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Icu ultrasound

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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
#1
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
#2
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/29747267/-application-of-uterine-lower-part-breakwater-like-suture-operation-in-placenta-previa
#3
Y Zhao, J W Zhu, D Wu, Q H Wang, S S Lu, X X Liu, L Zou
Objective: To explore the efficacy and safety of uterine lower posterior wall breakwater-like suture technique in controlling the intraoperative bleeding of placenta previa. Methods: From June 2016 to June 2017, 47 patients were diagnosed placenta previa in Union Hospital, Tongji Medical College of Huazhong University of Science and Technology. Posterior wall breakwater-like suture technique was used preferentially, as for cases with poor myometrium layer, lower anterior wall stitch suture was used at the same time...
April 25, 2018: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/29726988/validation-of-noninvasive-absolute-intracranial-pressure-measurements-in-traumatic-brain-injury-and-intracranial-hemorrhage
#4
Jenny C Kienzler, Rolandas Zakelis, Sabrina Bäbler, Elke Remonda, Arminas Ragauskas, Javier Fandino
BACKGROUND: Increased intracranial pressure (ICP) causes secondary damage in traumatic brain injury (TBI), and intracranial hemorrhage (ICH). Current methods of ICP monitoring require surgery and carry risks of complications. OBJECTIVE: To validate a new instrument for noninvasive ICP measurement by comparing values obtained from noninvasive measurements to those from commercial implantable devices through this pilot study. METHODS: The ophthalmic artery (OA) served as a natural ICP sensor...
May 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29719745/acute-acalculous-cholecystitis-in-the-setting-of-negative-ultrasound-and-computed-tomography-scan-of-the-abdomen
#5
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/29705730/paediatric-traumatic-cardiac-arrest-a-delphi-study-to-establish-consensus-on-definition-and-management
#6
Annette C Rickard, James Vassallo, Tim Nutbeam, Mark D Lyttle, Ian K Maconochie, Doyo G Enki, Jason E Smith
AIMS: Paediatric traumatic cardiac arrest (TCA) is associated with low survival and poor outcomes. The mechanisms that underlie TCA are different from medical cardiac arrest; the approach to treatment of TCA may therefore also need to differ to optimise outcomes. The aim of this study was to explore the opinion of subject matter experts regarding the diagnosis and treatment of paediatric TCA, and to reach consensus on how best to manage this group of patients. METHODS: An online Delphi study was conducted over three rounds, with the aim of achieving consensus (defined as 70% agreement) on statements related to the diagnosis and management of paediatric TCA...
April 28, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29703223/comparison-of-exercise-intensity-during-four-early-rehabilitation-techniques-in-sedated-and-ventilated-patients-in-icu-a-randomised-cross-over-trial
#7
Clément Medrinal, Yann Combret, Guillaume Prieur, Aurora Robledo Quesada, Tristan Bonnevie, Francis Edouard Gravier, Elise Dupuis Lozeron, Eric Frenoy, Olivier Contal, Bouchra Lamia
BACKGROUND: In the ICU, out-of-bed rehabilitation is often delayed and in-bed exercises are generally low-intensity. Since the majority of rehabilitation is carried out in bed, it is essential to carry out the exercises that have the highest intensity. The aim of this study was to compare the physiological effects of four common types of bed exercise in intubated, sedated patients confined to bed in the ICU, in order to determine which was the most intensive. METHODS: A randomised, single-blind, placebo-controlled crossover trial was carried out to evaluate the effects of four bed exercises (passive range of movements (PROM), passive cycle-ergometry, quadriceps electrical stimulation and functional electrical stimulation (FES) cycling) on cardiac output...
