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Echography in icu

Tahar Chouihed, Stéphane Manzo-Silberman, Nicolas Peschanski, Sandrine Charpentier, Meyer Elbaz, Dominique Savary, Eric Bonnefoy-Cudraz, Said Laribi, Patrick Henry, Nicolas Girerd, Faiez Zannad, Carlos El Khoury
BACKGROUND: An appropriate diagnostic process is crucial for managing patients with acute heart failure (AHF) in emergency department (ED). Our study aims to describe the characteristics and therapeutic management of patients admitted to the ED for dyspnea suspected to have AHF, their in-hospital pathway of care and their in-hospital outcome. METHODS: Consecutive patients admitted in 26 French ED for dyspnea suspected to be the consequence of AHF, prior to in hospital diagnostic test, were prospectively included at the time of their admission in the DeFSSICA Survey...
September 17, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Lucile Gignon, Claire Roger, Sophie Bastide, Sandrine Alonso, Laurent Zieleskiewicz, Hervé Quintard, Lana Zoric, Xavier Bobbia, Mathieu Raux, Marc Leone, Jean-Yves Lefrant, Laurent Muller
BACKGROUND: The collapsibility index of inferior vena cava (cIVC) is widely used to decide fluid infusion in spontaneously breathing intensive care unit patients. The authors hypothesized that high inspiratory efforts may induce false-positive high cIVC values. This study aims at determining a value of diaphragmatic motion recorded by echography that could predict a high cIVC (more than or equal to 40%) in healthy volunteers. METHODS: The cIVC and diaphragmatic motions were recorded for three levels of inspiratory efforts...
June 2016: Anesthesiology
Fabiano Broilo, Andre Meregalli, Gilberto Friedman
OBJECTIVE: To investigate whether the respiratory variation of the inferior vena cava diameter (∆DIVC) and right internal jugular vein diameter (∆DRIJ) are correlated in mechanically ventilated patients. METHODS: This study was a prospective clinical analysis in an intensive care unit at a university hospital. Thirty-nine mechanically ventilated patients with hemodynamic instability were included. ∆DIVC and ∆DRIJ were assessed by echography. Vein distensibility was calculated as the ratio of (A) Dmax--Dmin/Dmin and (B) Dmax--Dmin/ mean of Dmax--Dmin and expressed as a percentage...
July 2015: Revista Brasileira de Terapia Intensiva
Clémence Minet, Leila Potton, Agnès Bonadona, Rébecca Hamidfar-Roy, Claire Ara Somohano, Maxime Lugosi, Jean-Charles Cartier, Gilbert Ferretti, Carole Schwebel, Jean-François Timsit
Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep venous thrombosis (DVT), is a common and severe complication of critical illness. Although well documented in the general population, the prevalence of PE is less known in the ICU, where it is more difficult to diagnose and to treat. Critically ill patients are at high risk of VTE because they combine both general risk factors together with specific ICU risk factors of VTE, like sedation, immobilization, vasopressors or central venous catheter...
August 18, 2015: Critical Care: the Official Journal of the Critical Care Forum
Renaud Prevel, Philippe Garcon, François Philippart
OBJECTIVES: To report an unusual case of suicide attempt secondary complicated of pulmonary and systemic embolisms. DATA SOURCE: A 49-year-old-woman, with a factor V Leiden mutation and a notion of chronic depression, admitted to our intensive care unit for a suicide attempt by ingestion ofmepronizine and lormetazepam. DATA EXTRACTION: We report the rare evolution of this patient with a persistent alteration of consciousness associating a respiratory degradation...
January 2015: International Journal of Critical Illness and Injury Science
Anselmo Caricato, Sara Pitoni, Luca Montini, Maria Grazia Bocci, Pina Annetta, Massimo Antonelli
Transcranial sonography (TCS) is an ultrasound-based imaging technique, which allows the identification of several structures within the brain parenchyma. In the past it has been applied for bedside assessment of different intracranial pathologies in children. Presently, TCS is also used on adult patients to diagnose intracranial space occupying lesions of various origins, intracranial hemorrhage, hydrocephalus, midline shift and neurodegenerative movement disorders, in both acute and chronic clinical settings...
September 28, 2014: World Journal of Radiology
Giovanni Zagli, Morena Cozzolino, Alessandro Terreni, Tiziana Biagioli, Anna Lucia Caldini, Adriano Peris
BACKGROUND: To facilitate the clinical diagnosis of ventilator-associated pneumonia (VAP) in the ICU, the Clinical Pulmonary Infection Score (CPIS) has been proposed but has shown a low diagnostic performance in subsequent studies. We propose a new score based on procalcitonin level and chest echography with the aim of improving VAP diagnosis: the Chest Echography and Procalcitonin Pulmonary Infection Score (CEPPIS). METHODS: This retrospective pilot study recruited patients admitted to the Intensive Care Unit of the Emergency Department, Careggi University Hospital (Florence, Italy), from January 2009 to December 2011...
