{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T18:15:54Z","timestamp":1779387354564,"version":"3.53.1"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The recent guideline from the American Heart Association on acute pulmonary embolism provides an updated framework for diagnosis, risk stratification, and management. Computed tomography pulmonary angiography remains the reference standard for confirming pulmonary embolism. However, in critically ill patients with hemodynamic or respiratory instability, transport for definitive imaging may be unsafe or impractical. In this context, bedside evaluation becomes central to early decision-making. Point-of-care ultrasound (POCUS), particularly when performed as a multi-organ assessment integrating cardiac, pulmonary, and venous ultrasound, can rapidly identify signs of right ventricular dysfunction, detect thrombus in transit, and exclude alternative life-threatening causes of shock. Emerging evidence suggests that multi-organ POCUS has high diagnostic performance in critically ill patients with suspected pulmonary embolism. In unstable patients, bedside ultrasound may therefore provide clinically actionable information to support timely therapeutic decisions when definitive imaging is not immediately feasible.<\/jats:p>","DOI":"10.1186\/s13054-026-06097-4","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T18:00:16Z","timestamp":1779386416000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Point-of-care ultrasound in hemodynamically unstable pulmonary embolism"],"prefix":"10.1186","volume":"30","author":[{"given":"Oscar","family":"Moreno-Loaiza","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiano Bandeira","family":"de Melo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milagros","family":"Moreno-Loaiza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sim\u00e3o","family":"Bamberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"6097_CR1","doi-asserted-by":"publisher","unstructured":"Creager MA, Barnes GD, Giri J, Mukherjee D, Jones WS, Burnett AE, et al. 2026 AHA\/ACC\/ACCP\/ACEP\/CHEST\/SCAI\/SHM\/SIR\/SVM\/SVN guideline for the evaluation and management of acute pulmonary embolism in adults: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026. https:\/\/doi.org\/10.1161\/CIR.0000000000001415.","DOI":"10.1161\/CIR.0000000000001415"},{"key":"6097_CR2","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1001\/jama.295.2.172","volume":"295","author":"A van Belle","year":"2006","unstructured":"van Belle A, B\u00fcller HR, Huisman MV, Huisman PM, Kaasjager K, Kamphuisen PW, et al. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. JAMA. 2006;295:172\u20139. https:\/\/doi.org\/10.1001\/jama.295.2.172.","journal-title":"JAMA"},{"key":"6097_CR3","doi-asserted-by":"publisher","first-page":"2317","DOI":"10.1056\/NEJMoa052367","volume":"354","author":"PD Stein","year":"2006","unstructured":"Stein PD, Fowler SE, Goodman LR, Gottschalk A, Hales CA, Hull RD, et al. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med. 2006;354:2317\u201327. https:\/\/doi.org\/10.1056\/NEJMoa052367.","journal-title":"N Engl J Med"},{"key":"6097_CR4","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1016\/j.echo.2017.03.004","volume":"30","author":"JM Fields","year":"2017","unstructured":"Fields JM, Davis J, Girson L, Au A, Potts J, Morgan CJ, et al. Transthoracic echocardiography for diagnosing pulmonary embolism: a systematic review and meta-analysis. J Am Soc Echocardiogr. 2017;30:714-723.e4. https:\/\/doi.org\/10.1016\/j.echo.2017.03.004.","journal-title":"J Am Soc Echocardiogr"},{"key":"6097_CR5","doi-asserted-by":"publisher","DOI":"10.1186\/2110-5820-3-10","volume":"3","author":"E Parmentier-Decrucq","year":"2013","unstructured":"Parmentier-Decrucq E, Poissy J, Favory R, Nseir S, Onimus T, Guerry MJ, et al. Adverse events during intrahospital transport of critically ill patients: incidence and risk factors. Ann Intensive Care. 2013;3:10. https:\/\/doi.org\/10.1186\/2110-5820-3-10.","journal-title":"Ann Intensive Care"},{"key":"6097_CR6","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1136\/thoraxjnl-2021-216838","volume":"77","author":"C Falster","year":"2022","unstructured":"Falster C, Jacobsen N, Coman KE, H\u00f8jlund M, Gaist TA, Posth S, et al. Diagnostic accuracy of focused deep venous, lung, cardiac and multiorgan ultrasound in suspected pulmonary embolism: a systematic review and meta-analysis. Thorax. 