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ultrasound during cardiopulmonary resuscitation

Justin K Lui, Gisela I Banauch
Bedside goal-directed ultrasound is a powerful tool for rapid differential diagnosis and monitoring of cardiopulmonary disease in the critically ill patient population. The bedside intensivist is in a unique position to integrate ultrasound findings with the overall clinical situation. Medically critically ill patients who require urgent bedside diagnostic assessment fall into 2 categories: (1) acute respiratory failure and (2) hemodynamic derangements. The first portion of this review outlines the diagnostic role of bedside ultrasound in the medically critically ill patient population for the diagnosis and treatment of acute respiratory failure, acute respiratory distress, and severe hypoxemia...
July 8, 2016: Journal of Intensive Care Medicine
D C Mandel, P G Pryde, D M Shah, J I Iruretagoyena
Cardiopulmonary bypass, the extreme of non-obstetric surgery during pregnancy, presents unique challenges to minimize maternal and fetal risk. We present our experience with a woman who was diagnosed with a left atrial myxoma following an ischemic cerebrovascular accident. We discuss clinical management specific to cardiopulmonary bypass during pregnancy and delivery in the context of a multidisciplinary team approach. We recommend using intermittent Doppler ultrasound as a non-invasive real-time assessment of uteroplacental perfusion during non-obstetric surgery in pregnancy...
August 2016: International Journal of Obstetric Anesthesia
Suat Zengin, Erdal Yavuz, Behçet Al, Şener Cindoruk, Gökhan Altunbaş, Hasan Gümüşboğa, Cuma Yıldırım
UNLABELLED: The purpose of this study was to evaluate a rapid cardiac ultrasound assessment performed by trained non-expert sonographers integrated into the advanced cardiac life support (ACLS). MATERIAL AND METHODS: This study was prospectively performed in 179 patients (104 males and 75 females) who underwent cardiopulmonary resuscitation (CPR) in an emergency department (ED) during two calendar years (2013 and 2014). Two senior doctors, who had received emergency cardiac ultrasonography training, performed cardiac ultrasound through the apical, subxiphoid, or parasternal windows...
May 2016: Resuscitation
Takashi Cho, Nobuyasu Komasawa, Masanori Haba, Shunsuke Fujiwara, Ryosuke Mihara, Toshiaki Minami
PURPOSE: Recent guidelines for cardiopulmonary resuscitation emphasize that all rescuers should minimize the interruption of chest compressions, even for intravenous access. We assessed the utility of needle guides during ultrasound-guided central venous catheterization (US-CVC) with chest compressions via simulation. METHODS: Twenty-five anesthesiologists with more than 2years of experience performed US-CVC on a manikin with or without a needle guide and with or without chest compressions...
June 2016: American Journal of Emergency Medicine
C Engelen, C Trebes, S Czarnecki, A Junger
Central venous catheterization is an invasive procedure which can be associated with severe complications. These include in particular unsuccessful arterial puncture and vascular injuries, which in addition to loss of blood can lead to massive soft tissue swelling. A 63-year-old female patient developed massive cervical bleeding during ultrasound-guided internal jugular vein puncture and the rapidly enlarging hematoma led to compromisation of the airway. A cannot intubate, cannot ventilate situation developed and the subsequent hypoxia led to cardiac arrest that was only resolved after emergency surgical tracheotomy during cardiopulmonary resuscitation...
March 2016: Der Anaesthesist
Jacek A Wojtczak, Davide Cattano
Waveform capnography was recommended as the most reliable method to confirm correct endotracheal tube or laryngeal mask airway placements. However, capnography may be unreliable during cardiopulmonary resuscitation and during low flow states. It may lead to an unnecessary removal of a well-placed endotracheal tube, re-intubation and interruption of chest compressions. Real-time upper airway (laryngo-tracheal) ultrasonography to confirm correct endotracheal tube placement was shown to be very useful in cadaveric models and during emergency intubation...
