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Intensive care ultrasound

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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/29752922/a-non-inferiority-randomized-controlled-trial-to-compare-transabdominal-and-transvaginal-sonography-for-eligibility-assessment-prior-to-medical-abortion
#4
Annie Fu, Caitlin E Weber, Emma Gilmore, Anne R Davis, Gregory Hirsch, Carolyn L Westhoff
OBJECTIVES: To compare transabdominal sonography (TAS) to transvaginal sonography (TVS) in medical abortion eligibility assessment; specifically to measure how often clinicians chose to order additional testing for eligibility assessment following TAS and TVS, and to look for differences by patient and clinician characteristics. Also, to compare patient acceptability between the two modalities. STUDY DESIGN: This pragmatic multi-site randomized non-inferiority trial compared TAS to TVS at 10 New York City and New Jersey health centers that provide medical abortion...
May 9, 2018: Contraception
https://www.readbyqxmd.com/read/29747214/intestinal-perforation-due-to-deep-infiltrating-endometriosis-during-pregnancy-case-report
#5
Márcia Mendonça Carneiro, Luciana Maria Pyramo Costa, Maria Das Graças Torres, Patrícia Salomé Gouvea, Ivete de Ávila
We report the case of a 33 year-old woman who complained of severe dysmenorrhea since menarche. From 2003 to 2009, she underwent 4 laparoscopies for the treatment of pain associated with endometriosis. After all four interventions, the pain recurred despite the use of gonadotropin-releasing hormone (GnRH) analogues and the insertion of a levonorgestrel intrauterine system (LNG-IUS). Finally, a colonoscopy performed in 2010 revealed rectosigmoid stenosis probably due to extrinsic compression. The patient was advised to get pregnant before treating the intestinal lesion...
April 2018: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/29731077/predictive-factors-of-liver-dysfunction-after-right-hemihepatectomy-for-adult-living-donor-liver-transplantation
#6
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
#7
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/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/29703214/ultrasound-assessed-diaphragmatic-impairment-is-a-predictor-of-outcomes-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-undergoing-noninvasive-ventilation
#11
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
#12
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/29701410/digital-artery-aneurysm-case-report
#13
José Vidoedo, José Teixeira
INTRODUCTION AND METHODS: A 71-year-old patient, housewife, with a history of hypertension, elevated cholesterol and hypotyroidism was referred to the outpatient clinic for tumefaction of the right hand 5th finger noticed 3-4 months earlier. She denied past or recent history of trauma, cardiac or infectious disease and had no familial history of aneurysmatic disease. She was asymptomatic except for local slight discomfort when she had to press or push something with her hand. She had no sensitivity or mobility impairment...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701402/endovascular-treatment-of-a-complicated-type-b-acute-aortic-dissection-with-3-d-ultrasound-control
#14
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/29693940/the-peas-protocol-an-airway-ultrasound-technique
#15
Akihiro Suzuki
In the past ultrasound identification of the airway structure was rather difficult However, recent advancement of the high frequency linear type transducer allows us to visualize airway structure easily. Accordingly, now we have difficult airway society guideline 2015. resuscitation guideline 2015, and Australia and New Zealand Intensive Care Society guidelines for percutaneous dilatational tracheostomy which recommend use of ultrasound in airway management Airway ultrasound is an emerging technique for all physicians, and the author introduces perioperative evaluation of the airway via sonography, the PEAS protocol...
May 2017: Masui. the Japanese Journal of Anesthesiology
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/29693936/cardiac-point-of-care-using-ultrasound
#17
Mitsuharu Kodaka
Patients with cardiac disease have high mortality rates, mainly owing to shock. Therefore, evaluation of cardiac function is one of the most challenging issues in the intensive and critical care unit. Cardiac point-of-care tests using ultrasound, such as focus assessed transthoracic echo (FATE) and rapid ultrasound in shock (RUSH). are useful for diagnosis and initial care of such patients. The author will introduce first a basic FATE protocol of how to scan from position 1-4, including subcostal 4-chamber, apical 4-chamber, parasternal long and short axis, and pleural scanning...
May 2017: Masui. the Japanese Journal of Anesthesiology
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/29682014/neurosurgical-interventions-for-occipital-encephalocele
#19
Lal Rehman, Ghulam Farooq, Irum Bukhari
Aims and Objectives: The aim of this study is to find the outcome of repair and resection of the occipital encephalocele. Study Design: Case series. Materials and Methods: The clinical data of fifty consecutive occipital encephalocele patients were retrieved from medical records including operative notes, postoperative follow-up visits, and postsurgical complications were noted for analysis from November 2009 to November 2013 at the Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29680471/the-neu-prem-trial-neuromonitoring-of-brains-of-infants-born-preterm-during-resuscitation-a-prospective-observational-cohort-study
#20
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
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