Echography in icu

OBJECTIVES: The aim of this study was to evaluate if the presence of a pulsatile femoral vein pattern is an indicator of venous congestion in the intensive care unit (ICU). DESIGN: Retrospective observational study. SETTING: Three medico-surgical university-affiliated ICUs. PARTICIPANTS: Adult patients who had an ultrasound evaluation at several time points during their ICU stay: at baseline (within 24 hours of admission to ICU), daily during their ICU stay, and within 24 hours before ICU discharge...

PURPOSE: Venous congestion is a pathophysiologic state that can result in organ dysfunction, particularly acute kidney injury (AKI). We sought to evaluate the feasibility of performing a definitive observational study to determine the impact of venous congestion quantified using point-of-care ultrasound (POCUS) in patients with septic shock. METHODS: We conducted a prospective observational feasibility study at two intensive care units (ICUs). We recruited adult patients with septic shock within 12 hr of ICU admission...

Clazosentan, a potent selective endothelin receptor subtype A antagonist, has been demonstrated to be effective in preventing cerebral vasospasms after subarachnoid hemorrhage. We report the successful management of respiratory failure due to pulmonary edema associated with clazosentan, with a hemodynamic monitoring system. A 49-year-old Japanese man underwent emergency clipping for a right internal carotid-posterior communicating artery aneurysm. The surgery and general anesthesia for the rupture proceeded with no complications...

Chest and abdominal X-rays after the insertion of an epicutaneo-caval catheter in infants are the standard method of checking the tip location in many neonatal intensive care units. The role of ultrasound in the tip location of the epicutaneo-caval catheter in neonates has been the subject of many recent studies. This systematic review investigates the accuracy of epicutaneo-caval catheter tip location by comparing ultrasound and conventional radiology. We performed a systematic literature search in multiple databases...

Heart valve leaflet's aneurysm is a rare finding, and literature about this topic is sparse. Early recognition is important because their rupture can lead to catastrophic valve regurgitation. An 84-year-old male with chronic ischemic cardiomyopathy was admitted to the coronary intensive care unit for non-ST elevation myocardial infarction. Baseline transthoracic echocardiography showed normal biventricular function with inhomogeneous thickening of aortic leaflets with moderate aortic regurgitation. Because the acoustic window was limited, a transesophageal echocardiography was performed, detecting a small mass in the right aortic coronary cusp with moderate regurgitation (orifice regurgitation area: 0...

BACKGROUND: Limited studies have evaluated the use of ultrasound for detection of intracerebral hemorrhage (ICH) using diagnostic ultrasound Transcranial Doppler machines in adults. The feasibility of ICH detection using Point of care Ultrasound (POCUS) machines has not been explored. We evaluated the feasibility of using cranial POCUS B mode imaging performed using intensive care unit (ICU) POCUS device for ICH detection with a secondary goal of mapping optimal imaging technique and brain topography likely to affect sensitivity and specificity of ICH detection with POCUS...

BACKGROUND: We report the successful preoperative management of respiratory failure in a patient with a solid giant retroperitoneal tumor with a hemodynamic monitoring system and nasal high-flow therapy (NHFT). CASE PRESENTATION: Twenty days before his scheduled resection of a giant retroperitoneal liposarcoma, a 64-year-old man presented with dyspnea. After admission to our intensive care unit, he received NHFT and hemodynamic therapy using a LiDCOrapid V3™ monitor (Masimo Japan, Tokyo)...

BACKGROUND: Fluid overload and venous congestion are associated with morbi-mortality in the ICU (intensive care unit). Administration of diuretics to correct the fluid balance is common, although there is no strong relationship between the consequent fluid loss and clinical improvement. The aim of the study was to evaluate the ability of the portal pulsatility index, the renal venous impedance index, and the VEXUS score (venous ultrasound congestion score) to predict appropriate diuretic-induced fluid depletion...

COVID-19 pandemic did not impact all countries in the same way, and in Spain, the percentage of intensive care unit (ICU) and the mortality rate patients has been very high. The present work aims to present the first case of the new Coronavirus-2019 (COVID-19) on March 23, 2020, in Tenerife, Canary Islands, Spain, of a patient on Invasive Mechanical Ventilation (IMV) affected by acute pneumonia which was treated by airway clearance techniques (ACT) thinking that she was not infected with COVID-19, since the first polymerase chain reaction (PCR) test was negative...

