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Ultrasound intensive care

Li Liu, Wanjun Chen, Xiaoye Lu, Keji Zhang, Changqing Zhu
BACKGROUND: Pyogenic liver abscesses have become common in emergency departments (EDs) in recent years in Shanghai, China due to a variety of risk factors contributory to the disease. OBJECTIVE: To review our experience in managing pyogenic liver abscesses to aid in the current management of this complex condition. METHODS: This retrospective study was conducted to collect and analyze information from adult patients diagnosed with liver hepatic abscesses who were admitted to Ren Ji Hospital during the period from January 1, 2010 to December 31, 2015...
October 17, 2016: Journal of Emergency Medicine
Gerhard Batz, Michael Dinkel
Echocardiography as an imaging method in anaesthesia and intensive care medicine has enabled a new dimension of hemodynamic monitoring: the direct visualization of the cardiac function and its disruptions. Preconditions for a broad application in this area was the development of mobile, high-definition ultrasonic devices and the origination of focused examination techniques. A successful application of this method requires the respective know-how of the examiner, in order to take relevant decisions and avoid misdiagnoses...
October 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Miguel José Francisco, Antonio Rahal, Fabio Augusto Cardillo Vieira, Paulo Savoia Dias da Silva, Marcelo Buarque de Gusmão Funari
Ultrasound examination of the chest has advanced in recent decades. This imaging modality is currently used to diagnose several pathological conditions and provides qualitative and quantitative information. Acoustic barriers represented by the aerated lungs and the bony framework of the chest generate well-described sonographic artifacts that can be used as diagnostic aids. The normal pleural line and A, B, C, E and Z lines (also known as false B lines) are artifacts with specific characteristics. Lung consolidation and pneumothorax sonographic patterns are also well established...
July 2016: Einstein
Patricia C Henwood, David C Mackenzie, Joshua S Rempell, Emily Douglass, Damas Dukundane, Andrew S Liteplo, Megan M Leo, Alice F Murray, Samuel Vaillancourt, Anthony J Dean, Resa E Lewiss, Stephen Rulisa, Elizabeth Krebs, A K Raja Rao, Emmanuel Rudakemwa, Vincent Rusanganwa, Patrick Kyanmanywa, Vicki E Noble
OBJECTIVE: We delivered a point-of-care ultrasound training programme in a resource-limited setting in Rwanda, and sought to determine participants' knowledge and skill retention. We also measured trainees' assessment of the usefulness of ultrasound in clinical practice. METHODS: This was a prospective cohort study of 17 Rwandan physicians participating in a point-of-care ultrasound training programme. The follow-up period was 1 year. Participants completed a 10-day ultrasound course, with follow-up training delivered over the subsequent 12 months...
October 19, 2016: Tropical Medicine & International Health: TM & IH
Federico Antenora, Riccardo Fantini, Andrea Iattoni, Ivana Castaniere, Antonia Sdanganelli, Francesco Livrieri, Roberto Tonelli, Stefano Zona, Marco Monelli, Enrico M Clini, Alessandro Marchioni
BACKGROUND AND OBJECTIVE: The prevalence and clinical consequences of diaphragmatic dysfunction (DD) during acute exacerbations of COPD (AECOPD) remain unknown. The aim of this study was (i) to evaluate the prevalence of DD as assessed by ultrasonography (US) and (ii) to report the impact of DD on non-invasive mechanical ventilation (NIV) failure, length of hospital stay and mortality in severe AECOPD admitted to respiratory intensive care unit (RICU). METHODS: Forty-one consecutive AECOPD patients with respiratory acidosis admitted over a 12-month period to the RICU of the University Hospital of Modena were studied...
October 14, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Anu K Kaskinen, Laura Martelius, Turkka Kirjavainen, Paula Rautiainen, Sture Andersson, Olli M Pitkänen
BACKGROUND: Lung ultrasounds show vertical artifacts known as B-lines in the presence of increased extravascular lung water (EVLW). We aimed to investigate whether lung ultrasound could estimate EVLW after congenital cardiac surgery. METHODS: This prospective observational study comprised 61 children (age range 3 days to 7.4 years) undergoing congenital cardiac surgery. We compared postoperative B-line scores from lung ultrasounds, early postoperative ultrasound as our primary interest, with corresponding postoperative chest radiography (CXR) lung edema scores, with static lung compliance, and with short-term clinical outcome interpreted as time on mechanical ventilation and length of pediatric intensive care unit (PICU) stay...
October 14, 2016: Pediatric Pulmonology
Nada Aracic, Ivica Stipic, Ivana Jakus Alujevic, Petar Poljak, Mario Stipic
AIM: To evaluate the influence of cervical length (CL) and parity as prediction factors for assessment of cesarean section (CS) risk in women with premature rupture of membranes (PROM) at term and unfavorable cervix, undergoing induction of labor (IOL) with dinoprostone intracervical gel. METHODS: A prospective study involved 50 nulliparous and 51 multiparous women admitted for IOL. Pre-induction CL was measured and delivery outcomes were recorded. RESULTS: Nulliparous women were younger than the multiparous (26...