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
#8
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/29682549/preliminary-exploration-of-epidemiologic-and-hemodynamic-characteristics-of-restrictive-filling-diastolic-dysfunction-based-on-echocardiography-in-critically-ill-patients-a-retrospective-study
#9
Yi Li, Wanhong Yin, Yao Qin, Xueying Zeng, Tongjuan Zou, Xiaoting Wang, Yangong Chao, Lina Zhang, Yan Kang, Chinese Critical Ultrasound Study Group Ccusg
Objective: To preliminarily describe the epidemiologic and hemodynamic characteristics of critically ill patients with restrictive filling diastolic dysfunction based on echocardiography. Setting: A retrospective study. Methods: Epidemiologic characteristics of patients with restrictive filling diastolic dysfunction in ICU were described; clinical and hemodynamic data were preliminarily summarized and compared between patients with and without restrictive filling diastolic dysfunction; most of the data were based on echocardiography...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29677008/evolution-of-acute-kidney-injury-and-its-association-with-systemic-hemodynamics-in-children-with-fluid-refractory-septic-shock
#10
Akash Deep, Hiremath Sagar, Chulananda Goonasekera, Palaniswamy Karthikeyan, Joe Brierley, Abdel Douiri
OBJECTIVES: There are no studies in pediatrics evaluating the progression of acute kidney injury in septic shock. We investigated the evolution of sepsis-associated acute kidney injury and its association with systemic hemodynamics in children with fluid-refractory septic shock. DESIGN: Prospective cohort study. SETTING: PICU of a tertiary care hospital. PATIENTS: All patients with fluid-refractory septic shock (n = 61) between September 2010 and February 2014...
April 19, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29669237/current-practice-of-diagnosis-and-management-of-acute-kidney-injury-in-intensive-care-unit-in-resource-limited-settings
#11
Nattachai Srisawat, Nattaya Sintawichai, Win Kulvichit, Nuttha Lumlertgul, Patita Sitticharoenchai, Nicha Thamrongsat, Sadudee Peerapornratana
PURPOSE: In a resource limited settings, there is sparse information about the management of acute kidney injury (AKI) based on systemic data collection. This survey aimed to described the current management of AKI in intensive care units (ICUs) across Thailand. MATERIALS AND METHODS: Questionnaires were distributed to 160 physicians involved in the intensive care between January and December 2014 across Thailand. Distribution was done through an online survey platform or telephone interview...
April 11, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29666712/eustachian-valve-endocarditis-echocardiographic-diagnosis-in-a-critical-care-patient
#12
Mariana Alves, Rita Faria, António Messias, Carlos Meneses-Oliveira
Eustachian valve endocarditis is rare. A literature review revealed that only 29 cases have been reported and, among them, there is only one mention of an intensive care unit (ICU) admission. We present an 82-year-old man without previous medical records who presented with septic shock with multiple organ dysfunction. The patient was admitted to the ICU and deteriorated with combined shock (septic + cardiogenic). A second ultrasound screen detected a prominent Eustachian valve with mobile multilobulated vegetation attached...
2018: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29656607/expert-agreement-in-the-interpretation-of-lung-ultrasound-studies-performed-on-mechanically-ventilated-patients
#13
Scott J Millington, Robert T Arntfield, Robert Jie Guo, Seth Koenig, Pierre Kory, Vicki Noble, Haney Mallemat, Jordan R Schoenherr
OBJECTIVES: Although lung ultrasound (US) has been shown to have high diagnostic accuracy in patients presenting with acute dyspnea, its precision in critically ill patients is unknown. We investigated common areas of agreement and disagreement by studying 6 experts as they interpreted lung US studies in a cohort of intensive care unit (ICU) patients. METHODS: A previous study by our group asked experts to rate the quality of 150 lung US studies performed by 10 novices in a population of mechanically ventilated patients...
April 15, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29650485/providing-transthoracic-echocardiography-training-for-intensive-care-unit-trainees-an-educational-improvement-initiative
#14
Catherine M Kuza, M Tariq Hanifi, Melissa Koç, Matthias Stopfkuchen-Evans
OBJECTIVE: Transthoracic echocardiography (TTE) is important in the management of critically ill patients, yet it has not been incorporated into many residency programs' curricula. Our objective is to determine if trainees undergoing a 60-minute training session on TTE have improved knowledge, ultrasound skills, and increases the utilization of TTE during their rotation in the intensive care unit (ICU). We will also compare the results of participants with prior TTE exposure to TTE-naïve trainees...
April 9, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29601314/diagnostic-accuracy-of-chest-radiograph-and-when-concomitantly-studied-lung-ultrasound-in-critically-ill-patients-with-respiratory-symptoms-a-systematic-review-and-meta-analysis
#15
Michiel H Winkler, Hugo R Touw, Peter M van de Ven, Jos Twisk, Pieter R Tuinman
OBJECTIVES: Chest radiograph is considered the first-line diagnostic imaging modality for patients presenting with pulmonary symptoms in the ICU. In this meta-analysis, we aim to evaluate the diagnostic accuracy of chest radiograph, and when concomitantly studied lung ultrasound, in comparison with the gold-standard CT for adult critically ill patients with respiratory symptoms. DATA SOURCES: PubMed, EMBASE, and Gray literature. STUDY SELECTION: Studies comparing chest radiograph, and if performed lung ultrasound, with CT for adult ICU patients with respiratory symptoms...
