Rezayat T, Barjaktarevic I, Mecham I, Yee L, Salah R, et al. (2018) Early Protocolized Bedside Ultrasound in Shock: Renal Function Improvements and Other Lessons Learned. Int J Crit Care Emerg Med 4:046.


© 2018 Rezayat T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

RESEARCH ARTICLE | OPEN ACCESSDOI: 10.23937/2474-3674/1510046

Early Protocolized Bedside Ultrasound in Shock: Renal Function Improvements and Other Lessons Learned

Talayeh Rezayat1*, Igor Barjaktarevic1, Ian Mecham2, Lisa Yee3, Ramy Salah1, Lisa Zhu4, Kereat Grewal5, Jody Anderson6, Nicholas J Jackson7, David Elashoff7 and Elizabeth Turner1

1David Geffen School of Medicine, USA

2University of Utah School of Medicine, USA

3Harbor UCLA Medical Center, Torrance, USA

4Stanford University School of Medicine, USA

5University of California, USA

6Division of Neurosurgery, David Geffen School of Medicine, USA

7Department of Medicine Statistics Core, USA



Rapid assessment and treatment of the critically ill in shock is crucial to survival. The RUSH (Rapid Ultrasound in Shock and Hypotension) exam uses Ultrasound (US) to determine the etiology of undifferentiated shock, but data to demonstrate impact of focused US on clinical outcomes is sparse. This study aimed to assess the clinical impact of early incorporation of the RUSH US exam in the care of patients with new onset shock on a population level.


In this single center randomized control trial, sixty patients were enrolled in the RUSH group and received an early protocolized US exam within the first 24 hours of shock onset, and 65 patients were enrolled in the usual care group. The primary outcome investigated was total hospital length of stay. Secondary outcomes included in-hospital mortality, common markers of morbidity, and resource utilization.


There was no difference in the length of stay or resource utilization between the two groups, however the RUSH subjects were more likely to have a lower stage of acute kidney injury by RIFLE staging (p = 0.019). There were non-significant trends towards less total fluid administered, reduced need for new hemodialysis, and fewer ventilator days in the RUSH group.


The use of early US in shock patients leads to improvement in renal outcomes which is known to have significant impact on morbidity and mortality. Future studies are required to further investigate additional clinical outcomes impacted by use of an early protocolized US examination for this population.