Point-of-care ultrasound in postoperative intensive care: A practical guide for the anaesthesiologist

Abstract

Point-of-Care Ultrasound (POCUS) has become a core competency for the anaesthesiologist managing patients in the postoperative intensive care unit. By providing immediate bedside imaging without consultative delay, it enhances diagnostic accuracy and directly informs haemodynamic and respiratory decision-making. This review addresses five clinical domains: lung and diaphragm assessment, cardiac evaluation and shock classification, fluid management, abdominal screening and deep vein thrombosis assessment, and procedural guidance. For each domain, sonographic findings, clinical interpretation, and management implications are described. A structured multi-organ approach with mandatory re-evaluation after every intervention is emphasised throughout. Governance requirements, including competency assessment, image archiving, and peer review are discussed alongside their medico-legal implications. Diagnostic accuracy is well established across all domains; randomised outcome data remain the principal evidence gap. Artificial intelligence may reduce operator dependency but requires prospective perioperative validation before routine implementation.