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Ultrasound in critical care

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https://www.readbyqxmd.com/read/28198726/community-acquired-pneumonia-requiring-hospitalization-rational-decision-making-and-interpretation-of-guidelines
#1
Douwe F Postma, Cornelis H van Werkhoven, Jan Jelrik Oosterheert
PURPOSE OF REVIEW: This review focuses on the evidence base for guideline recommendations on the diagnosis, the optimal choice, timing and duration of empirical antibiotic therapy, and the use of microbiological tests for patients hospitalized with community-acquired pneumonia (CAP): issues for which guidelines are frequently used as a quick reference. Furthermore, we will discuss possibilities for future research in these topics. RECENT FINDINGS: Many national and international guideline recommendations, even on critical elements of CAP management, are based on low-to-moderate quality evidence...
February 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28195961/bedside-ultrasound-to-facilitate-early-diagnosis-and-ease-of-follow-up-in-neurogenic-heterotopic-ossification-a-pilot-study-from-the-intensive-care-unit
#2
Konstantinos Stefanidis, Peter Brindley, Raymond Ramnarine, Michael Blaivas, Mohammad Daneshi, Paul S Sidhu, Abdoulrahman Alharthy, Dimitrios Karakitsos
OBJECTIVE: To explore the potential role of ultrasound (US) as a bedside tool in intensive care unit patients with presumed neurogenic heterotopic ossification (NHO). SETTING: Tertiary university teaching hospitals. PARTICIPANTS: Critical care patients with acquired brain injury. DESIGN: A multicenter prospective study of critical care patients with possible NHO. MAIN MEASURES: Following a screening clinical examination, the major joints were evaluated with US, serum laboratory work, and x-ray...
February 10, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28185691/thoracic-ultrasound-technique-applications-and-interpretation
#3
REVIEW
Suraj H Rambhia, Catherine A D'Agostino, Ali Noor, Robert Villani, Jason J Naidich, John S Pellerito
Thoracic ultrasound is used at the bedside in emergency and critical care settings. Advantages of ultrasound include rapid real-time, low-cost, diagnostic information that can direct patient care without the use of ionizing radiation. We describe methods on how to perform lung ultrasound, with the intent to educate the radiologist who might otherwise be relatively unfamiliar with thoracic sonography. We describe and depict the normal sonographic appearance of lung anatomy. We also show the sonographic appearance of a wide range of lung and pleural pathologies such as pneumonia, pneumothorax, as well as lung and pleural masses...
December 15, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28178063/detecting-pulmonary-edema-in-obstetric-patients-through-point-of-care-lung-ultrasonography
#4
Sarah Pachtman, Seth Koenig, Natalie Meirowitz
BACKGROUND: Point-of-care lung ultrasonography is used in critical care settings for evaluating respiratory symptoms. Lung ultrasonography is sensitive and specific for the diagnosis of pulmonary edema in nonpregnant patients but is not well-studied in pregnancy. TECHNIQUE: Lung ultrasonography was performed using a portable ultrasound machine with a 2- to 5-MHz curvilinear probe that is available on many labor and delivery units. EXPERIENCE: Lung ultrasonography guided management decisions in a case of shortness of breath after induction of labor for preeclampsia and a case of hemolysis, elevated liver enzymes, and low platelet count syndrome complicated by pulmonary edema...
February 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28177233/speed-of-sound-and-ultrasound-absorption-in-ionic-liquids
#5
Marzena Dzida, Edward Zorębski, Michał Zorębski, Monika Żarska, Monika Geppert-Rybczyńska, Mirosław Chorążewski, Johan Jacquemin, Ivan Cibulka
A complete review of the literature data on the speed of sound and ultrasound absorption in pure ionic liquids (ILs) is presented. Apart of the analysis of data published to date, the significance of the speed of sound in ILs is regarded. An analysis of experimental methods described in the literature to determine the speed of sound in ILs as a function of temperature and pressure is reported, and the relevance of ultrasound absorption in acoustic investigations is discussed. Careful attention was paid to highlight possible artifacts, and side phenomena related to the absorption and relaxation present in such measurements...
