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Diaphragmatic ultrasound

E Salzano, S E Raible, M Kaur, A Wilkens, G Sperti, R K Tilton, L R Bettini, A Rocca, G Cocchi, A Selicorni, L K Conlin, D McEldrew, R Gupta, S Thakur, K Izumi, I D Krantz
Pallister-Killian syndrome (PKS) is a tissue limited mosaic disorder, characterized by variable degrees of neurodevelopmental delay and intellectual disability, typical craniofacial findings, skin pigmentation anomalies and multiple congenital malformations. The wide phenotypic spectrum of PKS in conjunction with the mosaic distribution of the i(12p) makes PKS an underdiagnosed disorder. Recognition of prenatal findings that should raise a suspicion of PKS is complicated by the fragmentation of data currently available in the literature and challenges in diagnosing a mosaic diagnosis on prenatal testing...
October 5, 2018: American Journal of Medical Genetics. Part A
Zhicheng Qian, Ming Yang, Lin Li, Yaolong Chen
OBJECTIVE: The aim of this systematic review was to assess the diaphragmatic dysfunction (DD) as a predictor of weaning outcome. BACKGROUND: Successful weaning depends on several factors: muscle strength, cardiac, respiratory and metabolic. Acquired weakness in mechanical ventilation is a growing important cause of weaning failure. With the development of ultrasonography, DD can be evaluated with ultrasound in weakness patients to predict weaning outcomes. METHODS: The Cochrane Library, PubMed, Embase, Ovid Medline, WanFang Data and CNKI were systematically searched from the inception to September 2017...
October 4, 2018: BMJ Open
Rachel B Davy, Philip E Hamel, Yu Su, Clifford R Berry, Bobbi J Conner
Ultrasound techniques, including focused assessment with sonography for trauma (FAST) examinations, are commonly used in veterinary practice, making inclusion of ultrasound in veterinary curricula increasingly important. The best approach for teaching ultrasound techniques in veterinary medicine has not been evaluated. This study compared the results of two training techniques, live-animal training and online video instruction, on students' performance during abdominal FAST (A-FAST) examinations. Thirty-eight first- and second-year veterinary students were randomly assigned to learn A-FAST via a live-animal laboratory or an instructional video...
October 4, 2018: Journal of Veterinary Medical Education
Kit Fai Lee, Hon Ting Lok, Andrew K Y Fung, Charing C N Chong, Yue Sun Cheung, John Wong, Paul B S Lai
A 51-year-old man who was a hepatitis B carrier presented with ruptured hepatocellular carcinoma (HCC). Hepatic arterial embolization was performed for control of bleeding which was followed by staged open left lateral sectionectomy for tumor removal. Pathology confirmed a 3.5 cm ruptured subcapsular HCC in a cirrhotic liver with clear resection margin. However, the alpha-fetoprotein (AFP) increased from 14 to 72 µg/L after 7 months. A 1.7 × 0.8 cm nodule at left subdiaphragmatic region abutting on the spleen but no intrahepatic lesion was seen on computed tomography (CT)...
September 29, 2018: Journal of Robotic Surgery
Victoria Arruga Novoa Y Novoa, Laura F Sutton, Allan E Neis, Amber M Marroquin, Tracey M Coleman, Kathleen A Praska, Tamara A Freimund, Krystal L Ruka, Vicki L Warzala, Haleh Sangi-Haghpeykar, Rodrigo Ruano
OBJECTIVES: The aim of this study was to investigate the reproducibility of a standardized method to assess the ultrasound liver-to-thoracic area ratio in fetuses with congenital diaphragmatic hernia. METHODS: We selected 24 images of 9 fetuses diagnosed with left-sided at our institution between January 2010 and December 2017. Eight operators (1 maternal-fetal medicine specialist and 7 sonographers) reviewed the selected images and assessed the ultrasound liver-to-thoracic area ratio according to a standardized protocol...
September 23, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Ryne A Didier, Suzanne E DeBari, Edward R Oliver, Juliana S Gebb, Lori J Howell, Holly L Hedrick, N Scott Adzick, Beverly G Coleman
OBJECTIVES: To determine whether an abnormal orientation of the abdominal or hepatic vasculature and an abnormal gallbladder position on prenatal ultrasound (US) imaging are associated with intrathoracic liver herniation and postnatal outcomes in cases of congenital diaphragmatic hernia (CDH). METHODS: Children who underwent prenatal US examinations and postnatal CDH repair at our institution were eligible. Prenatal US images were reviewed, and the orientation of the superior mesenteric artery (SMA) and hepatic veins as well as gallbladder position were recorded...
