Canis ISSN: 2398-2942

Global FAST®: assessing patient volume status

Synonym(s):  Point-of-care ultrasound, GFAST, POCUS, VPOCUS

Contributor(s): Gregory Lisciandro, Elisa Mazzaferro

Definition of Veterinary POCUS

  • Veterinary point-of-care ultrasound (VPOCUS), which includes FAST and focused organ examinations, is defined as a goal-directed ultrasound examination(s) performed by a healthcare provider to answer a specific diagnostic question(s) or guide performance of an invasive procedure(s) cageside.
Acronyms Definitions
FAST

Focused Assessment with Sonography for Trauma, Triage and Tracking

AFAST® 5-view abdominal FAST protocol that incorporates a target-organ approach
(soft tissue screening test of the abdomen) and an abdominal fluid scoring system. 
The caudal vena cava is also assessed at its Diaphragmatico-Hepatic View.
TFAST® 5-view thoracic FAST protocol used to detect pleural and pericardial effusion,
assess echocardiography views, and pneumothorax, while also serving as a soft
tissue screening test of the heart. The caudal vena cava is also assessed at its
Diaphragmatico-Hepatic View.
Vet BLUE® 9-view lung ultrasound protocol with a B-line scoring system and a visual lung language
used as a soft tissue screening test of lung. Findings are synthesized using a regional,
pattern-based lung ultrasound approach. 
Global FAST® Combined use of AFAST®, TFAST® and Vet BLUE®  
Abbreviations and Terms
AFS AFAST®-applied Abdominal Fluid Score
CVC Caudal Vena Cava
CVP Central Venous Pressure
GFAST Global FAST®
POCUS Point-of-Care Ultrasound
PTX Pneumothorax
UOP Urine Output
Urinary Bladder Estimation Formula Length (cm) x Height (cm) x Width (cm) x 0.625 = Volume (ml)
VPOCUS Veterinary Point-of-Care Ultrasound
Satisfaction of Search Error Satisfaction of search error is a common error in diagnostic radiology
that occurs when the reporting radiologist fails to continue to search for
subsequent abnormalities after identifying an initial one.

Introduction

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Global FAST® approach

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TFAST® echo views

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Global FAST® non-echo fallback views

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AFAST®-TFAST® diaphragmatico-hepatic view evaluation of CVC

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Global FAST® evaluation of the source of volume loss

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AFAST®-applied abdominal fluid scoring system

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AFAST® cysto-colic view bladder volume estimation formula

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TFAST® pneumothorax (PTX) 1/3s rule

