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Ultrasound And Critical Care

Lara C Kovell, Mays T Ali, Allison G Hays, Thomas S Metkus, Jose A Madrazo, Mary C Corretti, Susan A Mayer, Theodore P Abraham, Edward P Shapiro, Monica Mukherjee
Echocardiography is the foundation for diagnostic cardiac testing, allowing for direct identification and management of various conditions. Point-of-care ultrasound (POCUS) has emerged as an invaluable tool for bedside diagnosis and management. The objective of this review is to address the current use and clinical applicability of POCUS to identify, triage, and manage a wide spectrum of cardiac conditions. POCUS can change diagnosis and management decisions of various cardiovascular conditions in a range of settings...
July 19, 2018: American Journal of Cardiology
Thomas W Conlon, David B Kantor, Erik R Su, Sonali Basu, Donald L Boyer, Bereketeab Haileselassie, Tara L Petersen, Felice Su, Akira Nishisaki
OBJECTIVES: To assess current diagnostic bedside ultrasound program core element (training, credentialing, image storage, documentation, and quality assurance) implementation across pediatric critical care medicine divisions in the United States. DESIGN: Cross-sectional questionnaire-based needs assessment survey. SETTING: Pediatric critical care medicine divisions with an Accreditation Council of Graduate Medical Education-accredited fellowship...
August 14, 2018: Pediatric Critical Care Medicine
Sander Rozemeijer, Jelle L G Haitsma Mulier, Jantine G Röttgering, Paul W G Elbers, Angélique M E Spoelstra-de Man, Pieter Roel Tuinman, Monique C de Waard, Heleen M Oudemans-van Straaten
INTRODUCTION: Shock is characterised by micro- and macrovascular flow impairment contributing to acute kidney injury (AKI). Routine monitoring of the circulation regards the macrocirculation but not the renal circulation which can be assessed with Doppler ultrasound as renal resistive index (RRI). RRI reflects resistance to flow. High RRI predicts persistent AKI. Study aims were to determine whether RRI is elevated in shock and to identify determinants of RRI. MATERIALS AND METHODS: This prospective observational cohort study included two cohorts of patients, with and without shock <24-h after intensive care admission...
August 14, 2018: Shock
Lucia De Martino, Nadya Yousef, Rafik Ben-Ammar, Francesco Raimondi, Shivani Shankar-Aguilera, Daniele De Luca
BACKGROUND AND OBJECTIVES: There are several lung ultrasound scores (LUS) for evaluating lung aeration in critically ill adults with restrictive lung disorders. A modified LUS adapted for neonates correlates well with oxygenation and is able to be used to predict the need for surfactant in preterm neonates with respiratory distress syndrome (RDS). However, no data are available for extremely preterm neonates for whom timely surfactant administration is especially important. We hypothesized that LUS might be reliable in extremely preterm neonates with RDS who are treated with continuous positive airway pressure...
August 14, 2018: Pediatrics
Daozheng Huang, Huan Ma, Zhiyuan Xiao, Michael Blaivas, Ying Chen, Jianyi Wen, Weixin Guo, Jun Liang, Xiaolong Liao, Zhonghua Wang, Hanbiao Li, Jie Li, Yangong Chao, Xiao Ting Wang, Yan Wu, Tiehe Qin, Ke Su, Shouhong Wang, Ning Tan
BACKGROUND: Lung ultrasound and echocardiography are mainly applied in critical care and emergency medicine. However, the diagnostic value of cardiopulmonary ultrasound in elderly patients with acute respiratory distress syndrome (ARDS) is still unclear. METHODS: Consecutive patients admitted to ICU with the diagnosis of suspected ARDS based on clinical grounds were enrolled. Cardiopulmonary ultrasound was performed as part of monitoring on day 1, day 2 and day 3...
August 13, 2018: BMC Pulmonary Medicine
Ying Zhou, Qianqian Fan, Omer Cavus, Xuezheng Zhang
Purpose: The purpose of the study was to review and summarize current literature concerning the validation and application of lung ultrasound (LUS) in critically ill patients with acute respiratory distress syndrome (ARDS). Materials and Methods: An extensive literature search was conducted using PubMed, Cochrane Review, Google Scholar, and Ohio State University Link based on the question if LUS should be considered a reliable investigational technique for ARDS diagnosis, treatment, and prognosis in pediatric and adult population...
July 2018: Saudi Journal of Anaesthesia
Matthew J Kaptein, John S Kaptein, Zayar Oo, Elaine M Kaptein
Background: Ultrasound (US) assessment of intravascular volume may improve volume management of dialysis patients. We investigated the relationship of intravascular volume evaluated by inferior vena cava (IVC) US to net volume changes with intermittent hemodialysis (HD) in critically ill patients. Methods: A retrospective cohort of 113 intensive care unit patients in 244 encounters had clinical assessment of intravascular volume followed by US of respiratory/ventilatory variation of IVC diameter, and had HD within 24 h...