February 8, 2017: Chemical Reviews
https://www.readbyqxmd.com/read/28151763/the-magnitude-and-time-course-of-muscle-cross-section-decrease-in-intensive-care-unit-patients
#6
Dianne Ten Haaf, Bea Hemmen, Henk van de Meent, Thamar J H BovendʼEerdt
OBJECTIVE: Bedriddenness and immobilization of patients at an intensive care unit may result in muscle atrophy and devaluation in quality of life. The exact effect of immobilization on intensive care unit patients is not known. The aim of this study was to investigate the magnitude and time course of muscle cross-section decrease in acute critically ill patients admitted to the intensive care unit. DESIGN: An observational pilot study was performed in intensive care unit patients...
February 1, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28149825/correlations-between-pulmonary-artery-pressures-and-inferior-vena-cava-collapsibility-in-critically-ill-surgical-patients-an-exploratory-study
#7
Stanislaw P Stawicki, Thomas J Papadimos, David P Bahner, David C Evans, Christian Jones
INTRODUCTION: As pulmonary artery catheter (PAC) use declines, search continues for reliable and readily accessible minimally invasive hemodynamic monitoring alternatives. Although the correlation between inferior vena cava collapsibility index (IVC-CI) and central venous pressures (CVP) has been described previously, little information exists regarding the relationship between IVC-CI and pulmonary artery pressures (PAPs). The goal of this study is to bridge this important knowledge gap...
October 2016: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28149575/veno-venous-extracorporeal-membrane-oxygenation-cannulation-techniques
#8
REVIEW
Carlo Banfi, Matteo Pozzi, Nils Siegenthaler, Marie-Eve Brunner, Didier Tassaux, Jean-Francois Obadia, Karim Bendjelid, Raphaël Giraud
The development of extracorporeal membrane oxygenation (ECMO) technology allows a new approach for the intensive care management of acute cardiac and/or respiratory failure in adult patients who are not responsive to conventional treatment. Current ECMO therapies provide a variety of options for the multidisciplinary teams who are involved in the management of these critically ill patients. In this regard, veno-venous ECMO (VV-ECMO) can provide quite complete respiratory support, even if this highly complex technique presents substantial risks, such as bleeding, thromboembolic events and infection...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28145770/objective-and-structured-assessment-of-lung-ultrasound-competence-a-multispecialty-delphi-consensus-and-construct-validity-study
#9
Søren Helbo Skaarup, Christian B Laursen, Anne Sofie Bjerrum, Ole Hilberg
RATIONALE: Point-of-care lung ultrasound imaging has substantial diagnostic value and is widely used in respiratory, emergency and critical care medicine. Like other ultrasound examinations, lung ultrasound is operator-dependent. The current recommendations for competence in lung ultrasound sets a fixed number of ultrasound procedures to be performed without considering different learning rates. Recommendations do not consider different uses of lung ultrasound across specialties. OBJECTIVE: To create a reliable, valid and feasible instrument to assess lung ultrasound competence that includes the diverse use of lung ultrasound among medical specialties...
February 1, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28144779/focused-cardiac-ultrasound-in-the-early-resuscitation-of-severe-sepsis-and-septic-shock-a-prospective-pilot-study
#10
Hiroshi Sekiguchi, Yohei Harada, Hector R Villarraga, Sunil V Mankad, Ognjen Gajic
PURPOSE: Point-of-care ultrasonography has been increasingly used in the care of critically ill patients; however, reports on its use during active resuscitation are limited. The aim of this study was to investigate the true impact of focused cardiac ultrasound (FCU) during the management of sepsis with early (6-h) resuscitation. METHODS: A prospective pilot observational study was conducted at an academic medical center from March 2011 through July 2012. Patients undergoing resuscitation for severe sepsis or septic shock were prospectively enrolled at medical and combined medical-surgical intensive care units...
