Aplicações do point-of-care ultrasound no processo de enfermagem ao paciente crítico: revisão sistemática

Autores

DOI:

https://doi.org/10.36517/2175-6783.20252695685

Palavras-chave:

Enfermagem; Processo de Enfermagem; Ultrassonografia; Cuidados Críticos.

Resumo

Objetivo: identificar as aplicações e desfechos do point-of-care ultrasound no processo de enfermagem na assistência ao paciente crítico. Métodos: revisão sistemática com busca guiada pela estratégia PICo, por meio de combinação dos descritores nas bases BDENF, EMBASE, LILACS, PubMed, SciELO, ScienceDirect, SCOPUS, Web of Science e Wiley. Avaliação da qualidade das evidências conforme Oxford. Síntese de dados descritiva. Resultados: inicialmente foram identificados 1.859 estudos, mas após a aplicação dos critérios de inclusão e exclusão, a amostra final foi composta por 28 estudos. Foram descritas aplicações com desfechos positivos do point-of-care ultrasound na primeira, quarta e quinta etapas do processo de enfermagem, como ferramenta complementar da avaliação, guia para implementações e monitorização da evolução de enfermagem. Houve predominância no estrato 2 do nível de evidência e com grau de recomendação B. Conclusão: no contexto do processo de enfermagem foram descritos aplicações e desfechos do point-of-care ultrasound na avaliação, implementação e evolução de enfermagem. Contribuições para a prática: o estudo destaca que o point-of-care ultrasound pode ampliar a avaliação, orientar intervenções e monitorar a evolução do paciente crítico na prática de enfermagem, promovendo cuidados mais precisos e eficientes.

Referências

1. Grogan SP, Mount CA. Ultrasound physics and instrumentation. StatPearls [Internet]. 2023 [cited Jul 9, 2025]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK570593/

2. Naito T, Hashizumi A, Sakai M, Okamoto K, Yamamoto T, Tanaka Y, et al. Sustained effects of bladder point-of-care ultrasound simulation exercise on nursing students: a prospective cohort study. BMC Med Educ. 2025;25(1):127. doi: https://doi.org/10.1186/s12909-025-06729-3

3. Borborema R, Alves V, Rodrigues D, Viera B, Pereira A, Brito M, et al. Technological advancement in obstetric nursing consultation with the use of ultrasound. Texto Contexto Enferm. 2024;33(15):e20230236. doi: https://dx.doi.org/10.1590/1980-265X-TCE-2023-0236en

4. Silva I, Schneider C, Silva L, Silva M, Moreira J. Avaliação de retenção urinária pelo enfermeiro através da ultrassonografia à beira leito. Rev Enf Atual In Derme. 2023;97(3):e023167. doi: http://doi.org/10.31011/reaid-2023-v.97-n.3-art.1852

5. Flores LK, Magalhães ALP, Moraes EB. Performing bedside ultrasound in critically ill patients: scoping review protocol. Online Braz J Nurs. 2024;23(Suppl 1):e20246677. doi: http://dx.doi.org/10.17665/1676-4285.20246677

6. Norton JE, Husz A, Gyorgyi Z. How to master point-of-care ultrasound as an advanced paediatric nurse practitioner in critical care. Nurs Crit Care. 2025;30(2):e70019. doi: http://doi.org/10.1111/nicc.70019

7. Gimenes FRE, Stabile AM, Bernardes RM, Santos VB, Menegueti MG, Prado PR, et al. Advancing digital education technologies by empowering nurses with point-of-care ultrasound: protocol for a mixed methods study. JMIR Res Protoc. 2024;13:e58030. doi: https://doi.org/10.2196/58030

8. Conselho Federal de Enfermagem (COFEN). Resolução COFEN nº 736 de 17 de janeiro de 2024. Dispõe sobre a implementação do Processo de Enfermagem em todo contexto socioambiental onde ocorre o cuidado de enfermagem [Internet]. 2024 [cited Jul 9, 2025]. Available from: https://www.cofen.gov.br/resolucao-cofen-no-736-de-17-de-janeiro-de-2024/

9. Conselho Federal de Enfermagem (COFEN). Resolução COFEN nº 679 de 20 de agosto de 2021. Aprova a normatização da realização de Ultrassonografia à beira do leito e no ambiente pré-hospitalar por enfermeiro [Internet]. 2021 [cited Jul 9, 2025]. Available from: https://www.cofen.gov.br/resolucao-cofen-no-679-2021/

10. Galon EC, Ribeiro DFS, Terassi M. The usability of bedside ultrasound in nursing practice for critically ill patients. Rev Bras Enferm. 2025;78(2):e20240296. doi: https://dx.doi.org/10.1590/0034-7167-2024-0296

11. 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. doi: https://doi.org/10.1136/bmj.n71

12. The Oxford Centre for Evidence-Based Medicine (CEBM). Levels of evidence [Internet]. 2024 [cited Jul 9, 2025]. Available from: https://www.cebm.ox.ac.uk/resources/levels-of-evidence