2022;77:679\u201389. https:\/\/doi.org\/10.1136\/thoraxjnl-2021-216838.","journal-title":"Thorax"},{"key":"6097_CR7","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-023-04495-6","volume":"27","author":"T Yoshida","year":"2023","unstructured":"Yoshida T, Yoshida T, Noma H, Nomura T, Suzuki A, Mihara T. Diagnostic accuracy of point-of-care ultrasound for shock: a systematic review and meta-analysis. Crit Care. 2023;27:200. https:\/\/doi.org\/10.1186\/s13054-023-04495-6.","journal-title":"Crit Care"},{"key":"6097_CR8","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1007\/s00134-025-08189-1","volume":"52","author":"L Muller","year":"2025","unstructured":"Muller L, Volpicelli G, Mongodi S, Girard M, Fraccalini T, Gargani L, et al. Bedside thoracic echography in ICU: new insights for acute circulatory and respiratory failure. Intensive Care Med. 2025;52:76\u201388. https:\/\/doi.org\/10.1007\/s00134-025-08189-1.","journal-title":"Intensive Care Med"},{"key":"6097_CR9","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-025-05359-x","volume":"29","author":"RH Melo","year":"2025","unstructured":"Melo RH, Gioli-Pereira L, Louren\u00e7o ID, Da Hora Passos R, Bernardo AT, Volpicelli G. Diagnostic accuracy of multi-organ point-of-care ultrasound for pulmonary embolism in critically ill patients: a systematic review and meta-analysis. Crit Care. 2025;29:162. https:\/\/doi.org\/10.1186\/s13054-025-05359-x.","journal-title":"Crit Care"},{"key":"6097_CR10","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/j.ajem.2023.07.011","volume":"72","author":"S Alerhand","year":"2023","unstructured":"Alerhand S, Adrian RJ. What echocardiographic findings differentiate acute pulmonary embolism and chronic pulmonary hypertension? Am J Emerg Med. 2023;72:72\u201384. https:\/\/doi.org\/10.1016\/j.ajem.2023.07.011.","journal-title":"Am J Emerg Med"},{"key":"6097_CR11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jscai.2022.100548","volume":"2","author":"MJ Silver","year":"2023","unstructured":"Silver MJ, Giri J, Duffy \u00c1, Jaber WA, Khandhar S, Ouriel K, et al. Incidence of mortality and complications in high-risk pulmonary embolism: a systematic review and meta-analysis. J Soc Cardiovasc Angiogr Interv. 2023;2:100548. https:\/\/doi.org\/10.1016\/j.jscai.2022.100548.","journal-title":"J Soc Cardiovasc Angiogr Interv"},{"key":"6097_CR12","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1007\/s00134-023-07275-6","volume":"50","author":"SJ Millington","year":"2023","unstructured":"Millington SJ, Aissaoui N, Bowcock E, Brodie D, Burns KEA, Doufl\u00e9 G, et al. High and intermediate risk pulmonary embolism in the ICU. Intensive Care Med. 2023;50:195\u2013208. https:\/\/doi.org\/10.1007\/s00134-023-07275-6.","journal-title":"Intensive Care Med"},{"key":"6097_CR13","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000002656","volume":"72","author":"G Doufl\u00e9","year":"2026","unstructured":"Doufl\u00e9 G, O\u2019Neil ER, Abreu S, Aljassim NA, Di Nardo M, Obonyo NG, et al. Ultrasound in extracorporeal membrane oxygenation: an ELSO state-of-the-art review. ASAIO J. 2026;72:85. https:\/\/doi.org\/10.1097\/MAT.0000000000002656.","journal-title":"ASAIO J"},{"key":"6097_CR14","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1177\/1358863X19880268","volume":"25","author":"E Yuriditsky","year":"2020","unstructured":"Yuriditsky E, Mitchell OJL, Sibley RA, Xia Y, Sista AK, Zhong J, et al. Low left ventricular outflow tract velocity time integral is associated with poor outcomes in acute pulmonary embolism. Vasc Med. 2020;25:133\u201340. https:\/\/doi.org\/10.1177\/1358863X19880268.","journal-title":"Vasc Med"},{"key":"6097_CR15","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-025-03236-6","author":"H Saleh","year":"2026","unstructured":"Saleh H, Patel K, Converse E, Ali M, Singh G, Pavlatos N, et al. Association of left ventricular outflow tract velocity-time integral with severity of pulmonary embolism in patients treated with catheter-directed therapies. J Thromb Thrombolysis. 2026. https:\/\/doi.org\/10.1007\/s11239-025-03236-6.","journal-title":"J Thromb Thrombolysis"}],"container-title":["Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13054-026-06097-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13054-026-06097-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13054-026-06097-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T18:00:16Z","timestamp":1779386416000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13054-026-06097-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,21]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6097"],"URL":"https:\/\/doi.org\/10.1186\/s13054-026-06097-4","relation":{},"ISSN":["1364-8535"],"issn-type":[{"value":"1364-8535","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,21]]},"assertion":[{"value":"8 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"271"}}