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https://www.readbyqxmd.com/read/29768359/case-report-of-gastric-distension-due-to-superior-mesenteric-artery-syndrome-mimicking-hollow-viscus-perforation-considerations-in-critical-care-ultrasound
#1
Yan-Mei Feng, Dong Wan, Rui Guo
RATIONALE: Critical care ultrasound identifies the signs of free intraperitoneal air and echogenic free fluid always indicates hollow viscus perforation (HVP) and needs immediate surgical interventions. However, in rare cases, these classic signs may also mislead proper clinical decisions. We report perforated viscus associated large peritoneal effusion with initial critical care ultrasound findings, whereas computed tomography (CT) examination confirmed a giant stomach due to superior mesenteric artery syndrome (SMAS)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29763777/incorporation-of-point-of-care-ultrasound-into-morning-round-is-associated-with-improvement-in-clinical-outcomes-in-critically-ill-patients-with-sepsis
#2
Zhonghua Chen, Yucai Hong, Junru Dai, Lifeng Xing
OBJECTIVES: Point-of-care ultrasound (POCUS) has been widely used in the intensive care unit (ICU). However, it is largely unknown whether the use of POCUS is associated with improved patient-important outcomes. The study aimed to investigate whether incorporation of POCUS during morning round on a routine basis was able to improve clinical outcomes in critically ill patients with sepsis. DESIGN: It was a prospective observational study. SETTING: A tertiary care emergency intensive care unit...
May 11, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29757913/association-between-muscle-wasting-and-muscle-strength-in-patients-who-developed-severe-sepsis-and-septic-shock
#3
Rodrigo Cerqueira Borges, Francisco Garcia Soriano
PURPOSE: To evaluate the association between the rectus femoris cross-sectional area (RFCSA) and the muscular strength obtained at the bedside in patients forwarded to the intensive care unit (ICU) for severe sepsis and septic shock. METHODS: A prospective cohort study. RFCSA was assessed by ultrasound on the following day of the ICU admission and monitored during hospitalization. The patients performed clinical tests of muscle strength (Medical Research Council (MRC) scale and handgrip dynamometry), when they could understand the verbal commands of the examiners...
May 11, 2018: Shock
https://www.readbyqxmd.com/read/29747267/-application-of-uterine-lower-part-breakwater-like-suture-operation-in-placenta-previa
#4
Y Zhao, J W Zhu, D Wu, Q H Wang, S S Lu, X X Liu, L Zou
Objective: To explore the efficacy and safety of uterine lower posterior wall breakwater-like suture technique in controlling the intraoperative bleeding of placenta previa. Methods: From June 2016 to June 2017, 47 patients were diagnosed placenta previa in Union Hospital, Tongji Medical College of Huazhong University of Science and Technology. Posterior wall breakwater-like suture technique was used preferentially, as for cases with poor myometrium layer, lower anterior wall stitch suture was used at the same time...
April 25, 2018: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/29731077/predictive-factors-of-liver-dysfunction-after-right-hemihepatectomy-for-adult-living-donor-liver-transplantation
#5
M Elshoubary, A Shehta, T Salah, A M Sultan, A M Yassen, M Abdulrazek, E A El-Magd, A N Elghawalby, U Shiha, M Elmorshedi, M Elsadany, E Abdelkhalek, O Fathy, M A Wahab
BACKGROUND: Living liver donors represent a special group of patients. They are healthy individuals who are exposed to a major surgery, in which the dominant liver proportion is extracted as a graft. Of all potential donor-related morbidities, posthepatectomy liver dysfunction (PHLD) is the most significant as it may be directly related to donor mortality. We aimed to review our data of adult living donor liver transplantation (LDLT) utilizing the right hemiliver grafts to determine the incidence and potential predictors for the development of PHLD, defined according to the International Study Group of Liver Surgery...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29731074/postoperative-doppler-ultrasonography-in-liver-transplantation
#6
Y K Chung, H J Choi, G H Na, Y K You, I Y Park
BACKGROUND: Doppler ultrasonography plays an important role in the postoperative management of liver transplantation. We present our initial experiences evaluating liver transplants with the use of postoperative Doppler sonography. METHODS: In our hospital, we performed 20 liver transplantations from July 2014 to October 2016. Among 20 patients, we performed 15 deceased-donor liver transplantations (DDLTs) and 5 living-donor liver transplantations (LDLTs). For deceased donors, inferior vena cava anastomoses were performed with the use of the piggyback technique, and for living donors, modified right grafts were used with middle hepatic vein reconstruction by Dacron graft...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29726988/validation-of-noninvasive-absolute-intracranial-pressure-measurements-in-traumatic-brain-injury-and-intracranial-hemorrhage
#7
Jenny C Kienzler, Rolandas Zakelis, Sabrina Bäbler, Elke Remonda, Arminas Ragauskas, Javier Fandino
BACKGROUND: Increased intracranial pressure (ICP) causes secondary damage in traumatic brain injury (TBI), and intracranial hemorrhage (ICH). Current methods of ICP monitoring require surgery and carry risks of complications. OBJECTIVE: To validate a new instrument for noninvasive ICP measurement by comparing values obtained from noninvasive measurements to those from commercial implantable devices through this pilot study. METHODS: The ophthalmic artery (OA) served as a natural ICP sensor...