13. Paula TR, Menezes AP, Guedes NG, Silva VM, Cardoso MVLML, Ramos ES. Effectiveness of mobile applications for behavioral changes in health: a systematic review. Rev Rene. 2020;21:e43845. doi:https://doi.org/10.15253/2175-6783.20202143845

14. Brannam L, Blaivas M, Lyon M, Flake M. Emergency nurses’ utilization of ultrasound guidance for placement of peripheral intravenous lines in difficult-access patients. Acad Emerg Med. 2004;11(12):1361-3. doi: https://dx.doi.org/10.1197/j.aem.2004.08.027

15. Henderson SO, Ahern T, Williams D, Mailhot T, Mandavia D. Emergency department ultrasound by nurse practitioners. J Am Acad Nurse Pract. 2010;22(7):352-5. doi: https://doi.org/10.1111/j.1745-7599.2010.00518.x

16. Tai PH, Lau WS, Chan PY, Ng SY, Lam YC, Mak HT, et al. Nurse performed ultrasonography in confirming the position of nasogastric tube in the emergency department: a prospective single group diagnostic test study. Hong Kong J Emerg Med. 2016;23(6):340-9. doi: https://doi.org/10.1177/102490791602300603

17. Fabiani A, Dreas L, Sanson G. Ultrasound-guided deep-arm veins insertion of long peripheral catheters in patients with difficult venous access after cardiac surgery. Heart Lung. 2017;46(1):46-53. doi: http://doi.org/10.1016/j.hrtlng.2016.09.003

18. 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. doi: https://doi.org/10.1136/bmjopen-2017-020220

19. Brunhoeber LA, King J, Davis S, Witherspoon B. Nurse practitioner use of point-of-care ultrasound in critical care. J Nurse Pract. 2018;14(5):383-8. doi: https://doi.org/10.1016/j.nurpra.2017.12.002

20. Edwards C, Jones J. Development and implementation of an ultrasound-guided peripheral intravenous catheter program for emergency nurses. J Emerg Nurs. 2018;44(1):33-6. doi: https://doi.org/10.1016/j.jen.2017.07.009

21. Cover M, Tafoya C, Long B, Cranford J, Burkhardt J, Huang R, et al. Creation of a flight nurse critical care ultrasound program. Air Med J. 2019;38(4):266-72. doi: https://doi.org/10.1016/j.amj.2019.03.010

22. Leibenguth E, Magdic K, Loeslie V, Yadav H, Guttendorf J. Implementation of pulmonary ultrasound training for critical care advanced practice providers. J Am Assoc Nurse Pract. 2019;31(4):247-54. doi: http://doi.org/10.1097/jxx.0000000000000128

23. Tulleken AM, Gelissen H, Lust E, Smits T, van Galen T, Girbes ARJ, et al. UltraNurse: teaching point-of-care ultrasound to intensive care nurses. Intensive Care Med. 2019;45(5):727-9. doi: https://dx.doi.org/10.1007/s00134-018-05512-x

24. Itoh T, Gorga S, Hashikawa A, Cranford J, Thomas J, Hatton C, et al. Point-of-care ultrasound for pediatric endotracheal tube placement confirmation by advanced practice transport nurses. Air Med J. 2020;39(6):448-53. doi: https://dx.doi.org/10.1016/j.amj.2020.09.004

25. Mele R, Panesar LE, Heyden M, Sridhar S, Brandon D. Neonatal nurse practitioner use of ultrasonography to verify umbilical venous catheter placement in the neonatal intensive care unit. Adv Neonatal Care. 2020;20(4):294-300. doi: https://doi.org/10.1097/anc.0000000000000708

26. Bhargava VE, Su E, Haileselassie B, Davis D, Steffen KM. Ultrasound education improves safety for peripheral intravenous catheter insertion in critically ill children. Pediatr Res. 2022;91(5):1057-63. doi: http://doi.org/10.1038/s41390-021-01568-6

27. 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;69:103183. doi: https://doi.org/10.1016/j.iccn.2021.103183

28. Ferraboli SF, Beghetto MG. Bedside ultrasound for nasogastric tube location: nurse-physician agreement. Rev Gaúcha Enferm. 2022;43(esp): 20220211. doi: http://dx.doi.org/10.1590/1983-1447.2022.20220211.en

29. Sağlam C, Güllüpınar B, Karagöz A, Tandon S, Bilge O, Aykır M, et al. Verification of endotracheal tube position by emergency nurses using ultrasound: a repeated measures cadaver study. J Emerg Nurs. 2022;48(2):181-8. doi: https://doi.org/10.1016/j.jen.2022.01.002

30. Tsolaki V, Zakynthinos GE, Zygoulis P, Bardaka F, Malita A, Aslanidis V, et al. Ultrasonographic confirmation of nasogastric tube placement in the COVID-19 era. J Pers Med. 2022;12(3):337. doi: https://doi.org/10.3390/jpm12030337