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Further Reading

Publications

Refereed Papers

  • Recent references from VetMed Resource and PubMed.
  • Dicker S A, Lisciandro G R, Newell S M et al (2019) Diagnosis of pulmonary contusions with point-of-care lung ultrasonography and thoracic radiography compared to thoracic computed tomography in dogs with motor vehicle trauma: 29 cases (2017-2018). J Vet Emerg Crit Care In Press.
  • Lisciandro G R, Fosgate G T, Romero L A et al (2019) The frequency and amount of free peritoneal fluid estimated using abdominal FAST- applied abdominal fluid scores in clinically normal adult and juvenile dogs. J Vet Emerg Crit Care In Press.
  • Ward J L, Lisciandro G R, Ware W A et al (2019) Lung ultrasound findings in 100 dogs with various etiologies of cough. J Am Vet Med Assoc In Press.
  • Cambournac M, Goy-Thollot I, Violé A et al (2018) Sonographic assessment of volaemia: development and validation of a new method in dogs. J Small Anim Pract  59(3), 174-182 PubMed.
  • Darnis E, Boysen S, Merveille A C et al (2018) Establishment of references values of the caudal vena cava by fast-ultrasonography through different views in healthy dogs. J Vet Intern Med 32(4), 1308-1318 PubMed.
  • Kwak J, Yoon H, Kim J et al (2018) Ultrasonographic measurement of caudal vena cava to aorta ratios for determination of volume depletion in normal beagle dogs.  Vet Radiol Ultrasound  59(2), 203-211 PubMed.
  • Marshall K A, Thomovsky E J, Brooks A C et al (2018) Ultrasound measurements of the caudal vena cava before and after blood donation in 9 greyhound dogs. Can Vet J 59(9), 973-980 PubMed.
  • Bucci M, Rabozzi R, Gugliemini C et al (2017) Respiratory variation in aortic blood peak velocity and caudal vena cava diameter can predict fluid responsiveness in anesthetized and mechanically ventilated dogs.  Vet J 227, 30-35 PubMed
  • Lisciandro G R, Fosgate G T (2017) Use of AFAST Cysto-Colic View Urinary Bladder Measurements to Estimate Urinary Bladder Volume in Dogs and Cats. J Vet Emerg Crit Care 27(6), 713-717 PubMed.
  • Lisciandro G R, Fulton R M, Fosgate G T, Mann K A (2017) Frequency of B-lines using a regionally-based lung ultrasound examination (the Vet BLUE protocol) in 49 cats with normal thoracic radiographical lung findings.  J Vet Emerg Crit Care 27(3), 267-277.
  • Vezzosi T, Mannucci A, Pistoresi F et al (2017) Assessment of Lung Ultrasound B‐Lines in Dogs with Different Stages of Chronic Valvular Heart Disease. J Vet Intern Med 31(3), 700-704 PubMed.
  • Ward J L, Lisciandro G R, Keene B W et al (2017) Accuracy of point-of-care lung ultrasonography for the diagnosis of cardiogenic pulmonary edema in dogs and cats with acute dyspnea. J Am Vet Med Assoc 250, 666-675 PubMed.
  • Lisciandro G R (2016) The use of the diaphragmatico-hepatic (DH) views of the abdominal and thoracic focused assessment with sonography for triage (AFAST/TFAST) examinations for the detection of pericardial effusion in 24 dogs (2011-2012). J Vet Emerg Crit Care 26(1), 125-31 PubMed.
  • Lisciandro G R, Ward J L, DeFrancesco T C, Mann K A (2016) Absence of B-lines on Lung Ultrasound (Vet BLUE protocol) to Rule Out Left-sided Congestive Heart Failure in 368 Cats and Dogs. J Vet Emerg Crit Care 26(S1), S8 Abstract.
  • Meneghini C, Rabozzi R, Franci P (2016) Correlation of the ratio of caudal vena cava diameter and aorta diameter with systolic pressure variation in anesthetized dogs. Am J Vet Res 77(2), 137-143 PubMed.
  • Lisciandro G R, Fosgate G T, Fulton R M (2014) Frequency of ultrasound lung rockets using a regionally-based lung ultrasound examination named veterinary bedside lung ultrasound exam (Vet BLUE) in 98 dogs with normal thoracic radiographic lung findings. Vet Radiol Ultrasound​ 55(3), 315-22 PubMed.
  • Rademacher N, Pariaut R, Pate J et al (2014) Transthoracic lung ultrasound in normal dogs and dogs with cardiogenic pulmonary edema: a pilot study. Vet Radiol Ultrasound 55(4), 447-452 PubMed.
  • Volpicelli G, Boero E, Stefano V et al (2013) Unusual new signs of pneumothorax at lung ultrasound. Crit Ultrasound J  5(1), 10 doi: 10.1186/2036-7902-5-10 PubMed.
  • Dipti A, Soucy Z, Surana A et al (2012) Role of inferior vena cava diameter in assessment of volume status: a meta-analysis. Am J Emerg Med 30(8), 1414-1419 PubMed.
  • Ferrada P, Attand R J, Whelan J et al (2012) Qualitative assessment of the inferior vena cava: useful tool for the evaluation of volume status in critically ill patients. Am Surg 78(4), 468-470 PubMed.
  • Ferrada P, Vanguri P, Anand R J et al (2012) Flat inferior vena cava: indicator of poor prognosis in trauma and acute care surgery patients. Am Surg 78(12), 1396-1398 PubMed.
  • Lisciandro G (2012) Evaluation of initial and serial combination focused assessment with sonography for trauma (CFAST) examinations of the thorax (TFAST) and abdomen (AFAST) with the application of an abdominal fluid scoring system in 49 cats. J Vet Emerg Crit Care 22(S2), S11 Abstract.
  • Volpicelli G, Elbarbary M, Blaivas M et al (2012) International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 38, 577-591 PubMed.
  • Lisciandro G R (2011) Abdominal and thoracic focused assessment with sonography for trauma, triage and monitoring in small animals. J Vet Emerg Crit Care 21(2),104-122 PubMed.
  • Lichtenstein D A (2010) Should lung ultrasonography be more widely used in the assessment of acute respiratory disease? Expert Rev Resp Med 4(5), 533-538.
  • Nelson N C, Drost W T, Lerche P et al (2010) Noninvasive estimation of central venous pressure in anesthetized dogs by measurement of hepatic venous blood flow velocity and abdominal venous diameter. Vet Radiol & Ultrasound 51(3), 313- 323 PubMed.
  • Perera P, Mailhot T, Riley D et al (2010) The RUSH exam: Rapid Ultrasound in SHock in the evaluation of the critically lll. Emerg Med Clin North Am 28(1), 29-56 PubMed.
  • Lichtenstein D, Mezière  G, Lagoueyte J F et al (2009) A-lines and B-lines: lung ultrasonography as a bedside tool for predicting pulmonary artery occlusion pressure in the critically ill. Chest 136, 1014-1020 PubMed.
  • Lisciandro G R, Lagutchik M S, Mann K A et al (2009) Evaluation of an abdominal fluid scoring (AFS) system determined using abdominal focused assessment with sonography for trauma (AFAST) in 101 dogs with motor vehicle trauma. J Vet Emerg Crit Care 19(5), 426-437 PubMed.
  • Lisciandro G R, Lagutchik M S, Mann K A et al (2008) Accuracy of Focused Assessment with Sonography for Trauma (TFAST) to detect pneumothorax in 145 dogs with blunt and penetrating trauma. J Vet Emerg Crit Care 18(3), 258-269.
  • Atalan G, Barr F J, Holt P E (1999) Frequency of urination and ultrasonographic estimation of residual urine in normal and dysuric dogs. Res Vet Sci 67(3), 295-299 PubMed.

