Feasibility and clinical value of nurse-led point-of-care ultrasound screening for prethrombotic state in postoperative cardiac ICU patients: a cross-sectional study

Feasibility and clinical value of nurse-led point-of-care ultrasound screening for prethrombotic state in postoperative cardiac ICU patients: a cross-sectional study

Authors

  • Jingjing Cheng Department of Intensive Care Medical Center, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
  • Lu Liu Department of Intensive Care Medical Center, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
  • Xuemei Tang Department of Intensive Care Medical Center, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
  • Chunlin Xiang Department of Intensive Care Medical Center, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
  • Yiwei Qin The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
  • Yi Zhang Department of Intensive Care Medical Center, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
  • Zhenjie Jiang Department of Intensive Care Medical Center, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
  • Xiaoting Zeng Department of Respiratory and Critical Care Medicine, Wenjiang District People’s Hospital, Chengdu, China
  • Ying Wu Department of Intensive Care Unit, Chengdu Fourth People’s Hospital, Chengdu, China
  • Xiaoyu Chen Department of Intensive Care Medical Center, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
  • Fengchun Liu Department of Intensive Care Medical Center, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
  • Xiaoxiao Wu Department of Intensive Care Medical Center, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
  • Yiping Wang Department of Intensive Care Medical Center, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China

Keywords:

Nurse-led POCUS, Prethrombotic state, Cardiac surgical procedures, Interprofessional relations, Critical care nursing

Abstract

Background: Postoperative cardiac ICU patients are at increased risk of developing venous thromboembolism (VTE), yet early identification of prethrombotic state (PTS) remains challenging. Nurse-led point-of-care ultrasound (POCUS) offers a non-invasive, real-time tool for vascular screening that may enhance early risk stratification.

Objectives: To determine the prevalence of PTS in postoperative cardiac ICU patients using a nurse-led POCUS protocol, identify associated clinical risk factors, and evaluate the feasibility and clinical value of integrating this screening model into routine nursing care within an interprofessional framework.

Methods: This cross-sectional study included 123 adult patients following cardiac surgery. ICU nurses trained in POCUS independently performed bedside color Doppler scans to detect the “blizzard” sign in lower limb veins. Demographic, clinical, and laboratory data were collected. Multivariate logistic regression was used to identify independent predictors of PTS. The nurse-led POCUS protocol was implemented collaboratively with doctors, who provided image verification and clinical oversight as needed.

Results: The “blizzard” sign was observed in 61.8% of patients, most commonly in the popliteal and posterior tibial veins. Nine patients developed deep vein thrombosis, all of whom had prior severe, diffuse-type “blizzard” signs. Independent predictors of PTS included prolonged bed rest (OR 1.016, P = 0.031), elevated peak platelet count (OR 1.007, P = 0.041), and increased postoperative C-reactive protein levels (OR 1.015, P < 0.001). The nurse-led POCUS protocol was implemented successfully with doctor oversight and demonstrated high feasibility and diagnostic yield.

Conclusion: Nurse-led POCUS is a feasible, non-invasive approach for early identification of PTS in postoperative cardiac ICU patients. Embedding such screening protocols into nursing workflows may support timely thromboprophylaxis, expand nursing roles in advanced assessment, and enhance interprofessional ICU care delivery.

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Published

2025-10-14

Issue

Vol. 17 No. 1 (2025): The Ultrasound Journal 2025; volume 17

Section

Original Research Papers

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Copyright (c) 2025 Jingjing Cheng, Lu Liu, Xuemei Tang, Chunlin Xiang, Yiwei Qin, Yi Zhang, Zhenjie Jiang, Xiaoting Zeng, Ying Wu, Xiaoyu Chen, Fengchun Liu, Xiaoxiao Wu, Yiping Wang (Author)

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How to Cite

1.
Cheng J, Liu L, Tang X, et al. Feasibility and clinical value of nurse-led point-of-care ultrasound screening for prethrombotic state in postoperative cardiac ICU patients: a cross-sectional study. Ultrasound J. 2025;17(1):52. Accessed January 30, 2026. https://www.mattioli1885journals.com/index.php/theultrasoundjournal/article/view/18169