December 2014: Chest
Matthieu Jabaudon, Sébastien Perbet, Bruno Pereira, Alexis Soummer, Laurence Roszyk, Renaud Guérin, Emmanuel Futier, Qin Lu, Jean-Etienne Bazin, Vincent Sapin, Jean-Jacques Rouby, Jean-Michel Constantin
RATIONALE: Postextubation distress after a successful spontaneous breathing trial (SBT) is associated with increased morbidity and mortality. Lung ultrasound determination of changes in lung aeration predicts weaning failure. It remains unknown whether this derecruitment is related to alveolar epithelial dysfunction or not. OBJECTIVE: To verify whether lung alveolar type I epithelial cell injury marker sRAGE (soluble form of the receptor for advanced glycation end-products) is predictive of postextubation distress and weaning failure or not, and to verify whether plasma sRAGE levels can be related to lung derecruitment during the process of weaning from mechanical ventilation or not...
2013: PloS One
Francesco Raimondi, Fiorella Migliaro, Angela Sodano, Angela Umbaldo, Antonia Romano, Gianfranco Vallone, Letizia Capasso
INTRODUCTION: At birth, lung fluid is rapidly cleared to allow gas exchange. As pulmonary sonography discriminates between liquid and air content, we have used it to monitor extrauterine fluid clearance and respiratory adaptation in term and late preterm neonates. Ultrasound data were also related to the need for respiratory support. METHODS: Consecutive infants at 60 to 120 minutes after birth underwent lung echography. Images were classified using a standardized protocol of adult emergency medicine with minor modifications...
November 14, 2012: Critical Care: the Official Journal of the Critical Care Forum
Anselmo Caricato, Vittorio Mignani, Maria Grazia Bocci, Mariano Alberto Pennisi, Claudio Sandroni, Alessandra Tersali, Alessandra Antonaci, Chiara de Waure, Massimo Antonelli
OBJECTIVE: To assess the agreement between computed tomography and transcranial sonography in patients after decompressive craniectomy. DESIGN: Prospective study. SETTING: The medical intensive care unit of a university-affiliated teaching hospital. PATIENTS: Thirty head-injured patients consecutively admitted to the intensive care unit of "A. Gemelli" Hospital who underwent decompressive craniectomy were studied. Immediately before brain cranial tomography, transcranial ultrasonography was performed...
June 2012: Critical Care Medicine
Sara Mandorla, Paolo Trambaiolo, Margherita De Cristofaro, Mara Baldassi, Maria Penco
One of the main tasks of a scientific society is to define the theoretical bases and appropriate management strategies with the aim to maintain a high-quality diagnostic and therapeutic standard. As far as echocardiography is concerned, the task of the Italian Society of Cardiovascular Echography is to provide appropriate, complete, and useful echocardiographic tests for clinical application, as well as procedural, technological, organizational and economic indications to be adopted in clinical practice. In addition, there is an increasing need for regulating access to echocardiographic assessment according to clinical priority, because of the huge proportion of patients who should undergo a first or follow-up echocardiographic evaluation...
June 2010: Giornale Italiano di Cardiologia
Jan Poelaert
Echography has developed as an indispensable tool in diagnosis and subsequent therapy in the critically ill. Although pulmonary and abdominal ultrasounds play a major role in their management, this article will discuss the advantages and indications of echocardiography in the intensive care unit (ICU). The assessment of morphological abnormalities, left or right ventricular malfunction, pulmonary arterial hypertension and valvular dysfunctions is a routine indication of echocardiography. Actually, besides contractility, several preload and even afterload indicators can also be assessed...
September 2009: Best Practice & Research. Clinical Anaesthesiology
Dana Tomescu, Anca Vişan, I Popescu, D Tulbure
We report the case of a 56 years old male patient, smoker, obese, with untreated arterial hypertension, hospitalized on 16.02.07 with the diagnosis of inferior acute myocardial infarction, for which he received thrombolysis with streptokinase, followed by anticoagulation with non fractioned heparin. Two days later he started to complain of acute abdominal pain, and laboratory findings showed a low hemoglobin level. Imaging findings (ultrasonography and CT scan) showed evidence of subcapsular liver haematoma, caused by bleeding at hepatic and splenic level...
