Contributions of point-of-care ultrasound (POCUS) in intensive care nursing: an integrative review
DOI:
https://doi.org/10.17267/2317-3378rec.2026.e6718Keywords:
Nursing Care, Nursing, Ultrasound, Intensive Care UnitsAbstract
OBJECTIVE: To analyze the scientific production on the main contributions of the use of point-of-care ultrasound (POCUS) in intensive nursing care. METHOD: Integrative literature review (period: February to July 2024), conducted through an electronic search in the LILACS and PubMed databases, covering primary studies in full text in which POCUS was performed by nurses, in Portuguese and English. The recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed. RESULTS: A total of 806 papers were found; 11 were included in this study, mostly published in 2022 (n=3) and in English (n=8). The main contributions of using POCUS in nursing care were: guidance for the insertion and confirmation of the location of invasive devices (venous and arterial catheters and feeding tubes), assessment of cardiac and pleural changes, measurement of gastric and bladder volume, and the prevention, detection, and monitoring of pressure injuries. CONCLUSION: POCUS is established as a tool for inserting and confirming invasive device placement and assessing clinical changes. It is consolidating itself as an innovative practice that strengthens the autonomy and safety of intensive care nursing in the care of critically ill patients.
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References
1. Dias BL, Siqueira DS. Humanization of care in intensive care units: an integrative review. Revista FT. 2023;27(125). https://doi.org/10.5281/zenodo.8302822
2. Ouchi JD, Lupo APR, Alves BO, Andrade RV, Fogaça MB. O papel do enfermeiro na unidade de terapia intensiva diante de novas tecnologias de saúde. Rev Saúde Foco [Internet]. 2018;10:412-28. Available from: https://portal.unisepe.com.br/unifia/wp-content/uploads/sites/10001/2018/07/054_O_PAPEL_DO_ENFERMEIRO_NA_UNIDADE_DE_TERAPIA_INTENSIVA.pdf
3. Venturi V, Viana CP, Maia LFS, Basílio MJ, Oliveira AV, Sobrinho JC, et al. The nurse's role in the management of hemodynamic monitoring in the intensive care unit. Revista Recien. 2016;6(17):19-23. https://doi.org/10.24276/rrecien2358-3088.2016.6.17.19-23
4. Menezes JDS, Pereira AA, Silva IS, Chiminez HM, Rodrigues CDS, Rodrigues AMS. Perspectives on the use of ultrasound by nurses in the emergency department: an integrative review. Res Soc Dev. 2022;11(9):e36511931896. https://doi.org/10.33448/rsd-v11i9.31896
5. Posses, FP. Ultrassonografia: o que é ultrassom e como funciona o exame. [Internet]. [updated 2025 Setp. 26; cited 2024 July 29]. Available from: https://star.med.br/ultrassonografia-exame-de-ultrassom/
6. Wessler AS, Cerqueira ML, Lage NM, Santos RF, Alves EK. The use of bedside ultrasound by nurses as a support tool in performing procedures of greater complexity [trabalho de conclusão de curso] [Internet]. Santa Catarina: UniSociesc; 2021. [cited 2024 Jan. 30]. Available from: https://repositorio.animaeducacao.com.br/handle/ANIMA/25727
7. Resolução do COFEN n° 679/2021, de 30 de agosto de 2021 (Brazil). Aprova a normatização da realização de Ultrassonografia à beira do leito e no ambiente pré-hospitalar por Enfermeiro. [Internet]. Conselho Federal de Enfermagem. Brasília, 2021 [citado em 2024 jan 29]. Available from: https://www.cofen.gov.br/resolucao-cofen-no-679-2021/
8. Soares, AEV. O Uso do Ultrassom Point-of-Care por Enfermeiros de Unidade de Terapia Intensiva Neonatal: Um Protocolo de Scoping Review [trabalho de conclusão de curso] [Internet]. Rio Grande do Norte: Universidade Federal do Rio Grande do Norte; 2022. [cited 2024 Apr. 15]. Available from: https://repositorio.ufrn.br/handle/123456789/49136