December 2014: Journal of Ultrasonography
Gerard O'Connor, Gareth Fitzpatrick, Ayman El-Gammal, Peadar Gilligan
More than 70% of cardiac arrest cases are caused by acute myocardial infarction (AMI) or pulmonary embolism (PE). Although thrombolytic therapy is a recognised therapy for both AMI and PE, its indiscriminate use is not routinely recommended during cardiopulmonary resuscitation (CPR). We present a case describing the successful use of double dose thrombolysis during cardiac arrest caused by pulmonary embolism. Notwithstanding the relative lack of high-level evidence, this case suggests a scenario in which recombinant tissue Plasminogen Activator (rtPA) may be beneficial in cardiac arrest...
2015: Case Reports in Emergency Medicine
Angelo Polito, Daniele G Biasucci, Paola Cogo
We report the case of a 12-day-old newborn affected by coarctation of the aorta and intraventricular defect who underwent coarctectomy and pulmonary artery banding. On post-operative day 7, the patient suffered from pulseless electric activity due to tension pneumothorax. Point-of-care ultrasound was performed during cardiopulmonary resuscitation in an attempt to diagnose pneumothorax. The diagnosis was made without delaying or interrupting chest compressions, and the pneumothorax was promptly treated.
February 2016: Cardiology in the Young
Adeyinka A Adedipe, Deborah L Fly, Scott D Schwitz, Dawn B Jorgenson, Haris Duric, Michael R Sayre, Graham Nichol
OBJECTIVE: High quality chest compressions are the cornerstone of effective cardiopulmonary resuscitation (CPR). There is no available method of real time noninvasive hemodynamic measurement and feedback to inform rescuers of the efficacy of compressions. Ultrasound-based measures of blood flow may provide immediate, noninvasive hemodynamic information. Our objective was to determine the feasibility and safety of using ultrasound to measure blood flow on patients with cardiac arrest. METHODS: Study design This was a prospective cohort study in an emergency department setting...
November 2015: Resuscitation
Feico J J Halbertsma, Thilo Mohns, Levinus A Bok, Hendrik J Niemarkt, Boris W Kramer
BACKGROUND: Chest compressions (CC) during cardiopulmonary resuscitation (CPR) are the cornerstone of adult CPR protocols and are meant to restore circulation and improve outcome. Although adverse effects such as air-embolisms have been reported, these are rare and considered to be outweighed by beneficial effect. In newborns, however, the lung tissue is more fragile. Thus, the high intra-thoracic pressures resulting from CC may make the newborns more vulnerable for air-embolisms. OBJECTIVES: We studied the postmortem prevalence of air-embolism in neonates that have received CPR...
August 2015: Resuscitation
Adam R Parks, Glenn Verheul, Denise LeBlanc-Duchin, Paul Atkinson
BACKGROUND: Goal-directed point-of-care ultrasound (PoCUS) protocols have been shown to improve the diagnostic accuracy of the initial clinical assessment of the critically ill patient. The diagnostic impact of the Abdominal and Cardiac Evaluation with Sonography in Shock (ACES) protocol was assessed in simulated emergency medical scenarios. METHODS: Following a focused PoCUS training program, the diagnostic accuracy, confidence, and precision of 12 medical learners participating in standardized scenarios were tested using high-fidelity clinical and ultrasound simulators...
May 2015: CJEM
Jainn-Jim Lin, Shao-Hsuan Hsia, Huei-Shyong Wang, Ming-Chou Chiang, Kuang-Lin Lin
AIM OF THE STUDY: The aim of the present study was to assess the cerebral flow in children receiving therapeutic hypothermia after resuscitation. The prognostic value of transcranial Doppler findings was correlated with the clinical outcomes in these children. METHODS: A retrospective cohort study was conducted at the paediatric intensive care unit of Chang Gung Children's Hospital between January 2011 and December 2012. All children from 1 month to 18 years of age who received therapeutic hypothermia after resuscitation were eligible...