September 23, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Michael C Sklar, Martin Dres, Nuttapol Rittayamai, Brent West, Domenico Luca Grieco, Irene Telias, Detajin Junhasavasdikul, Michela Rauseo, Tai Pham, Fabiana Madotto, Carolyn Campbell, Elizabeth Tullis, Laurent Brochard
BACKGROUND: Noninvasive ventilation (NIV) is the first-line treatment of adult patients with exacerbations of cystic fibrosis (CF). High-flow nasal oxygen therapy (HFNT) might benefit patients with hypoxemia and can reduce physiological dead space. We hypothesized that HFNT and NIV would similarly reduce work of breathing and improving breathing pattern in CF patients. Our objective was to compare the effects of HFNT versus NIV in terms of work of breathing, assessed noninvasively by the thickening fraction of the diaphragm (TFdi, measured with ultrasound), breathing pattern, transcutaneous CO2 (PtcCO2 ), hemodynamics, dyspnea and comfort...
September 5, 2018: Annals of Intensive Care
Ingrid Anne Mandy Schierz, Mario Giuffrè, Ettore Piro, Maria Clara Leone, Giuseppa Pinello, Giovanni Corsello
BACKGROUND: Congenital space-occupying thoracic malformations and diaphragmatic hernia have in common pulmonary hypoplasia. Our study aims to assess cardiac involvement during post-natal adaptation. METHODS: A retrospective study was carried out on newborns with prenatally diagnosed intrathoracic mass. Gathering for respiratory distress syndrome (RDS), 35 neonates were compared for clinical course, cardiovascular enzymes, ECG, and ultrasound. RESULTS: The analysis revealed a high left heart defect rate in patients with severe RDS, without being influenced by the laterality...
August 22, 2018: Italian Journal of Pediatrics
Sylvain Droneau, Elise Noel-Savina, Gavin Plat, Marlene Murris-Espin, Aurélie Leborgne-Krams, Laurent Brouchet, Marcel Dahan, Alain Didier
The authors report their findings regarding lung ultrasound profiles in a population of transplant recipients. Twenty-two patients were studied once each in multiple different ultrasound windows focusing on pleural, lung, and diaphragmatic signatures. All studies were performed in presumably otherwise healthy recipients at an outpatient follow-up visit at least 3 months after transplantation. Those with recent pulmonary infections or decline in lung function were excluded from enrollment. The majority of scans revealed otherwise normal lungs with lung sliding, but there were more abnormalities than one would expect in a healthy control group...
August 19, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Julie Monteagudo, Catherine M Dickinson, Michelle Wakeley, Shamlal Mangray, Hale E Wills, Francois I Luks
INTRODUCTION:  Rhabdomyomatous dysplasia (RD) is a pathologic finding in CPAMs that was incorrectly attributed to their malignant potential. The increasing recognition of extrathoracic (intradiaphragmatic and intraabdominal) congenital pulmonary airway malformations (CPAMs) offers a clue to the origin of RD. We hypothesize that the presence of RD is related to the CPAM's anatomic location. MATERIALS AND METHODS:  Retrospective review was performed of all children who underwent resection of a CPAM during a 10-year period...
August 13, 2018: European Journal of Pediatric Surgery
Ankur Sharma, Sunaina Tejpal Karna, Manish Tandon, Chandra Kant Pandey, Ravindra Chaturvedi, Varuna Vyas, Akhil Dhanesh Goel
Background and Objectives: The present study was designed to explore the utility of ultrasound-guided diaphragmatic thickness in the preoperative period in healthy controls scheduled for live-related donor hepatectomy and patients suffering from chronic liver disease scheduled for liver transplantation (LT) and its use as a predictor of postoperative weaning failure. Materials and Methods: This prospective observational study was conducted in a tertiary health care center and 65 adult (18-70 years) participants (30 healthy liver donors and 35 liver transplant recipients) were enrolled for this study...
July 2018: Saudi Journal of Anaesthesia
Kazuya Mimura, Masayuki Endo, Keiko Matsuoka, Takuji Tomimatsu, Yuko Tazuke, Hiroomi Okuyama, Makoto Takeuchi, Tadashi Kimura
Congenital rachischisis and brachioesophagus with secondary intrathoracic stomach, which is described as "serpentine-like syndrome", is a very rare condition. We report the prenatal findings of serpentine-like syndrome in a fetus at 18 weeks of gestation. The stomach was entirely elevated into the thoracic area, but the liver retained its normal position. Our initial diagnosis was isolated left congenital diaphragmatic hernia (CDH). At 20 weeks of gestation, the pregnancy was terminated, and a male newborn weighing 338 g was vaginally delivered...
August 9, 2018: Journal of Medical Ultrasonics
Nens van Alfen, Jonne Doorduin, Marieke H J van Rosmalen, Jeroen J J van Eijk, Yvonne Heijdra, Andrea J Boon, Michael A Gaytant, Ries J M van den Biggelaar, Roy T M Sprooten, Peter J Wijkstra, Jan T Groothuis
OBJECTIVE: To describe the clinical phenotype and recovery of diaphragm dysfunction caused by neuralgic amyotrophy in a large cohort of patients, to improve accurate awareness of this entity, and to encourage adoption of a standardized approach for diagnosis and treatment. METHODS: This observational cohort study recruited adult patients with neuralgic amyotrophy and symptoms of idiopathic phrenic neuropathy from the database of the Dutch expert center for neuralgic amyotrophy and the Dutch centers for home mechanical ventilation...