BACKGROUND AND OBJECTIVE: Placing an endotracheal tube (ETT) in neonates is challenging and currently requires timely radiographic confirmation of correct tip placement. The objective was to establish the reliability of ultrasound (US) for assessing ETT position in the neonatal intensive care unit (NICU), time needed to do so, and patients' tolerance. METHODS: A prospective study on 71 newborns admitted to our NICU whose ETT placement was evaluated with US (ETT-echo) and confirmed on chest X-rays (CXR)...

The "gold" standard radiological method for the diagnosis of the lung findings in COVID-19 patients is known to be the chest high-resolution computed tomography. However, in a mass casualty scenario, as in times of COVID-19 epidemics, in which emergency departments, intensive care units, and whole hospitals are massive overcrowded and continue to change their original configuration, a more rapid, flexible, and performant diagnostic approach is required. Moreover, the high contagiousness of these patients and the risk of transporting critical patients make chest computed tomography (CT) a limited option for them...

This paper aims to highlight the usefulness of "bedside" lung ultrasound in the context of the COVID-19 pandemic. The evaluation of lung artifacts allows to detect at the subpleural level the presence of an altered "tissue/air" ratio both in case of consolidative or not consolidative lung lesions. Furthermore, lung ultrasound allows acquiring topographical images of the lesions, establishing their extension on the lung surface as well as their evolution or regression over time, without radiation exposure...

Association of thoracic and abdominal injuries in patients with major trauma is common. Under emergency conditions, it is often difficult to promptly perform a certain diagnosis and identify treatment priorities of life-threatening lesions. We present the case of a young man with combined thoracic and abdominal injuries after a motorcycle accident. Primary evaluation through echography and X-ray showed fluid within the hepatorenal recess and an enlarged mediastinum. Volume load, blood transfusions, and vasoactive agents were initiated to sustain circulation...

Objective: To investigate the diagnostic performances of renal resistive index (RRI) and semiquantitative power Doppler ultrasound (PDU) scores in predicting acute kidney injury (AKI) stage 3 in critically ill patients. Methods: This prospective observational study included 148 patients (80 with reduced cardiac index [CI], 68 with maintained CI). RRI and semiquantitative PDU scores were measured within 6 h after intensive care unit admission. AKI was defined according to Kidney Disease Improving Global Outcomes criteria...

OBJECTIVE: To explore the predicting performance of renal resistive index (RRI), semi quantitative power Doppler ultrasound (PDU) score and serum cystatin C (Cys C) for acute kidney injury (AKI) in patients with cardiac failure or sepsis. METHODS: A prospective, observational study was conducted. Critically ill patients with acute cardiac failure or sepsis admitted to the emergency intensive care unit (ICU) of Cangzhou Central Hospital from January 1st to December 31st in 2018 were enrolled...

INTRODUCTION: Echocardiography is an important tool for diagnosis of cardiac abnormalities that can impact the management and outcome of the sick newborn in the intensive care unit. A preliminary echocardiogram performed by the neonatologist under the supervision of a paediatric cardiologist for interpretation and review is an alternate when there is not a cardiologist on site. The aim of this study was to evaluate frequency of use, neonatal characteristics, and indications of neonatologist-performed echocardiography in a Tertiary Neonatal Care Centre in Tunisia...

BACKGROUND: Dynamic arterial elastance (Eadyn ) has been proposed as an indicator of vascular tone that predicts the decrease in arterial pressure in response to changes in norepinephrine (NE). The purpose of this study was to determine whether Eadyn measured by uncalibrated pulse contour analysis (UPCA) can predict a decrease in arterial pressure when the NE dosage is decreased. METHODS: We conducted a prospective study in a university hospital intensive care unit...

BACKGROUND: Many patients with tetralogy of Fallot (TOF) who underwent surgical correction of their congenital cardiac malformation during infancy develop right ventricular dysfunction and exercise intolerance in the long term. The right ventricle (RV) dilates due to the development of severe pulmonary regurgitation (and secondary tricuspid insufficiency). To reduce RV dilation and improve exercise tolerance pulmonary valve replacement (PVR) is the common therapeutic strategy. Whether concomitant tricuspid valve repair (TVR) is beneficial in these pure volume-overload conditions is still unknown...

Background: This study aimed to summarize percutaneous occluder device closure of atrial septal defects (ASD) through the femoral vein, using guidance by transthoracic echocardiography under local anesthesia without radiation or fluoroscopic guidance. Methods: This was a case series of fourteen patients, 3 males and 11 females, diagnosed with central ASD, the diameter of the defect ranged from 9 to 32 mm, and the patients had no other heart malformations or organ dysfunction...

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...