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https://www.readbyqxmd.com/read/29231781/dynamic-autoregulation-of-cerebral-blood-flow-measured-non-invasively-with-fast-diffuse-correlation-spectroscopy
#1
Ashwin B Parthasarathy, Kimberly P Gannon, Wesley B Baker, Christopher G Favilla, Ramani Balu, Scott E Kasner, Arjun G Yodh, John A Detre, Michael T Mullen
Cerebral autoregulation (CA) maintains cerebral blood flow (CBF) in the presence of systemic blood pressure changes. Brain injury can cause loss of CA and resulting dysregulation of CBF, and the degree of CA impairment is a functional indicator of cerebral tissue health. Here, we demonstrate a new approach to noninvasively estimate cerebral autoregulation in healthy adult volunteers. The approach employs pulsatile CBF measurements obtained using high-speed diffuse correlation spectroscopy (DCS). Rapid thigh-cuff deflation initiates a chain of responses that permits estimation of rates of dynamic autoregulation in the cerebral microvasculature...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29230709/point-of-care-gastric-ultrasound-and-aspiration-risk-assessment-a-narrative-review
#2
Anahi Perlas, Cristian Arzola, Peter Van de Putte
This narrative review summarizes the current knowledge on point-of-care ultrasound (POCUS) of gastric contents in order to inform an assessment of aspiration risk and guide anesthetic management at the bedside. An I-AIM framework (Indication, Acquisition, Interpretation, and Medical decision-making) is used to summarize and organize the content areas. This narrative review spans the breadth of the literature on pediatric and adult subjects as well as on special patient populations such as obstetric and severely obese individuals...
December 11, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29225889/efficacy-of-sonographic-and-biological-pleurodesis-indicators-of-malignant-pleural-effusion-simple-protocol-of-a-randomised-controlled-trial
#3
Ioannis Psallidas, Hania E G Piotrowska, Ahmed Yousuf, Nikolaos I Kanellakis, Gayathri Kagithala, Seid Mohammed, Lei Clifton, John P Corcoran, Nicky Russell, Melissa Dobson, Robert F Miller, Najib M Rahman
Introduction: Malignant pleural effusion (MPE) is common and currently in UK there are an estimated 50 000 new cases of MPE per year. Talc pleurodesis remains one of the most popular methods for fluid control. The value of thoracic ultrasound (TUS) imaging, before and after pleurodesis, in improving the quality and efficacy of care for patients with MPE remains unknown. Additionally, biomarkers of successful pleurodesis including measurement of pleural fluid proteins have not been validated in prospective studies...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/29209928/subclavian-and-axillary-vessel-anatomy-a-prospective-observational-ultrasound-study
#4
Catherine Lavallée, Christian Ayoub, Asmaa Mansour, Jean Lambert, Jean-Sébastien Lebon, Manoj M Lalu, André Denault
PURPOSE: The primary objective of this study was to define the ultrasound-derived anatomy of the axillary/subclavian vessels. As a secondary objective, we evaluated the relationship between the vascular anatomy and demographic, anthropometric, and hemodynamic data of patients. METHODS: This observational anatomical study used bedside ultrasound with 150 cardiac surgical patients in the operating room. Bilateral axillary and subclavian anatomy was determined using a high-frequency ultrasound probe with fixed reference points...
December 5, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29207924/speckle-tracking-in-transcranial-ultrasound-allows-noninvasive-analysis-of-pulsation-patterns-of-the-third-ventricle
#5
Benjamin Würzer, Cristina Laza, Jörn Pons-Kühnemann, Manfred Kaps, Bernd Junge, Florian C Roessler
Cerebrospinal fluid (CSF) flow is sensitive to many cerebral disorders. We aimed to develop a noninvasive bedside method to detect physiological and pathological CSF phenomena by measuring pulsation patterns of the third ventricle. By transcranial B-mode ultrasound, electrocardiography (ECG)-gated video loops of the third ventricle were acquired. "Speckle tracking" software was used to quantify the relative change of its width. We conducted measurements of nine cardiac cycles in 11 healthy subjects in sitting and in supine position during Valsalva maneuver to investigate the influence of an increased intracranial pressure on the relative deformation of the third ventricle...
December 1, 2017: Ultrasonic Imaging
https://www.readbyqxmd.com/read/29204338/giant-left-atrium-encountered-during-right-sided-thoracentesis
#6
Rashmi Advani, Benjamin T Galen
Giant left atrium is an uncommon pathology to encounter during bedside chest ultrasound, but is an important structure to be aware of when considering thoracentesis. This cardiac structure could easily be mistaken for loculated pleural fluid. This case also supports growing evidence that expert users can safely perform thoracentesis without completely reversing therapeutic anticoagulation.
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29202259/bedside-lung-ultrasound-in-the-care-of-the-critically-ill
#7
Máté Rudas, Sam Orde, Marek Nalos
OBJECTIVE: To describe the technique and review the utility of bedside lung ultrasound in acute care. SUMMARY: Lung ultrasound is a useful point-of-care investigation in acute care, especially in patients with dyspnoea or haemodynamic instability. Although normal lung parenchyma is not accessible to ultrasound, distinctive artefacts arising from parietal and visceral pleura indirectly imply the presence of normal lung. As aeration of lung tissue reduces with disease process, visual assessment of several pathologic entities by ultrasound becomes possible...