9. Parrela ATR. Uso da Ultrassonografia Point-of-Care para Avaliação Vesical: Capacitação Para Enfermeiros de Áreas Críticas [dissertação] [Internet]. Florianópolis: Universidade Federal de Santa Catarina; 2022. [cited 2024 Apr. 19]. Available from: https://repositorio.ufsc.br/handle/123456789/242594
10. Santos VB, Silva WP, Apablaza MFS, Silva TV, Gimenes FRE. The use of point-of-care ultrasound in nurses’ clinical practice as a foundation for patient safety. Rev Bras Enferm. 2024;77(Suppl 2):e77suppl0201. https://doi.org/10.1590/0034-7167.202477suppl0201pt
11. Migot BM, Passos MV, Simões ASA, Marques ALM, Teodoro RMO, Faria EC. Uso do ultrassom point-of-care (POCUS) por enfermeiros: uma revisão integrativa. Revista FT. 2024;29(140). Available from: https://revistaft.com.br/uso-do-ultrassom-point-of-care-pocus-por-enfermeiros-uma-revisao-integrativa/
12. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. https://doi.org/10.1136/bmj.n71
13. Araujo WCO. Health information retrieval: construction, models andstrategies. ConCI: Conv Ciênc Inform. 2020;3(2):100-34. https://doi.org/10.33467/conci.v3i2.13447
14. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan—a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):210. https://doi.org/10.1186/s13643-016-0384-4
15. Souza MT, Silva MD, Carvalho R. Integrative review: what is it? How to do it? Einstein [Internet]. 2010;8(1 Pt 1):102–6. Available from: https://www.scielo.br/j/eins/a/ZQTBkVJZqcWrTT34cXLjtBx/?format=pdf&lang=pt
16. Alexaitis I, Broome B. Implementation of a Nurse-Driven Protocol to Prevent Catheter-Associated Urinary Tract Infections. J Nurs Care Qual. 2014;29(3):245-52. https://doi.org/10.1097/NCQ.0000000000000041
17. Grap MJ, Burj RS, Lucas V, Munro C, Wetzel PA, Schubert CM. Use of high frequency ultrasound to detect changes in skin integrity: An image evaluation validation procedure. Intensive Crit Care Nurs. 2015;31(3):141-7. https://doi.org/10.1016/j.iccn.2014.08.002
18. Li X, Fang G, Yang D, Wang L, Zheng C, Ruan L, et al. Ultrasonic Technology Improves Radial Artery Puncture and Cannulation in Intensive Care Unit (ICU) Shock Patients. Med Sci Monit. 2016;22:2409-16. https://doi.org/10.12659/msm.896805
19. Li Y, Ye Y, Mei Y, Ruan H, Yu Y. Semi-automated ultrasound guidance applied to nasogastrojejunal tube replacement for enteral nutrition in critically ill adults. Biomed Eng Online. 2018;17(1):21. https://doi.org/10.1186/s12938-018-0452-1
20. Imbriaco G, Monesi A, Giugni A, Cilloni N. Radial artery cannulation in intensive care unit patients: Does distance from wrist joint increase catheter durability and functionality? J Vasc Access. 2021;22(4):561-7. https://doi.org/10.1177/1129729820953020
21. Ferraboli SF, Beghetto MG. Bedside ultrasonography for the confirmation of gastric tube placement: agreement between nurse and doctor. Rev Gaúcha Enferm. 2022;43(esp):20220211. https://doi.org/10.1590/1983-1447.2022.20220211.pt
22. Souza RS, Pinheiro FA, Soares SCL, Queiroz AGS, Sottocornola SF, Barbosa SG. Ultrasound in clinical nurses practice: Peripheral venous access. Braz J Dev. 2022;8(1):5848-58. https://doi.org/10.34117/bjdv8n1-396
23. Brotfain E, Erblat A, Luft P, Elir A, Gruenbaum BF, Livshiz-Riven I, et al. Nurse-performed ultrasound assessment of gastric residual volume and enteral nasogastric tube placement in the general intensive care unit. Intensive Crit Care Nurs. 2022;69:e103183. https://doi.org/10.1016/j.iccn.2021.103183
24. Sørensen ML, Oterhals K, Pönitz V, Morken IM. Point-of-care examinations using handheld ultrasound devices performed by intensive care nurses in a cardiac intensive care unit. Eur J Cardiovasc Nurs. 2023;22(5):482-88. https://doi.org/10.1093/eurjcn/zvac089
25. Lopes KR, Jorge BM, Barbosa MH, Barichello E, Nicolussi AC. Use of ultrasonography in the evaluation of urinary retention in critically ill patients. Rev Latino-Am Enfermagem [Internet]. 2023;31:e4027. Available from: https://revistas.usp.br/rlae/pt_BR/article/view/216948
