Transforming Perioperative Safety: A Clinical Review of Multi-Organ Point-of-Care Ultrasound (POCUS) and Technical Stewardship in Anesthesia Care

Abstract

Background: Conventional perioperative monitoring relies primarily on static hemodynamics and external anatomical landmarks, which frequently fail to detect acute cardiopulmonary collapse or anatomical challenges in real time. Point-of-Care Ultrasound (POCUS) has emerged as an essential bedside diagnostic and procedural adjunct across the perioperative continuum.

Objectives: To synthesize contemporary clinical evidence regarding multi-organ perioperative sonography, detail clinical decision algorithms, and define the operational role of anesthesia technologists in equipment stewardship.

Methods: A comprehensive, systematic literature search was conducted in PubMed, Scopus, Google Scholar, and the Cochrane Library for peer-reviewed studies published between 2020 and 2026 that focused on perioperative multi-organ POCUS applications.

Results: Bedside gastric sonography objectively stratifies aspiration risk by identifying elevated residual volumes (> 1.5 mL/kg). Airway sonography improves the prediction of difficult direct laryngoscopy and facilitates rapid cricothyroid membrane localization. During acute instability, Focused Cardiac Ultrasound (FoCUS) and Lung Ultrasound (LUS) categorize shock etiologies and quantify atelectasis. Real-time dynamic guidance serves as the standard of care for vascular access and regional blocks.

Conclusion: Multi-organ POCUS transforms perioperative diagnostic precision and procedural safety. Maximizing clinical utility requires structured training programs and rigorous technical stewardship by anesthesia technologists in transducer selection, optimization, and disinfection