April 2015: Resuscitation
Mirko Zanatta, Piero Benato, Vito Cianci
No abstract text is available yet for this article.
January 22, 2015: Resuscitation
Élizabeth Lalande, Francis Fournier
A shortcut review was carried out to establish whether transtracheal ultrasonography can reliably identify tracheal placement of and endotracheal tube during cardiac arrest. Using the reported searches, 260 papers were found of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this best paper are tabulated. It is concluded that transtracheal ultrasonography may be a supplementary tool for establishing the correct tracheal tube placement in cardiac arrest...
December 2014: Emergency Medicine Journal: EMJ
H Cebicci, O Salt, S Gurbuz, S Koyuncu, O Bol
INTRODUCTION: Cardiopulmonary resuscitation (CPR) is the most important intervention that connects the cardiopulmonary arrests (CPA), to life. Ultrasonography  (USG) is used to detect the presence of cardiac activity during CPR. METHODS: Files of the patiens, admitted to Kayseri Training and Research Hospital during one calendar year (2011) and suffered CPA were retrospectively evaluated by using hospital information management system. Patients enrolled in the study should have arrival electrocardiogram and cardiac ultrasound performed and  recorded...
April 2014: Hippokratia
Elisabeth Dovern, Marlene R Mende, Niels J Elderson, Eelko Ronner, Steven J Sleeswijk Visser
Massive pulmonary embolism has a high mortality rate. Standard treatment includes systemic thrombolysis. If this fails, surgical embolectomy or a percutaneous catheter-guided approach is advised in current guidelines. However, these treatment options might not be available in many non-tertiary care hospitals. We describe a case of a 25-year old woman with cardiac arrest from massive pulmonary embolism. She was treated with thrombus fragmentation using a pulmonary artery catheter and intra-pulmonary thrombolysis after failure of systemic thrombolysis along with 90 minutes of cardiopulmonary resuscitation (CPR)...
2014: Acute Medicine
Christoph Sponholz, Christoph Schelenz, Konrad Reinhart, Uwe Schirmer, Sebastian N Stehr
BACKGROUND: Management of cardiac surgery patients is a very standardized procedure in respective local institutions. Yet only very limited evidence exists concerning optimal indication, safety and efficacy of hemodynamic monitoring catecholamine and fluid therapy. METHODS: Between April and May 2013, all 81 German anaesthesia departments involved in cardiac surgery care were asked to participate in a questionnaire addressing the institutional specific current practice in hemodynamic monitoring, catecholamine and volume therapy...
2014: PloS One
Rolf P Engelberger, Aris Moschovitis, Jennifer Fahrni, Torsten Willenberg, Frederic Baumann, Nicolas Diehm, Do-Dai Do, Iris Baumgartner, Nils Kucher
AIMS: No standardized local thrombolysis regimen exists for the treatment of pulmonary embolism (PE). We retrospectively investigated efficacy and safety of fixed low-dose ultrasound-assisted catheter-directed thrombolysis (USAT) for intermediate- and high-risk PE. METHODS AND RESULTS: Fifty-two patients (65 ± 14 years) of whom 14 had high-risk PE (troponin positive in all) and 38 intermediate-risk PE (troponin positive in 91%) were treated with intravenous unfractionated heparin and USAT using 10 mg of recombinant tissue plasminogen activator per device over the course of 15 h...
March 7, 2015: European Heart Journal
Teresa S Wu
Critically ill patients require rapid, accurate assessments and appropriate therapeutic interventions to maximize their chances of recovery. Often the cause of a patient's decompensation is not readily apparent based solely on history and physical examination findings. The Concentrated Overview of Resuscitative Efforts (CORE scan) is a compilation of targeted bedside ultrasound exams that should be performed during the assessment and management of critically ill patients. The CORE scan can be used to help make critical diagnoses and guide resuscitation efforts in patients with undifferentiated deterioration...
January 2014: Critical Care Clinics
Michael Blaivas
No abstract text is available yet for this article.
December 2013: Resuscitation
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