January 31, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28118684/ultrasound-in-undergraduate-medical-education-a-systematic-and-critical-review
#11
REVIEW
Zac Feilchenfeld, Tim Dornan, Cynthia Whitehead, Ayelet Kuper
CONTEXT: The use of point-of-care ultrasound (POCUS) in clinical care is growing rapidly and advocates have recently proposed the integration of ultrasound into undergraduate medical education (UME). The evidentiary basis for this integration has not been evaluated critically or systematically. OBJECTIVES: We conducted a critical and systematic review framed by the rationales enumerated in academic publications by advocates of ultrasound in UME. METHODS: This research was conducted in two phases...
January 24, 2017: Medical Education
https://www.readbyqxmd.com/read/28116010/an-analysis-of-the-top-cited-articles-in-emergency-medicine-education-literature
#12
Brendan W Munzer, Jeffery Love, Barbara L Shipman, Brendan Byrne, Stephen J Cico, Robert Furlong, Sorabh Khandelwal, Sally A Santen
INTRODUCTION: Dissemination of educational research is critical to improving medical education, promotion of faculty and ultimately patient care. The objective of this study was to identify the top 25 cited education articles in the emergency medicine (EM) literature and the top 25 cited EM education articles in all journals, as well as report on the characteristics of the articles. METHODS: Two searches were conducted in the Web of Science in June 2016 using a list of education-related search terms...
January 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28101565/use-of-neuromuscular-electrical-stimulation-to-preserve-the-thickness-of-abdominal-and-chest-muscles-of-critically-ill-patients-a-randomized-clinical-trial
#13
Ana M Dall' Acqua, Amanda Sachetti, Laura J Santos, Fernando A Lemos, Tanara Bianchi, Wagner S Naue, Alexandre S Dias, Graciele Sbruzzi, Silvia R R Vieira
OBJECTIVE: To evaluate and compare the effects of neuromuscular electrical stimulation combined with conventional physical therapy on muscle thickness in critically ill patients. DESIGN: Double-blind, randomized controlled trial. PATIENTS: Twenty-five patients participated in the study. METHODS: Patients on mechanical ventilation for 24-48 h were randomized to an intervention group (neuromuscular electrical stimulation + conventional physical therapy) or a conventional group (sham neuromuscular electrical stimulation + conventional physical therapy)...
January 19, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28101364/hemodynamic-effects-of-electrical-muscle-stimulation-in-the-prophylaxis-of-deep-vein-thrombosis-for-intensive-care-unit-patients-a-randomized-trial
#14
Masahiro Ojima, Ryosuke Takegawa, Tomoya Hirose, Mitsuo Ohnishi, Tadahiko Shiozaki, Takeshi Shimazu
BACKGROUND: Deep vein thrombosis (DVT) is a major complication in critical care. There are various methods of prophylaxis, but none of them fully prevent DVT, and each method has adverse effects. Electrical muscle stimulation (EMS) could be a new effective approach to prevent DVT in intensive care unit (ICU) patients. We hypothesized that EMS increases the venous flow of the lower limbs and has a prophylactic effect against the formation of DVT. METHODS: This study included 26 patients admitted to a single ICU...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28076607/vascular-access-the-impact-of-ultrasonography
#15
Carlos Eduardo Saldanha de Almeida
Vascular punctures are often necessary in critically ill patients. They are secure, but not free of complications. Ultrasonography enhances safety of the procedure by decreasing puncture attempts, complications and costs. This study reviews important publications and the puncture technique using ultrasound, bringing part of the experience of the intensive care unit of the Hospital Israelita Albert Einstein, São Paulo (SP), Brazil, and discussing issues that should be considered in future studies. RESUMO Punções vasculares são muitas vezes necessárias em pacientes gravemente enfermos...