September 2008: Chirurgia
V Exbrayat, J Morel, J-P De Filippis, G Tourne, R Jospe, C Auboyer
We report the case of a 31-year-old pregnant patient in the 33rd week of gestation, with no history of dyslipidaemia, admitted for sub-acute epigastric pain. The milky aspect of blood samples was remarkable. Blood analysis showed a moderate increase in pancreatic enzymes but a major hyperlipaemia: triglyceridaemia 113 g/l and total cholesterolaemia 25 g/l. We suspected a hypertriglyceridemia-induced pancreatitis in pregnancy. The diagnosis was confirmed by CT-scan. Abdominal echography showed no abnormalities in biliary duct...
July 2007: Annales Françaises D'anesthèsie et de Rèanimation
Philippe Vignon, Anthony Dugard, Julie Abraham, Dominique Belcour, Guillaume Gondran, Frédéric Pepino, Benoît Marin, Bruno François, Hervé Gastinne
OBJECTIVE: We sought to evaluate the efficacy of a limited training dedicated to residents without knowledge in ultrasound for performing goal-oriented echocardiography in ICU patients. DESIGN: Prospective pilot observational study. SETTING: Medical-surgical ICU of a teaching hospital. PATIENTS: 61 consecutive adult ICU patients (SAPS II score: 38 +/- 17; 46 ventilated patients) requiring a transthoracic echocardiography were studied...
October 2007: Intensive Care Medicine
Fadi Farhat, Marion Durand, Loïc Boussel, Ingrid Sanchez, Jacques Villard, Olivier Jegaden
OBJECTIVE: To evaluate the risks and benefits of a systematic reimplantation valve sparing procedure in the surgical treatment of type A aortic dissection (TAAD). PATIENTS AND METHODS: From February December 2005, 15 consecutive patients (mean age 61+/-12 years) who underwent surgery for TAAD were analyzed prospectively. Eleven had a preoperative CT-scan and all had an echography. Eight patients presented with a preoperative aortic insufficiency>2/4 and seven had an ascending aortic aneurysm over 50mm...
January 2007: European Journal of Cardio-thoracic Surgery
Frédéric Vargas, Hoang Nam Bui, Alexandre Boyer, Cécile Marie Bébear, Stéphane Lacher-Fougére, Bertillle Marie De-Barbeyrac, Louis Rachid Salmi, Louis Traissac, Georges Gbikpi-Benissan, Didier Gruson, Gilles Hilbert
OBJECTIVE: The aim of this prospective study was to evaluate the value of sinus echography results to directly indicate a transnasal puncture in intubated patients with suspicion of nosocomial maxillary sinusitis. DESIGN: prospective clinical investigation. SETTING: medical intensive care unit. PATIENTS: sixty patients undergoing intubation and mechanical ventilation more than 2 days, with a clinical suspicion of maxillary sinusitis with purulent nasal discharge...
June 2006: Intensive Care Medicine
Dominique P Germain
Vascular Ehlers-Danlos syndrome (EDS) is a life-threatening inherited disorder of connective tissue causing severe arterial and gastrointestinal fragility and rupture, as well as complications of surgical and radiologic interventions. The diagnosis should be considered in patients under the age of 45 years who present with arterial tearing or dissection, colonic perforation, or visceral rupture. As for many orphan diseases, delayed diagnosis can lead to inaccurate care. Therefore, vascular EDS is particularly important to surgeons, radiologists, and obstetricians because knowledge of the diagnosis may help in the management of visceral complications...
April 2006: Current Treatment Options in Cardiovascular Medicine
S Federici, I Claudet, E Laporte-Turpin, M O Marcoux, E Cheuret, K Maréchal
UNLABELLED: We report a case of an accidental intoxication in a 20-month-old boy resulting from the ingestion of a rodenticide containing alpha-chloralose. CASE REPORT: Three hours after initial admission to the pediatric emergency department for wheezing bronchitis, this patient was readmitted with a clinical presentation of respiratory insufficiency, a Glasgow coma score of 9 alternating with agitation, areflexia and unilateral mydriasis. Parental interview revealed he had episodes of shaking in the afternoon...
April 2006: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
B de La Vaissière, B Castello, B Quinet, R Cohen, E Grimprel
OBJECTIVES: To describe the different modalities of ambulatory management of acute pyelonephritis in patients older than 3 months of age in paediatric emergency units of the Ile de France region in 2004. METHODS: Between October 2003 and April 2004, referents of 39 paediatric emergency units of the Ile de France region were questioned through a written questionnaire concerning the management of acute pyelonephritis: in or outpatient modalities, antibiotic regimen (molecule and route of administration), investigations and follow-up...
March 2006: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
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