May 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29722867/evaluating-the-quality-of-the-processes-of-care-and-clinical-outcomes-of-premature-newborns-admitted-to-neonatal-intensive-care-units-in-mexico
#8
Svetlana V Doubova, Heladia Josefa-García, Irma Alejandra Coronado-Zarco, Sandra Carrera-Muiños, Guadalupe Cordero-Gonzalez, Leonardo Cruz-Reynoso, Leovigildo Mateos-Sanchez, Ana Jesica Maya-García, Ricardo Pérez-Cuevas
Objectives: To develop quality of care (QoC) indicators, evaluate the quality of the processes of care (QPC) and clinical outcomes, and analyze the association between the QPC and severe clinical outcomes of preterm newborns admitted to neonatal intensive care units (NICUs). Design: Mixed methods approach: (1) development of QoC indicators via modified RAND/UCLA method; (2) cross-sectional study of QoC evaluation and (3) multiple logistic regression analysis to ascertain the association between the QPC and severe clinical outcomes...
April 4, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29719745/acute-acalculous-cholecystitis-in-the-setting-of-negative-ultrasound-and-computed-tomography-scan-of-the-abdomen
#9
Muhammad Shafiq, Yousaf Zafar
Acute acalculous cholecystitis (AAC) is most commonly seen after surgery in critically ill patients. Early diagnosis and treatment is the key in the management of AAC. Ultrasound is the commonly used first modality for right upper quadrant (RUQ) pain with sensitivity equal to or greater than 80% for AAC. Computed tomography (CT) scan is reported to have a sensitivity close to 90% and if both the ultrasound and CT scan are combined, it further increases the sensitivity for the diagnosis of AAC. It is unlikely for AAC to be present in the setting of both negative ultrasound and CT scan of the abdomen...
February 28, 2018: Curēus
https://www.readbyqxmd.com/read/29715700/lung-ultrasound-findings-in-congenital-pulmonary-airway-malformation
#10
Nadya Yousef, Mostafa Mokhtari, Philippe Durand, Francesco Raimondi, Fiorella Migliaro, Alexandra Letourneau, Pierre Tissières, Daniele De Luca
BACKGROUND AND OBJECTIVE:  Congenital pulmonary airway malformation (CPAM) is a group of rare congenital malformations of the lung and airways. Lung ultrasound (LU) is increasingly used to diagnose neonatal respiratory diseases since it is quick, easy to learn, and radiation-free, but no formal data exist for congenital lung malformations. We aimed to describe LU findings in CPAM neonates needing neonatal intensive care unit (NICU) admission and to compare them with a control population...