October 8, 2016: Journal of Perinatal Medicine
Yosuke Baba, Hironori Takahashi, Akihide Ohkuchi, Rie Usui, Shigeki Matsubara
AIM: During cesarean section (CS) for placenta previa (PP), the size/area/portion of the lower uterine segment occupied by the placenta may affect the bleeding amount and the subsequent need for a blood transfusion (BT). We propose a new concept, indiscernible edge total PP (IEPP), when vaginal ultrasound does not discern the lower placental edge because the placenta covers the visible lower segment. We characterized IEPP, focusing on its allogeneic BT requirement. METHODS: We classified PP (n = 307) into four types: marginal, partial, discernible edge total PP (DEPP) and IEPP: internal ostium (os)-placental edge distance measurable or unmeasurable on vaginal ultrasound in DEPP or IEPP, respectively...
October 8, 2016: Journal of Obstetrics and Gynaecology Research
Pearl W Chang, Jennifer M Abidari, Mark W Shen, Tara L Greenhow, Michael Bendel-Stenzel, Heidi K Roman, Eric A Biondi, Alan R Schroeder
OBJECTIVES: To describe renal ultrasound (RUS) and voiding cystourethrogram (VCUG) findings and determine predictors of abnormal imaging in young infants with bacteremic urinary tract infection (UTI). METHODS: We used retrospective data from a multicenter sample of infants younger than 3 months with bacteremic UTI, defined as the same pathogenic organism in blood and urine. Infants were excluded if they had any major comorbidities, known urologic abnormalities at time of presentation, required intensive unit care, or had no imaging performed...
October 5, 2016: Hospital Pediatrics
David Wright, Ioanna Dragan, Argyro Syngelaki, Ranjit Akolekar, Kypros H Nicolaides
OBJECTIVE: To estimate the patient-specific risk of preeclampsia (PE) at 30-34 weeks' gestation by a combination of maternal characteristics and medical history with multiple of the median (MoM) values of mean arterial pressure, uterine artery pulsatility index, serum placental growth factor and serum soluble fms-like tyrosine kinase-1 and stratify women into high-, intermediate- and low-risk management groups. METHODS: This was a prospective observational study in women attending for a third-trimester ultrasound scan at 30-34 weeks as part of routine pregnancy care...
September 27, 2016: Ultrasound in Obstetrics & Gynecology
Sebastián Fernández-Bussy, Gonzalo Labarca, Mario Lanza, Erik Folch, Adnan Majid
The use of thoracic ultrasound as a diagnostic tool in the emergency department, intensive care unit or in patients with pulmonary diseases is increasing steadily. It is used to guide percutaneous tracheostomies, to assess pleural effusions, to rule out pneumothorax, and to guide the placement of endovascular and pleural catheters. It is also useful in the assessment of patients with dyspnea. The aim of this review is to provide the practical and technical basics for the use of this diagnostic tool among internists and specialists in pulmonary diseases...
July 2016: Revista Médica de Chile
Marie Cécile Fevre, Caroline Vincent, Julien Picard, Arnaud Vighetti, Claire Chapuis, Maxime Detavernier, Benoit Allenet, Jean François Payen, Jean Luc Bosson, Pierre Albaladejo
Ultrasound (US) guided needle positioning is safer than anatomical landmark techniques for central venous access. Hand-eye coordination and execution time depend on the professional's ability, previous training and personal skills. Needle Guidance Positioning Systems (GPS) may theoretically reduce execution time and facilitate needle positioning in specific targets, thus improving patient comfort and safety. Three groups of healthcare professionals (41 anaesthesiologists and intensivists, 41 residents in anaesthesiology and intensive care, 39 nurse anaesthetists) were included and required to perform 3 tasks (positioning the tip of a needle in three different targets in a silicon phantom) by using successively a conventional US-guided needle positioning and a needle GPS...
September 19, 2016: Anaesthesia, Critical Care & Pain Medicine
Mehdi Fathi, Azra Izanloo, Saeed Jahanbakhsh, Mehryar Taghavi Gilani, Ali Majidzadeh, Azam Sabri Benhangi, Naser Paravi
BACKGROUND: Central venous cannulation is a current and important procedure used in the operating room and intensive care unit. Some studies have shown that the application of ultrasound-guided cannulation can improve the success rate of surgery, save time, reduce the number of required needlesticks, and mitigate many complications compared to anatomical landmark-guided cannulation. OBJECTIVES: The aim of the present study was to draw a comparison between central venous cannulation of the internal jugular vein using ultrasound-guided and anatomical landmark-guided techniques...