August 28, 2018: Neurology
Gurpreet S Dhillon, Shiraz A Maskatia, Robert W Loar, John L Colquitt, Amy R Mehollin-Ray, Rodrigo Ruano, Michael A Belfort, Oluyinka O Olutoye, Joshua A Kailin
OBJECTIVES: Fetal endoscopic tracheal occlusion (FETO) is offered to fetuses with congenital diaphragmatic hernia (CDH) and severe lung hypoplasia to promote lung growth and may secondarily affect left heart growth. The effects of FETO on left heart hypoplasia (LHH) are not described post-CDH repair. METHODS: A retrospective analysis was performed for fetuses with left-sided CDH who underwent FETO and severity-matched controls from 2007 to 2016 at our institution...
July 26, 2018: Prenatal Diagnosis
P Kot Baixauli, P Rodriguez Gimillo, J Baldo Gosalvez, J de Andrés Ibáñez
Phrenic nerve block is a complication that can occur after brachial plexus anaesthesia above the clavicle. The main consequence of this blockage is ipsolateral diaphragmatic paralysis, which can sometimes lead to the appearance of post-operative respiratory complications. A case is presented on a woman, who after having undergone a total shoulder prosthesis, presented with dyspnoea in the post-operative recovery unit. A diaphragmatic ultrasound was performed that enabled a rapid diagnosis to be made of a complete paralysis of the ipsolateral hemi-diaphragm...
July 19, 2018: Revista Española de Anestesiología y Reanimación
V Núñez Cerezo, M Romo Muñoz, J L Encinas, J Jiménez, M D Elorza Fernández, B Herrero, E Antolín, L Martínez Martínez, M López Santamaría
INTRODUCTION AND OBJECTIVES: The aim of this study is to identify respiratory clinic and pulmonary arterial hypertension (PAH) in congenital diaphragmatic hernia (CDH) and whether these could be predicted by prenatal measures. MATERIAL AND METHODS: We studied fetal ultrasound: Observed/expected Lung to Head Ratio (O/E LHR) and classified patients according to their outcome (group 1: O/E LHR <25%, group 2: 26-35%, group 3: 36-45%, group 4: >55%) as well as the severity of PAH (group 0: non-PAH, group 1: mild, group 2: moderate, group 3: severe) in echocardiograms at birth, 1st, 6th, 12th and 24 months of life...
April 20, 2018: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Kengo Hattori, Shigeru Takamizawa, Yuichiro Miyake, Tomoko Hatata, Katsumi Yoshizawa, Tomoko Furukawa, Yoshiaki Kondo
BACKGROUND: Sonographic assessment before congenital diaphragmatic hernia repair has rarely been studied. OBJECTIVE: To evaluate the accuracy of preoperative ultrasound in measuring the defect size and in anticipating the presence of a rim and thereby to determine ultrasound's usefulness in informing the surgical approach for definitive repair of congenital diaphragmatic hernia. MATERIALS AND METHODS: We performed a retrospective review of the medical records of seven children with left congenital diaphragmatic hernia who had undergone ultrasound and definitive repair between 2014 and 2017 at our institution...
October 2018: Pediatric Radiology
Kavi Haji, Darsim Haji, David J Canty, Alistair G Royse, Cameron Green, Colin F Royse
BACKGROUND: Failed extubation from mechanical ventilation in critically ill patients is multifactorial, complex and not well understood. We aimed to identify whether combined transthoracic echocardiography, lung and diaphragmatic ultrasound can predict extubation failure in critically ill patients. RESULTS: Fifty-three participants who were intubated > 48 h and deemed by the treating intensivist ready for extubation underwent a 60-min pre-extubation weaning trial (pressure support ≤ 10 cmH2 O and positive end expiratory pressure 5 cmH2 O)...
July 4, 2018: Critical Ultrasound Journal
Abhinav Banerjee, Gesu Mehrotra
Background and Aims: The diaphragm is considered the main respiratory muscle and difficulty in weaning can occur because of impaired diaphragmatic function. Hence, monitoring diaphragmatic function is important. The aim of this study is to assess the ability of various lung ultrasound (US) indices and the rapid shallow breathing index (RSBI) to predict the outcome of the weaning process and compare them with RSBI. Materials and Methods: This was a prospective study conducted on patients admitted to critical care unit at a tertiary care hospital in north India from February 2017 to June 2017...
June 2018: Indian Journal of Critical Care Medicine
Søren Helbo Skaarup, Anders Løkke, Christian B Laursen
BACKGROUND: Ultrasound can be used to assess diaphragm movement. Existing methods focus on movement at a single point at the hemidiaphragm and may not consider the anatomic and functional complexity. We aimed to develop an ultrasound method, the Area method, to assess movement of the entire hemidiaphragm dome and to compare it with existing methods to evaluate accuracy, inter-rater agreement, and feasibility. METHODS: Movement of the diaphragm was evaluated by ultrasonography in 19 healthy subjects and correlated with simultaneously performed spirometry...
June 27, 2018: Critical Ultrasound Journal
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