May 1, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29705730/paediatric-traumatic-cardiac-arrest-a-delphi-study-to-establish-consensus-on-definition-and-management
#11
Annette C Rickard, James Vassallo, Tim Nutbeam, Mark D Lyttle, Ian K Maconochie, Doyo G Enki, Jason E Smith
AIMS: Paediatric traumatic cardiac arrest (TCA) is associated with low survival and poor outcomes. The mechanisms that underlie TCA are different from medical cardiac arrest; the approach to treatment of TCA may therefore also need to differ to optimise outcomes. The aim of this study was to explore the opinion of subject matter experts regarding the diagnosis and treatment of paediatric TCA, and to reach consensus on how best to manage this group of patients. METHODS: An online Delphi study was conducted over three rounds, with the aim of achieving consensus (defined as 70% agreement) on statements related to the diagnosis and management of paediatric TCA...
April 28, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29703223/comparison-of-exercise-intensity-during-four-early-rehabilitation-techniques-in-sedated-and-ventilated-patients-in-icu-a-randomised-cross-over-trial
#12
Clément Medrinal, Yann Combret, Guillaume Prieur, Aurora Robledo Quesada, Tristan Bonnevie, Francis Edouard Gravier, Elise Dupuis Lozeron, Eric Frenoy, Olivier Contal, Bouchra Lamia
BACKGROUND: In the ICU, out-of-bed rehabilitation is often delayed and in-bed exercises are generally low-intensity. Since the majority of rehabilitation is carried out in bed, it is essential to carry out the exercises that have the highest intensity. The aim of this study was to compare the physiological effects of four common types of bed exercise in intubated, sedated patients confined to bed in the ICU, in order to determine which was the most intensive. METHODS: A randomised, single-blind, placebo-controlled crossover trial was carried out to evaluate the effects of four bed exercises (passive range of movements (PROM), passive cycle-ergometry, quadriceps electrical stimulation and functional electrical stimulation (FES) cycling) on cardiac output...
April 27, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29703214/ultrasound-assessed-diaphragmatic-impairment-is-a-predictor-of-outcomes-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-undergoing-noninvasive-ventilation
#13
Alessandro Marchioni, Ivana Castaniere, Roberto Tonelli, Riccardo Fantini, Matteo Fontana, Luca Tabbì, Andrea Viani, Francesco Giaroni, Valentina Ruggieri, Stefania Cerri, Enrico Clini
BACKGROUND: Ultrasound (US) evaluation of diaphragmatic dysfunction (DD) has proved to be a reliable technique in critical care. In this single-center prospective study, we investigated the impact of US-assessed DD on noninvasive ventilation (NIV) failure in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and its correlation with the transdiaphragmatic pressure assessed using the invasive sniff maneuver (Pdi sniff). METHODS: A population of 75 consecutive patients with AECOPD with hypercapnic acidosis admitted to our respiratory intensive care unit (RICU) were enrolled...
April 27, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29701878/targeted-full-energy-and-protein-delivery-in-critically-ill-patients-a-pilot-randomized-controlled-trial-feed-trial
#14
Kate Fetterplace, Adam M Deane, Audrey Tierney, Lisa J Beach, Laura D Knight, Jeffrey Presneill, Thomas Rechnitzer, Adrienne Forsyth, Benjamin M T Gill, Marina Mourtzakis, Christopher MacIsaac
BACKGROUND: International guidelines recommend greater protein delivery to critically ill patients than they currently receive. This pilot randomized clinical trial aimed to determine whether a volume-target enteral protocol with supplemental protein delivered greater amounts of protein and energy to critically ill patients compared with standard care. METHODS: Sixty participants received either the intervention (volume-based protocol, with protein supplementation) or standard nutrition care (hourly-rate-based protocol, without protein supplementation) in the intensive care unit (ICU)...