June 2016: Anesthesiology and Pain Medicine
Guotao Ma, Qi Miao, Xingrong Liu, Chaoji Zhang, Jianzhou Liu, Yuehong Zheng, Jiang Shao, Ninghai Cheng, Shunda Du, Zhan Hu, Zhinan Ren, Luxi Sun
Intravenous leiomyomatosis (IVL) is a rare benign tumor. The study aimed to assess outcomes of patients treated surgically for IVL.Between November 2002 and January 2015, 76 patients were treated for IVL. The stage of IVL was evaluated preoperatively by echocardiography and enhanced computerized tomography (CT) scan, and graded into 4 stages according to intravascular tumor progression. We recorded age, lower limb edema before surgery, surgical parameters, and hospitalization expenses. Patients were followed up every 6 months and tumor recurrence was assessed by CT and ultrasound...
September 2016: Medicine (Baltimore)
Amit Kumar Mittal, Namrata Gupta
In the era of evidence-based medicine, ultrasonography has emerged as an important and indispensable tool in clinical practice in various specialties including critical care. Lung ultrasound (LUS) has a wide potential in various surgical and clinical situations for timely and easy detection of an impending crisis such as pulmonary edema, endobronchial tube migration, pneumothorax, atelectasis, pleural effusion, and various other causes of desaturation before it clinically ensues to critical level. Although ultrasonography is frequently used in nerve blocks, airway handling, and vascular access, LUS for routine intraoperative monitoring and in crisis management still necessitates recognition...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
Poul Henning Madsen, Søren Hess
Basic knowledge of pulmonary embolism is relevant to most practicing physicians. Many medical specialties care for patients with increased risk of pulmonary embolism, why recognition of relevant symptoms, a thorough medical history, assessment of the clinical condition of the patient and possibly referral to a relevant facility should be a part of the skills of all clinicians. Sudden onset dyspnea, chest pain, syncope and hemoptysis are essential symptoms of pulmonary embolism, and in most of these patients basic investigations like arterial blood gas analysis, electrocardiogram, chest x-ray and biochemical analyses are appropriate...
September 13, 2016: Advances in Experimental Medicine and Biology
Massimo Zambon, Massimiliano Greco, Speranza Bocchino, Luca Cabrini, Paolo Federico Beccaria, Alberto Zangrillo
PURPOSE: Diaphragmatic dysfunction (DD) has a high incidence in critically ill patients and is an under-recognized cause of respiratory failure and prolonged weaning from mechanical ventilation. Among different methods to assess diaphragmatic function, diaphragm ultrasonography (DU) is noninvasive, rapid, and easy to perform at the bedside. We systematically reviewed the current literature assessing the usefulness and accuracy of DU in intensive care unit (ICU) patients. METHODS: Pubmed, Cochrane Database of Systematic Reviews, Embase, Scopus, and Google Scholar Databases were searched for pertinent studies...
September 12, 2016: Intensive Care Medicine
Radović V Saša, Lazovic Ranko, Crnogorac Snezana, Banjac Lidija, Suhih Djordje
BACKGROUND: Embryologically, duodenal atresia results from inadequate recanalisation and proliferation of gut epithelius in the 6th week of gestation, while apple-pee atresia of small bowel is a consequence of a vascular accident in subsequent embryonic development, and the two are rather rarely manifested as a joint clinical entity. CASE PRESENTATION: We present here a 29 week preterm boy admitted to the intensive care unit due to breathing difficulties and low birthweight...
2016: BMC Pediatrics
(no author information available yet)
OBJECTIVE: To observe the occurrence rate of elevated serum amylase and lipase in critically ill children, to explore the relationship between elevated pancreatic enzymes and pancreatic injury, and the effect of elevated pancreatic enzymes on state of illness and the prognosis. METHOD: The data of cases treated in pediatric intensive care unit(ICU) of 17 children's hospitals were collected prospectively from January 2012 to March 2014 according to the inclusion and exclusion criteria...
September 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Monodeep Biswas, Rajendrakumar Patel, Charles German, Anant Kharod, Ahmed Mohamed, Harvinder S Dod, Poonam Malhotra Kapoor, Navin C Nanda
The knowledge gained from echocardiography is paramount for the clinician in diagnosing, interpreting, and treating various forms of disease. While cardiologists traditionally have undergone training in this imaging modality during their fellowship, many other specialties are beginning to show interest as well, including intensive care, anesthesia, and primary care trainees, in both transesophageal and transthoracic echocardiography. Advances in technology have led to the development of simulation programs accessible to trainees to help gain proficiency in the nuances of obtaining quality images, in a low stress, pressure free environment, often with a functioning ultrasound probe and mannequin that can mimic many of the pathologies seen in living patients...
September 1, 2016: Echocardiography
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