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In Reply We agree with Dr Hyzy that focused ultrasonography is a diagnostic technique to consider as part of multimodal hemodynamic assessment during the care of select patients with septic shock, as illustrated in the Figure in our article. As suggested by Hyzy, our systematic review of the recent literature found no RCTs testing this device or its application in clinical practice (grade C evidence—expert opinion).
We agree that more rigorous standards for training and scientific testing are warranted because ultrasound assessments may be obtained frequently and in a timely manner,1 with relatively low risk,2 and may help to identify the significant proportion of patients with septic shock and concomitant myocardial dysfunction or hypovolemia.3
Seymour CW, Rosengart MR. Bedside Ultrasonography for Diagnosis of Septic Shock—Reply. JAMA. 2016;315(1):89-90. doi:10.1001/jama.2015.15073