April 27, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29701402/endovascular-treatment-of-a-complicated-type-b-acute-aortic-dissection-with-3-d-ultrasound-control
#15
Roger Rodrigues, Javier Villaverde, Jorge Noya, Gabriel Anacleto, Óscar Gonçalves
INTRODUCTION: Acute type B aortic dissection (ATBAD), identified within 2 weeks of symptom onset, accounts for 25%-40% of all aortic dissections. Approximately 25% of patients presenting with ATBAD are complicated at admission by malperfusion syndrome or hemodynamic instability, resulting in a high risk of early death when untreated. METHODS: We present a case of a patient with a complicated type B dissection treated by an endovascular technique with control of the sealing zone with transesophageal Echocardiogram (TEE) and 3-D images...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29693937/point-of-care-lung-ultrasound
#16
Makoto Sera
The evaluation of the lung has usually been considered off-limits for ultrasound, because ultrasound energy is rapidly dissipated by air. Lung ultrasound is not useful for the evaluation of the pulmonary parenchyma and the pleural line. However ultrasound machines have become more portable, with decreased start-up time, while simultaneously providing improved image quality and ease of image acquisition. Additionally, lung ultrasound is highly accurate for the diagnosis of pneumothorax, hemothorax. pleural effusions, pulmonary edema (cardiogenic or noncardiogenic), interstitial syndrome, and pneumonia...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29682549/preliminary-exploration-of-epidemiologic-and-hemodynamic-characteristics-of-restrictive-filling-diastolic-dysfunction-based-on-echocardiography-in-critically-ill-patients-a-retrospective-study
#17
Yi Li, Wanhong Yin, Yao Qin, Xueying Zeng, Tongjuan Zou, Xiaoting Wang, Yangong Chao, Lina Zhang, Yan Kang, Chinese Critical Ultrasound Study Group Ccusg
Objective: To preliminarily describe the epidemiologic and hemodynamic characteristics of critically ill patients with restrictive filling diastolic dysfunction based on echocardiography. Setting: A retrospective study. Methods: Epidemiologic characteristics of patients with restrictive filling diastolic dysfunction in ICU were described; clinical and hemodynamic data were preliminarily summarized and compared between patients with and without restrictive filling diastolic dysfunction; most of the data were based on echocardiography...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29682365/bedside-endoscopic-retrograde-cholangiopancreatography-using-portable-x-ray-in-acute-severe-cholangitis
#18
Rushikesh Shah, Emad Qayed
Patients with acute cholangitis require emergent biliary decompression. Those who are hemodynamically unstable on vasopressor support and mechanical ventilation are too critically ill to move outside of the intensive care unit. This prohibits performing Endoscopic Retrograde Cholangiopancreatography (ERCP) in the endoscopy unit. Fluoroscopic guidance is required to confirm deep biliary cannulation during ERCP. There are a few reported cases of bedside ERCP using portable C-arm fluoroscopy unit or ultrasound guided cannulation...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29680471/the-neu-prem-trial-neuromonitoring-of-brains-of-infants-born-preterm-during-resuscitation-a-prospective-observational-cohort-study
#19
Anup C Katheria, M J Harbert, Sunil B Nagaraj, Kathy Arnell, Debra M Poeltler, Melissa K Brown, Wade Rich, Kasim O Hassen, Neil Finer
OBJECTIVE: To determine whether monitoring cerebral oxygen tissue saturation (StO2 ) with near-infrared spectroscopy (NIRS) and brain activity with amplitude-integrated electroencephalography (aEEG) can predict infants at risk for intraventricular hemorrhage (IVH) and death in the first 72 hours of life. STUDY DESIGN: A NIRS sensor and electroencephalography leads were placed on 127 newborns <32 weeks of gestational age at birth. Ten minutes of continuous NIRS and aEEG along with heart rate, peripheral arterial oxygen saturation, fraction of inspired oxygen, and mean airway pressure measurements were obtained in the delivery room...
April 16, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29680409/-usefulness-of-early-lung-ultrasound-in-acute-mild-moderate-acute-bronchiolitis-a-pilot-study
#20
Elia Zoido Garrote, Cristina García Aparicio, Constanza Camila Torrez Villarroel, Antonio Pedro Vega García, Manoel Muñiz Fontán, Ignacio Oulego Erroz
OBJECTIVE: To determine the correlation between the findings seen in early lung ultrasound with the clinical severity scales, and its association with the subsequent progression of the mild-moderate acute bronchiolitis (AB). PATIENTS AND METHODS: An observational prospective study conducted on infants with mild-moderate BA, using lung ultrasound in the first 24hours of hospital care. The lung involvement was graded (range 0-50 points) based on an ultrasound score (ScECO) and 2routinely used clinical scales: the modified Wood Downes Ferres (WDFM), and the Hospital Sant Joan de Deu (HSJD)...
April 18, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
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