongoing challenges related to standardization, operator training, and incorporation into complex surgical protocols. Strengthening perioperative ultrasound skills offers an opportunity to enhance patient safety, diagnostic accuracy, and overall efficiency in cardiovascular care.
Resumen
Resumen: El ultrasonido en el punto de atención (POCUS) se ha consolidado como una herramienta esencial en el manejo perioperatorio de pacientes sometidos a cirugía cardíaca. Esta revisión narrativa analiza la evidencia reciente y la experiencia institucional sobre el impacto del POCUS en la optimización de la seguridad del paciente, la evaluación hemodinámica y la toma de decisiones clínicas en tiempo real. Se examina la integración del POCUS con la ecocardiografía transesofágica (TEE) y transtorácica (TTE), destacando su utilidad diagnóstica y terapéutica durante todo el proceso perioperatorio. Además, se identifican beneficios clínicos significativos, como la detección temprana de alteraciones cardiovasculares y la guía en procedimientos invasivos, así como desafíos relacionados con la estandarización, la capacitación y la implementación de esta tecnología en protocolos quirúrgicos complejos. El fortalecimiento de las competencias en ultrasonido perioperatorio representa una oportunidad para mejorar la seguridad y la eficiencia en la atención del paciente cardiovascular.
Keywords
Ultrasonography; Echocardiography, Transesophageal; Echocardiography, Transthoracic; Cardiac Surgical Procedures; Perioperative Care.
Biografias de autores
Gabriela Ramírez G.
Anestesiólogo cardiovascular. Hospital Lic. Adolfo López Mateos, ISSSTE, Ciudad de México, México.
Dante Vizcayno Soto.
Médico Anestesiólogo. Hospital San Angelin. Ciudad de México. México.
Alberto Hernández Guijosa.
Médico Anestesiólogo-Algólogo. IMSS HGM. Ciudad de México. México.
Referencias
Nicoara A, Skubas N, Ad N, Finley A, Hahn RT, Mahmood F, et al; American Society of Echocardiography, Society of Cardiovascular Anesthesiologists & Society of Thoracic Surgeons. Guidelines for the use of transesophageal echocardiography to assist with surgical decision-making in the operating room: a surgery-based approach. J Am Soc Echocardiogr. 2020 Jun;33(6):692–734. doi: 10.1016/j.echo.2020.03.0022.
2.- De Marchi L, Meineri M. POCUS in perioperative medicine: a North American perspective. Crit Ultrasound J. 2017;9:15. doi: 10.1186/s13089-017-0066-7.
3.- Cowie B. Three years’ experience of focused cardiovascular ultrasound in the peri-operative period. Anaesthesia. 2011 Apr;66(4):268–273. doi: 10.1111/j.1365-2044.2011.06622.x.
4.- Naji A, Chappidi M, Ahmed A, Monga A, Sanders J. Perioperative point-of-care ultrasound use by anesthesiologists. Cureus. 2021 May 24;13(5):e15217. doi: 10.7759/cureus.15217.
5.- Efrimescu CI, Moorthy A, Griffin M. Rescue transesophageal echocardiography: a narrative review of current knowledge and practice. J Cardiothorac Vasc Anesth. 2023 Apr;37(4):584–600. doi: 10.1053/j.jvca.2022.12.031.
6.- Verreet T, Defosse J, Verschueren J, Desruelles D, Deloof T, Vanden Eynde J, et al. Ensuring competency in focused cardiac ultrasound: a systematic review of training programs. J Intensive Care. 2020;8:57. doi: 10.1186/s40560-020-00503-x.
7.- Via G, Hussain A, Wells M, Reardon R, ElBarbary M, Noble VE, et al. International evidence-based recommendations for focused cardiac ultrasound. J Am Soc Echocardiogr. 2014 Jul;27(7):683.e1–683.e33. doi: 10.1016/j.echo.2014.05.001.
8.- Maheshwari S, Dagor H. Evolving the scope of cardiac point-of-care ultrasound in the current era. Cureus. 2024 Feb 10;16(2):e53985. doi: 10.7759/cureus.53985.
9.- Chisholm CB, Dodge WR, Balise RR, Williams SR, Gharahbaghian L, Beraud AS. Focused cardiac ultrasound training: how much is enough? J Emerg Med. 2013 Apr;44(4):818–822. doi: 10.1016/j.jemermed.2012.07.092.