Other sources of information

  • Lisciandro G R (2019) Chapter 36: POCUS: Global FAST for Patient Monitoring and Staging.  In: Point-of-Care Ultrasound for the Small Animal Practitioner, edited by Lisciandro G R. Wiley-Blackwell: Ames, IA, In Press.
  • Lisciandro G R (2019) Chapter 3: Point-of-care Ultrasound. In: Small Animal Diagnostic Ultrasound, edited by Mattoon J S, Sellon R, and Berry C R.  Elsevier: St. Louis, MO, In Press.
  • Lisciandro G R (2014) Chapter 9: The Thoracic FAST3 (TFAST3) Exam. In: Focused Ultrasound for the Small Animal Practitioner, edited by Lisciandro G R. Wiley Blackwell: Ames IA, pp 140-165.
  • Lisciandro G R (2014) Chapter 10: The Vet BLUE Lung Scan. In: Focused Ultrasound for the Small Animal Practitioner, edited by Lisciandro GR. Wiley Blackwell: Ames IA, pp 166-188.
  • DeFrancesco T C (2014) Chapter 11: Focused or COAST3 - Echo (Heart). In: Focused Ultrasound for the Small Animal Practitioner, edited by Lisciandro GR. Wiley Blackwell: Ames IA, pp 189-205.
  • Lisciandro G R (2014) Chapter 55: Ultrasound in animals. In: Critical Care Ultrasound (Human Ultrasound Textbook), Ed. Lumb and Karakitsos, Elsevier: St. Louis.
  • Lisciandro G R, Armenise A A (2014) Chapter 16: Focused or COAST3 - Cardiopulmonary Resuscitation (CPR), Global FAST (GFAST3), and the FAST-ABCDE Exam.  In: Focused Ultrasound for the Small Animal Practitioner, edited by Lisciandro GR. Wiley Blackwell: Ames IA, pp 269-285.
  • Candotti C, Arntfield R (2014) Chapter 17: Pericardial Effusion. In: Point-of-Care Ultrasound, edited by Soni NJ, Arntfield R, and Kory P. Elsevier: Philadephia PA, pp. 130-134.
  • Tchernodrinski S, Arntfield R (2014)  Chapter 18: Inferior Vena Cava.  In: Point-of-Care Ultrasound, Edited by Soni NJ, Arntfield R, and Kory P. Elsevier: Philadephia PA, pp. 135-141.

Organisation(s)

  • FASTVet.com provides online resources for learning AFAST®, TFAST®, Vet BLUE® and Global FAST®.


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