31. Burton SO, Donovan JK, Jones SL, Phillips LM, Anderson DJ, Meadley BN. Use of point of care ultrasound (POCUS) by intensive care paramedics to achieve peripheral intravenous access in patients predicted to be difficult: An out-of-hospital pilot study. Australas Emerg Care. 2023;26(2):164-8. doi: https://doi.org/10.1016/j.auec.2022.10.003

32. Corcoran E, Hopkins P, Fisher R, Wong A, Rose L. Intensive care nurse-led point of care ultrasound in the assessment and management of the critically ill COVID-19 patient: a single centre case series. Nurs Crit Care. 2023;28(5):781-8. doi: https://doi.org/10.1111/nicc.12871

33. 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. 2023;31:e4026. doi: https://doi.org/10.1590/1518-8345.6618.4026

34. Rath KA, Bonomo JB, Ballman K. Point-of-care ultrasonography for advanced practice providers: a training initiative. J Nurse Pract. 2023; 19(2):104435. doi: https://dx.doi.org/10.1016/j.nurpra.2022.08.018

35. Smits T, Heldeweg M, Tulleken AM, Verlaan B, Floor L, Eijsenga A, et al. Effects of nurse delivered thoracic ultrasound on management of adult intensive care unit patients: a prospective observational study. Int J Nurs Stud Adv. 2023;5:100135. doi: https://doi.org/10.1016/j.ijnsa.2023.100135

36. 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. doi: https://dx.doi.org/10.1136/bmjopen-2023-078106

37. Kessler R, Hall J, Chipman AK, Hall MK, Amick A. Nurse-focused ultrasound-guided IV program improves core emergency department process measures. J Vasc Access. 2025;26(2):578-85. doi: https://doi.org/10.1177/11297298241230109

38. Robles-González M, Arrogante O, Giralt JAS, Ortuño-Soriano I, Zaragoza-García I. Verification of nasogastric tube positioning using ultrasound by an intensive care nurse: a pilot study. Healthcare (Basel). 2024;12(16):1618. doi: https://dx.doi.org/10.3390/healthcare12161618

39. Zini T, Corso L, Mazzi C, Baraldi C, Nieddu E, Rinaldi L, et al. Ultrasound-guided centrally inserted central catheter (CICC) placement in newborns: a safe clinical training program in a neonatal intensive care unit. Children (Basel). 2024;11(4):395. doi: https://doi.org/10.3390/children11040395

40. León M, Marco DN, Cubedo M, González C, Guirao A, Cañueto MDC, et al. Comparing arterial catheterisation by palpation or ultrasound guidance by novice nurses in an adult intensive care unit: a prospective cohort study. Aust Crit Care. 2025;38(2):101135. doi: https://doi.org/10.1016/j.aucc.2024.101135

41. Voulgaridou A, Deftereos S, Chloropoulou P, Bekiaridou K, Tsouvala E, Meziridou R, et al. Emergency identification of endotracheal tube tip via ultrasonography used by trained nurse in the neonatal intensive care unit (NICU). Diagnostics. 2025;15(3):262. doi: https://doi.org/10.3390/diagnostics15030262

42. Chen LL, Tayban K, Tomicich J, Buchholz T, Barzola M, Mead E, et al. Point‑of‑care ultrasound (POCUS) program for critical care nurse practitioners and physician assistants in an oncological intensive care unit and rapid response team. J Am Assoc Nurse Pract. 2023;36(5):281-5. doi: https://doi.org/10.1097/jxx.0000000000000943

43. Schott CK, Kory P, Torres K, Pfoh E, Vranas KC, Sevransky J, et al. Current use, training, and barriers to point-of-care ultrasound use in ICUs in the Department of Veterans Affairs. Chest Crit Care. 2023;1(2):100012. doi: https://doi.org/10.1016/j.chstcc.2023.100012

44. Gong C, Shen Y, Wang J, Zhang P, Li Z. Application of ultrasound simulation training in intensive care nursing teaching. BMC Med Educ. 2025;25(1):566. doi: http://doi.org/10.1186/s12909-025-06968-4

45. Rodrigues MC, Silva TV, Teixeira HCS, Lopes CT, Lopes JL, Gimenes FRE, et al. Development and validity of tutorial guide for using lung ultrasound to identify “Excessive Fluid Volume” nursing diagnosis in patients with heart failure. Int J Nurs Knowl. 2025;1-10. doi: http://dx.doi.org/10.1111/2047-3095.70003

46. Silva TV, Teixeira HC, Rodrigues MC, Moraes JB, Lopes JL, Lopes CT, et al. Inferior Vena Cava Ultrasound: proposal for a new nursing intervention. Acta Paul Enferm. 2025;38:eAPE0002863. doi: https://doi.org/10.37689/acta-ape/2025AO0002863i

Publicado

2025-09-15

Edição

Seção

Artigos de Revisão

Como Citar

1.
Aplicações do point-of-care ultrasound no processo de enfermagem ao paciente crítico: revisão sistemática . Rev Rene [Internet]. 15º de setembro de 2025 [citado 5º de fevereiro de 2026];26(1):e95685. Disponível em: https://periodicos.ufc.br/rene/article/view/95685