26. Hansen ØM, Solbakken R. Experiences and perceptions of critical care nurses on the use of point-of-care ultrasound (POCUS) to establish peripheral venous access in patients with difficult intravenous access: a qualitative study. BMJ Open. 2024;14(6):e078106. https://doi.org/10.1136/bmjopen-2023-078106
27. Melo LA. Incidência e perfil do paciente com choque na Unidade de Terapia Intensiva [dissertação] [Internet]. São Paulo: Universidade de São Paulo; 2021. Available from: https://bdta.abcd.usp.br/directbitstream/a5a6625c-3aff-450b-9eff-806f713fd73f/TCC_Leonardo%20Alves%20de%20Melo.pdf
28. Resolução do COFEN n° 703/2022, de 18 de julho de 2022 (Brazil). Atualiza a norma para a execução, pelo Enfermeiro, da punção arterial para gasometria e/ou instalação de cateter intra-arterial para monitorização da pressão arterial invasiva (PAI). Conselho Federal de Enfermagem. Available from: https://www.cofen.gov.br/resolucao-cofen-no-703-2022
29. Monteiro MM, Alves LCS, Neves AD, Reis BHM, Lima HPBS, Campelo JMS, et al. A importância do uso de ultrassonografia point-of-care (POCUS) para a assistência de enfermagem nas unidades de terapia intensiva (UTIs) adulto. R Bras Met Cient. 2025. https://doi.org/10.5281/zenodo.17937117
30. Lopes KR, Nicolussi AC. Advantages of bladder ultrasound in measuring urine volume in critically ill patients: an integrative review. Rev Enferm UERJ. 2021;29:e61972. http://dx.doi.org/10.12957/reuerj.2021.61972
31. Carmo LFS, Santos FAA, Mendonça SCB, Araújo BCL. Gerenciamento do risco de broncoaspiração em pacientes com disfagia orofaríngea. Rev CEFAC. 2018;20(4):532-40.
32. Sharma V, Gudivada D, Gueret R, Bailitz J. Ultrasound-Assessed Gastric Antral Area Correlates With Aspirated Tube Feed Volume in Enterally Fed Critically Ill Patients. Nutr Clin Pract. 2017;32(2):206-11. https://doi.org/10.1177/0884533616681530
33. Ministério da Saúde. Radiações ionizantes. [updated 2023 July 3; cited 2024 May 29]. Available from: https://www.gov.br/inca/pt-br/assuntos/causas-e-prevencao-do-cancer/exposicao-no-trabalho-e-no-ambiente/radiacoes/radiacoes-ionizantes
34. Albuquerque GC, Rodrigues RSF, Souza WL. The use of bedside ultrasound as a decision-making tool for nurse. Revista FT. 2023;27(121). https://doi.org/10.5281/zenodo.7828552
35. Flores LK, Magalhães ALP. Bedside ultrasound by healthcare professionals in the critical care setting: a scoping review. Cuad Ed Desar. 2024;16(8):01-30. https://doi.org/10.55905/cuadv16n8-064
36. Azevedo ACT, Moreira IS, Ferreira IG, Madeira JDS, Spina RB, Brant TAC, et al. Use of point-of-care ultrasound (POCUS) in cardiorespiratory arrest (CRA). REAS/EJCH. 2020;12(12):e4790. https://doi.org/10.25248/reas.e4790.2020
37. Barbeiro BG. Diagnostic accuracy of point-of-care lung ultrasound in assessing blood volume in patients with acute kidney injury [dissertação] [Internet]. Ribeirão Preto: Universidade de São Paulo; 2023. [cited 2024 June 6]. Available from: https://teses.usp.br/teses/disponiveis/22/22134/tde-08032024-093631/
38. Melo JCF. Ultrassonografia para punção de acesso venoso periférico na perspectiva do (a) enfermeiro (a) [trabalho de conclusão de curso] [Internet]. Rio Grande do Sul: Universidade Federal do Rio Grande do Sul; 2019. [cited 2024 June 11]. Available from: http://hdl.handle.net/10183/202155
39. Bridey C, Thilly N, Lefevre T, Maire-Richard A, Morel M, Levy B, et al. Ultrasound-guided versus landmark approach for peripheral intravenous access by critical care nurses: a randomised controlled study. BMJ Open. 2018;8(6):e020220. https://doi.org/10.1136/bmjopen-2017-020220
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Copyright (c) 2026 Flávia Almeida dos Santos, Tássia Nery Faustino, Nabila Monalisa Mendes Dantas Sales, Vanessa Nascimento Batista, Douglas de Souza e Silva
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This work is licensed under a Creative Commons Attribution 4.0 International License.