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29189495/lumbar-spine-anatomy-in-women-sustaining-unintentional-dural-puncture-during-labor-epidural-placement-a-descriptive-study-using-magnetic-resonance-imaging-and-ultrasound
#8
Nicholas M Barrett, Cristian Arzola, Timo Krings, Kristi Downey, Jose C A Carvalho
BACKGROUND AND OBJECTIVES: Unintentional dural puncture is one of the most frequent complications of the epidural technique. One previous study suggested that atypical sonoanatomy of the ligamentum flavum/dura mater unit may be a risk factor for this complication. In this study, we describe the anatomy of the lumbar spine, assessed by magnetic resonance imaging (MRI) and ultrasound, in women sustaining unintentional dural puncture during epidural catheter placement for labor analgesia...
November 15, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29189342/the-diagnostic-accuracy-of-ultrasound-in-detecting-distal-radius-fractures-in-a-pediatric-population
#9
Chae Ko, Matthew Baird, Matthew Close, Kyle J Cassas
OBJECTIVE: Sports ultrasound (US) is becoming popular in diagnosing musculoskeletal injuries. This study, also called the Pediatric Distal Radius Ultrasound Study (PeDRUS), compared the diagnostic accuracy of sports US with plain radiographs in possible distal radius buckle fractures in pediatric population. METHODS: In this prospective observational study, patients (2-15 years) presenting to an outpatient orthopedic injury clinic with distal forearm injuries without deformity were recruited...
November 15, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29182210/the-role-of-point-of-care-ultrasound-in-intra-abdominal-hypertension-management
#10
Bruno M Pereira, Renato G Pereira, Robert Wise, Gavin Sugrue, Tanya L Zachrison, Alcir E Dorigatti, Rossano K Fiorelli, Manu L N G Malbrain
BACKGROUND: Intra-abdominal hypertension is a common complication in critically ill patients. Recently the Abdominal Compartment Society (WSACS) developed a medical management algorithm with a stepwise approach according to the evolution of the intra-abdominal pressure and aiming to keep IAP ≤ 15 mm Hg. With the increased use of ultrasound as a bedside modality in both emergency and critical care patients, we hypothesized that ultrasound could be used as an adjuvant point-of-care tool during IAH management...
November 28, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29180495/handheld-echocardiography-current-state-and-future-perspectives
#11
REVIEW
Mohammed A Chamsi-Pasha, Partho P Sengupta, William A Zoghbi
Echocardiography is the primary imaging modality for diagnosing cardiac conditions. Over the past 2 decades, technological advancements have resulted in the emergence of miniaturized handheld ultrasound equipment that is compact and battery operated, and handheld echocardiography can be readily performed at the point of care with reasonable image quality. The simplicity of use, availability at the patient's bedside, easy transportability, and relatively low cost have encouraged physicians to use these devices for prompt medical decision making...
November 28, 2017: Circulation
https://www.readbyqxmd.com/read/29174452/diagnosing-centrally-located-pulmonary-embolisms-in-the-emergency-department-using-point-of-care-ultrasound
#12
Kristin H Dwyer, Joshua S Rempell, Michael B Stone
OBJECTIVE: The study objective was to investigate the combined accuracy of right heart strain on focused cardiac ultrasound (FOCUS) and deep vein thrombosis (DVT) on compression ultrasound (CUS) for identification of centrally located pulmonary embolism (PE) diagnosed on computed tomography pulmonary angiography (CTPA). METHODS: This was a prospective observational study using a convenience sample of patients undergoing CTPA in the emergency department (ED) for evaluation of PE...
November 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29174327/a-case-of-cardiac-arrest-associated-with-aortic-valve-regurgitation
#13
Hyun Suk Chai, Suk Woo Lee, Jung Soo Park, Sang Chul Kim, Ji Han Lee, Hoon Kim
Blunt chest trauma can cause not only damage to the thoracic cage, but can also injure intracardiac structures including the papillary muscles, chordae tendineae, and valve leaflets. Aortic valve (AV) injury secondary to blunt chest trauma is a rare occurrence. Clinically, AV injury may be missed during the initial post-trauma assessment due to the lack of suspicion of cardiac involvement. Thus, the diagnosis of AV injury is often delayed or missed for a time interval of days to months. As a consequence, the traumatic AV regurgitation can rapidly or progressively lead to congestive heart failure unless surgically corrected...
November 20, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29152465/reproducibility-of-diaphragm-thickness-measurements-by-ultrasonography-in-patients-on-mechanical-ventilation
#14
Ashesh Dhungana, Gopi Khilnani, Vijay Hadda, Randeep Guleria
AIM: To prospectively evaluate the reproducibility of diaphragm thickness measurement by ultrasonography at the bedside by critical care physicians in patients on invasive mechanical ventilation. METHODS: In a prospective observational study of 64 invasively ventilated patients, diaphragmatic thickness measurement was taken by 2 different observers at the same site. Three measurements were taken by each observer and averaged. The intraobserver and interobserver variability was assessed by estimation of intraclass correlation coefficient...