10.- Russell FM, Herbert A, Zakeri B, Blaha M, Ferre RM, Sarmiento EJ, et al. Training the trainer: faculty from across multiple specialties show improved confidence, knowledge and skill in point-of-care ultrasound after a short intervention. Cureus. 2020 Dec 1;12(12):e11821. doi: 10.7759/cureus.11821.
11.- Mor-Avi V, Lang RM, Badano LP, Belohlavek M, Cardim NM, Derumeaux G, et al. Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EACVI consensus. J Am Soc Echocardiogr. 2021 Feb;34(2):136–165. doi: 10.1016/j.echo.2020.10.024.
12.- Kalagara H, Coker B, Gerstein NS, Kukreja P, Deriy L, Pierce A, Townsley MM. Point-of-care ultrasound (POCUS) for the cardiothoracic anesthesiologist. J Cardiothorac Vasc Anesth. 2021 Oct;35(10):3054–3071. doi: 10.1053/j.jvca.2021.01.018.
13.- Johri AM, Glass C, Hill B, Jensen T, Puentes W, Olusanya O, et al. The evolution of cardiovascular ultrasound: a review of cardiac point-of-care ultrasound (POCUS) across specialties. Am J Med. 2023 Jul;136(7):621–628. doi: 10.1016/j.amjmed.2023.02.020.
14.- Gu Y, Panda K, Spelde A, Jelly CA, Crowley J, Gutsche J, et al. Modernization of cardiac advanced life support: role and value of cardiothoracic anesthesiologist intensivist in post-cardiac surgery arrest resuscitation. J Cardiothorac Vasc Anesth. 2024 Nov;38(11):3005–3017. doi: 10.1053/j.jvca.2024.09.019.
15.- Rao VV, DellaValle J, Zierler RE, Wang H, Parshall CG, Day J, et al. POCUS25: top 25 point-of-care ultrasound (POCUS) community-defined practice domains. J Radiol Nurs. 2024;43(1):52–59. doi: 10.1016/j.jradnu.2023.09.011.
16.- Resnyk J, Weichold A. Barriers to learning and performing point-of-care ultrasound (POCUS): an integrative review. J Prof Nurs. 2024;54:54–62. doi: 10.1016/j.profnurs.2024.06.007.
17.- Moka E, Paladini A, Rekatsina M, Urits I, Viswanath O, Kaye AD, et al. Best practice in cardiac anesthesia during the COVID-19 pandemic: practical recommendations. Best Pract Res Clin Anaesthesiol. 2020 Dec;34(4):569–582. doi: 10.1016/j.bpa.2020.06.008.
18.- Subramaniam K, Subramanian H, Knight J, Mandell D, McHugh SM. An approach to standard perioperative transthoracic echocardiography practice for anesthesiologists—perioperative transthoracic echocardiography protocols. J Cardiothorac Vasc Anesth. 2022 Feb;36(2):367–386. doi: 10.1053/j.jvca.2021.08.100.
19.- Bouchez S, De Backer D, Fraipont V, Momeni M, Rex S, De Hert S. Perioperative hemodynamic monitoring techniques: a narrative review. Acta Anaesthesiol Belg. 2024;75(2):125–138.
20.- Meineri M, Bryson GL, Arellano R, Skubas N. Core point-of-care ultrasound curriculum: what does every anesthesiologist need to know? Can J Anesth. 2018 Apr;65(4):417–426. doi: 10.1007/s12630-018-1063-9.
How to Cite / Como citar
[1] Gabriela Ramírez G., Dante Vizcayno Soto, and Alberto Hernández Guijosa. 2026. POCUS en cirugía cardíaca: revisión de la evidencia y experiencia institucional. CRITICAL CARE & EMERGENGY MEDICINE 5, (January 2026), 44–49. https://doi.org/10.58281/ccem060126-rev-nar-07
Licencia
© 2025 Critical Care & Emergency Medicine by Ediciones Prado. This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0) .
The copyrights of the articles published in Critical Care & Emergency Medicine belong to Ediciones Prado. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Critical Care & Emergency Medicine without prior authorization for non-commercial use.
ISSN
2992-6785
eISSN: 2992-6785
DOI: 10.3989/ccem
Indexación
Patrocinadores