March 29, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29600543/speckle-tracking-analysis-in-intensive-care-unit-a-toy-or-a-tool
#16
REVIEW
Antonello D'Andrea, Juri Radmilovic, Donato Mele, Flavio D'Ascenzi, Eustachio Agricola, Andreina Carbone, Francesco Lo Iudice, Giuseppina Novo, Francesco Ancona, Francesca Maria Righini, Sergio Mondillo, Eduardo Bossone, Maurizio Galderisi
The use of conventional echocardiography in the intensive care unit (ICU) is today established to assess left and right ventricular systolic function, for preload determination and procedural guidance. Next step in ICU echocardiography could be the use of novel ultrasound techniques such as strain echocardiography to assist in the management of patients with acute coronary syndrome, heart failure, or pulmonary embolism. This review has gathered the available evidence supporting the incremental value of strain in the diagnostic workup of cardiac diseases treated in ICU...
March 30, 2018: Echocardiography
https://www.readbyqxmd.com/read/29581561/nutritional-risk-assessment-at-admission-can-predict-subsequent-muscle-loss-in-critically-ill-patients
#17
Amartya Mukhopadhyay, Bee Choo Tai, Deepa Remani, Jeya Henry, Yanika Kowitlawakul, Zudin Amika Puthucheary
Muscle loss in critically ill patients may be related to nutrition. We study the association between modified NUTrition RIsk in the Critically ill (mNUTRIC) score obtained at admission to intensive care unit (ICU) and subsequent muscle loss. We measured rectus femoris cross-sectional area (RFCSA) by ultrasound on days 1, 3, 7, and 10 of ICU admission. We used linear mixed effects model following natural logarithmic transformation of the data. Forty-eight patients (median (IQR) age 66 (55-72.5) years, 71% male, APACHE II score 31 (25-34), BMI 24...
March 26, 2018: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29544581/percutaneous-tracheostomy-by-physician-intensivists
#18
Asad Zaman Khan, Aslam Khan, Arshad Naseem
OBJECTIVE: To assess the safety of percutaneous tracheostomy when performed by physician intensivists. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Adult Medical ICU in the Department of Critical Care Medicine, Military Hospital, Rawalpindi, Pakistan, from September 2013 to August 2016. METHODOLOGY: Departmental record for percutaneous tracheostomies, performed by physician intensivifts, was evaluated...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29519280/-variability-of-peripheral-arterial-peak-velocity-predicts-fluid-responsiveness-in-patients-with-septic-shock
#19
Nianfang Lu, Li Jiang, Bo Zhu, Wenyong Han, Yingqi Zhao, Yuntao Shi, Fashuang Guo, Xiuming Xi
OBJECTIVE: To explore the accuracy of fluid responsiveness assessment by variability of peripheral arterial peak velocity and variability of inferior vena cava diameter (ΔIVC) in patients with septic shock. METHODS: A prospective study was conducted. The patients with septic shock undergoing mechanical ventilation (MV) admitted to intensive care unit (ICU) of Beijing Electric Power Hospital from January 2016 to December 2017 were enrolled. According to sepsis bundles of septic shock, volume expansion (VE) was conducted...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29498941/ultrasound-guided-laryngeal-air-column-width-difference-as-a-new-predictor-for-postextubation-stridor-in-children
#20
Doaa El Amrousy, Mohamed Elkashlan, Nagat Elshmaa, Ahmed Ragab
OBJECTIVES: To assess the efficacy of ultrasound-guided laryngeal air column width difference in predicting postextubation stridor in children. DESIGN: Prospective observational study. SETTING: Single, tertiary care pediatric hospital. PATIENTS: This study was carried out at PICU and surgical ICU, Tanta University Hospital on 400 ventilated children between January 2015 and May 2017. Patients who received mechanical ventilation and met criteria for a weaning trial were included...
June 2018: Critical Care Medicine
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