Objective  The purpose of this study was to investigate the evaluating value of the modified critical care ultrasonic examination (M-CCUE) protocol for those patients unplanned admission to the ICU and to analyze whether it could influence the management decision and predict the outcome.

  Methods  The clinical data of patients unplanned admission to the department of critical care medicine of Peking Union Medical College Hospital from December 2015 to June 2016 were collected and analyzed retrospectively, including the hemodynamic index, organ and tissue perfusion index, and prognosis evaluating index. All the enrolled patients received the M-CCUE within 30 minutes after admission to our department and were scored according to the M-CCUE scoring system (MCS). The correlation between MCS and the prognosis and its effect on the management decision were analyzed.

  Results  A total of 272 patients who met the inclusion and exclusion criteria were enrolled in this study. Only 3 patients (1.1%, 3/272)did not show any anomaly in M-CCUE; the management decision of 138 patients (50.7%, 138/272), was adjusted; 81 patients (29.8%, 81/272) underwent additional invasive diagnostic procedures or treatment. The univariate analysis revealed that MCS correlated positively with the 28-day mortality (r=0.432, P=0.020), 48-hour mortality (r=0.594, P=0.008), ventilator time (r=0.454, P=0.040), and length of ICU stay (r=0.563, P=0.003). The multivariate analysis demonstrated that age, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), MCS, and sequential organ failure assessment score were the independent risk factors for the 28-day mortality, while age, MCS, and sequential organ failure assessment score were the independent risk factors for the 48-hour mortality.

  Conclusions  M-CCUE protocol can achieve the early bedside cardiopulmonary function assessment; its quantitative assessment results are associated with the prognosis and might improve the clinical management decision.