November 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29151423/-guiding-significance-of-diaphragm-function-evaluation-in-ventilation-weaning
#15
Jieying Luo, Xiaotong Han, Maiying Fan, Hui Wen, Jing Xu, Yanfang Pei, Ying Huang
Diaphragm dysfunction is common in clinical work, which is a frequently important cause of ventilation weaning failure ignored by clinicians. Assessing diaphragmatic function while weaning helps early detection and prevention of weaning failure, so as to improve the clinical outcome of patients on mechanical ventilation (MV). Reviewing studies of diaphragmatic function evaluation in weaning, we can find that assessing diaphragmatic function during weaning can help guide weaning. Weaning predictors including pressure index, electrophysiological index and morphological index, among which bedside ultrasound as a morphological index is widely used in intensive care unit (ICU), which is simple, non-invasive, and easy to operate...
November 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29151003/lung-ultrasound-in-the-critically-ill-luci-a-translational-discipline
#16
Daniel A Lichtenstein, Manu L N G Malbrain
In the early days of ultrasound, it was not a translational discipline. The heart was claimed by cardiologists, with others, such as gynaecologists, urologists and vascular surgeons claiming their part while the rest was given to radiologists. Only recently, ultrasound transgressed and crossed the usual borders between the different disciplines, such as emergency and critical care medicine. The advent of portable machines in the early 1980s, allowed the critical care physician to perform bedside ultrasound, and the development of whole body critical care ultrasound (CCUS) was born...
November 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29146416/fulminant-adrenergic-myocarditis-complicated-by-pulmonary-edema-cardiogenic-shock-and-cardiac-arrest
#17
Pawel Rostoff, Bohdan Nessler, Patrycja Pikul, Karolina Golinska-Grzybala, Tomasz Miszalski-Jamka, Jadwiga Nessler
Adrenergic myocarditis is an uncommon presentation of pheochromocytoma and extremely rare cause of de novo acute heart failure (AHF). We present a case of a 31-year-old Caucasian woman with a history of hypertension and recurrent occipital headaches who was admitted to the emergency department due to severe de novo AHF presenting as pulmonary edema and cardiogenic shock. During the hospital admission the patient experienced asystolic cardiac arrest and was successfully resuscitated, intubated, and mechanically ventilated...
November 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29142797/cervical-funneling-potential-pitfall-of-point-of-care-pelvic-ultrasound
#18
Lori A Stolz, Richard Amini, Elaine H Situ-LaCasse, Faryal Shareef, Heather A Reed, Srikar Adhikari
Though point-of-care ultrasound applications continue to expand, there are findings that are not within the scope of emergency ultrasound. It is important for emergency physicians to be aware of incidental findings that can be identified on comprehensive ultrasounds performed by other imaging departments in order to fully understand the limitations of bedside ultrasound. In this case, a gravid patient presented to the emergency department with pelvic cramping and vaginal bleeding. Point-of-care transabdominal pelvic ultrasound examination was performed and demonstrated cervical funneling...
September 3, 2017: Curēus
https://www.readbyqxmd.com/read/29141727/point-of-care-ultrasound-for-extrapulmonary-tuberculosis-in-india-a-prospective-cohort-study-in-hiv-positive-and-hiv-negative-presumptive-tuberculosis-patients
#19
Stefan F Weber, Kavitha Saravu, Tom Heller, Rajagopal Kadavigere, Shashidhar Vishwanath, Stephan Gehring, Sabine Bélard, And Pocus Eti Study Group
Diagnosing extrapulmonary tuberculosis (EPTB) is challenging. Point-of-care ultrasound (POCUS) for human immunodeficiency virus (HIV)-associated EPTB is applied in sub-Saharan Africa. This study aimed at evaluating the applicability of POCUS for diagnosing EPTB in HIV-positive and HIV-negative presumptive tuberculosis (TB) patients in India, a country of moderate relative TB and HIV burden. Presumptive TB patients at Kasturba Hospital, Manipal, India, prospectively underwent POCUS evaluating for pericardial, pleural and ascitic effusion, abdominal lymphadenopathy, and hepatic and splenic microabscesses...
October 16, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29137035/enteral-nutrition-tube-placement-assisted-by-ultrasonography-in-patients-with-severe-acute-pancreatitis-a-novel-method-for-quality-improvement
#20
Gang Li, Yiyuan Pan, Jing Zhou, Zhihui Tong, Lu Ke, Weiqin Li
To evaluate the effect of a novel procedure using real-time ultrasonography to assist nasojejunal tube placement at bedside in patients with severe acute pancreatitis (SAP).Single center, prospective descriptive study in a 15-bed surgery intensive care unit of a university hospital. Thirty SAP patients were enrolled. The whole procedure of placing nasojejunal tube was performed by a single physician, who places nasojejunal tube at the bedside and performs ultrasonography to guide the tube positioning. The final nasojejunal tube position was confirmed by abdominal radiograph...
November 2017: Medicine (Baltimore)
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