October 2016: Einstein
https://www.readbyqxmd.com/read/28074819/percutaneous-tracheostomy
#16
REVIEW
Chitra Mehta, Yatin Mehta
Percutaneous dilatational tracheostomy (PDT) is a commonly performed procedure in critically sick patients. It can be safely performed bedside by intensivists.This has resulted in decline in the use of surgical tracheostomy in intensive care unit (ICU) except in few selected cases. Most common indication of tracheostomy in ICU is need for prolonged ventilation. About 10% of patients requiring at least 3 days of mechanical ventilator support get tracheostomised during ICU stay. The ideal timing of PDT remains undecided at present...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28040615/should-procedural-skills-be-a-part-of-the-acute-care-nurse-practitioner-curriculum
#17
Amita Avadhani
Invasive procedures are an integral component of the time sensitive management of the acute and critically ill patients. Acute Care Nurse Practitioner (ACNP) students aspiring to be employed in their roles in the acute care settings cannot be autonomous in their practices unless they have a minimum level of proficiency to perform life sustaining invasive procedures. Offering additional level of benefits of safety and quality in healthcare, simulation as a teaching method has grown in popularity among various levels of education among variety of disciplines...
March 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28040139/prenatal-diagnosis-of-paternal-duplication-of-11p15-5%C3%A2-14-3-its-implication-of-beckwith-wiedemann-syndrome
#18
Kuan Ju Chen, Yu Mei Liu, Chien Hong Li, Yao Lung Chang, Shuenn Dyh Chang
OBJECTIVE: To characterize a prenatally detected chromosomal aberration with molecular cytogenetic approaches and explore its relationship with Beckwith-Wiedemann syndrome (BWS). CASE REPORT: A 33-year-old woman, gravida 2, para 0, was referred to our prenatal clinic at 20+ weeks due to an abnormal amniocentesis karyotyping finding, which showed 46,XY,add(11)(q24.2)dn. The mother conceived through in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI), then embryo transfer...
December 2016: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28030932/usage-of-perioperative-anxiety-neuromarker-for-improving-the-quality-of-life-of-a-patient-operated-on-for-critical-stenosis-of-the-internal-carotid-artery
#19
Mariusz Trystuła, Paweł Półrola, Juri Kropotov
OBJECTIVE: The aim of the study was to find a neuromarker of perioperative anxiety in a patient with critical carotid stenosis through the use of neuromarkers in Quantitative EEG (QEEG) and Event Related Potentials (ERPs). The indirect purpose of the research was evaluation of improvement in the patient's quality of life. CASE STUDY: A 45-year-old woman was admitted to the Department of Vascular Surgery and Endovascular Interventions at the John Paul II Hospital in Krakow, with the diagnosis of critical internal carotid stenosis (over 80%), confirmed by Doppler Ultrasound and Angio-CT examinations...
23, 2016: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/28028552/venous-thromboembolic-events-in-critically-ill-traumatic-brain-injury-patients
#20
Markus B Skrifvars, Michael Bailey, Jeffrey Presneill, Craig French, Alistair Nichol, Lorraine Little, Jacques Duranteau, Olivier Huet, Samir Haddad, Yaseen Arabi, Colin McArthur, D James Cooper, Rinaldo Bellomo
PURPOSE: To estimate the prevalence, risk factors, prophylactic treatment and impact on mortality for venous thromboembolism (VTE) in patients with moderate to severe traumatic brain injury (TBI) treated in the intensive care unit. METHODS: A post hoc analysis of the erythropoietin in traumatic brain injury (EPO-TBI) trial that included twice-weekly lower limb ultrasound screening. Venous thrombotic events were defined as ultrasound-proven proximal deep venous thrombosis (DVT) or clinically detected pulmonary embolism (PE)...
December 27, 2016: Intensive Care Medicine
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