2018: International Journal of Nephrology and Renovascular Disease
Vera Joskova, Anna Patkova, Eduard Havel, Simona Najpaverova, Daniela Uramova, Miroslav Kovarik, Zdenek Zadak, Miloslav Hronek
OBJECTIVE: Loss of muscle mass in critically ill patients is associated with serious consequences, such as prolonged mechanical ventilation, intensive care unit confinement, and higher mortality. Thus, monitoring muscle mass, and especially its decline, should provide a useful indicator of morbidity and mortality. Performing evaluations according only to body mass index is imperfect, therefore the aim of this article was to evaluate appropriate methods for muscle mass loss determination in ICU patients...
August 6, 2018: Journal of Rehabilitation Medicine
A Michon, S Jammal, A Passeron, G De Luna, C Bomahou, V Jullien, J Pouchot, J-B Arlet, B Ranque
INTRODUCTION: Point of care ultrasound (POCUS) is routinely used by intensivists and emergency physicians for many years. Its interest is not arguable any more for these specialists, despite the large variety of diseases they care. Hospitalists and internists also should find some interest in POCUS, which convenience and wide range of indications responds well to the variety of their practice. However, it is still not widely used in internal medicine departments. METHODS: We here report our experience of using a pocket-sized ultrasound device in a French internal medicine department...
August 2, 2018: La Revue de Médecine Interne
Gabriel Prada, Antoine Vieillard-Baron, Archer K Martin, Antonio Hernandez, Farouk Mookadam, Harish Ramakrishna, Jose L Diaz-Gomez
Proficiency in echocardiography and lung ultrasound has become essential for anesthesiologists and critical care physicians. Nonetheless, comprehensive echocardiography measurements often are time-consuming and technically challenging, and conventional 2-dimensional images do not permit evaluation of specific conditions (eg, systolic anterior motion of the mitral valve, pneumothorax), which have important clinical implications in the perioperative setting. M-mode (motion-based) ultrasonographic imaging, however, provides the most reliable temporal resolution in ultrasonography...
June 30, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Peter Wallbridge, Daniel Steinfort, Tunn Ren Tay, Louis Irving, Mark Hew
Acute respiratory failure (ARF) is a common life-threatening medical condition, with multiple underlying aetiologies. Diagnostic chest ultrasound provides accurate diagnosis of conditions that commonly cause ARF, and may improve overall diagnostic accuracy in critical care settings as compared to standard diagnostic approaches. Respiratory physicians are becoming increasingly familiar with ultrasound as a part of routine clinical practice, although the majority of data to date has focused on the emergency and intensive care settings...
August 2018: Respiratory Medicine
Julien Le Coz, Silvia Orlandini, Luigi Titomanlio, Victoria Elisa Rinaldi
IMPORTANCE: Point-of-care ultrasonography (POCUS) allows to obtain real-time images to correlate with the patient's presenting signs and symptoms. It can be used by various specialties and may be broadly divided into diagnostic and procedural applications. OBJECTIVE: We aimed at reviewing current knowledge on the use of POCUS in Pediatric Emergency Departments (PEDs). FINDINGS: US diagnostic capacity in paediatric patients with suspected pneumonia has been studied and debated whereas literature regarding the usefulness of point-of-care echocardiography in the pediatric setting is still limited...
July 27, 2018: Italian Journal of Pediatrics
Enyo A Ablordeppey, Anne M Drewry, Daniel L Theodoro, LinLin Tian, Brian M Fuller, Richard T Griffey
PURPOSE: Although routine chest radiographs (CXR) to verify correct central venous catheter (CVC) position and exclude pneumothorax is commonly performed, emerging evidence suggests that this practice can be replaced by point of care ultrasound (POCUS). POCUS is advantageous over CXR because it avoids radiation while verifying correct placement and lack of pneumothorax without delay. We hypothesize that a knowledge translation gap exists in this area. We aim to describe the current clinical practice regarding POCUS alone for CVC position confirmation and pneumothorax exclusion as compared to chest radiography...
July 25, 2018: Shock
Delia L Gold, Jennifer R Marin, Demetris Haritos, L Melissa Skaugset, Jennifer M Kline, Rachel M Stanley, David P Way, David P Bahner
Objectives: Point-of-care ultrasound (POCUS) has been identified as a critical skill for pediatric emergency medicine (PEM) physicians. The purpose of this study was to profile the current status of PEM POCUS in pediatric emergency departments (EDs). Methods: An electronic survey was distributed to PEM fellows and attending physicians at four major pediatric academic health centers. The 24-item questionnaire covered professional demographics, POCUS experience and proficiency, and barriers to the use of POCUS in pediatric EDs...
October 2017: AEM education and training
L Zieleskiewicz, L Bouvet, S Einav, G Duclos, M Leone
Complications during pregnancy are not frequent, but may occur abruptly. Point-of-care ultrasound is a non-invasive, non-ionising diagnostic tool that is available at the bed-side when complications occur. This review covers the use of ultrasound in various clinical situations. Gastric ultrasound can identify stomach contents that put the woman at risk for pulmonary aspiration. In the future, this tool will probably be used routinely before induction of anaesthesia to determine the presence of stomach contents above a particular risk threshold...
July 26, 2018: Anaesthesia
C Del Giudice, D Van Den Heuvel, J Wille, T Mirault, E Messas, R Ferraresi, S Kum, M Sapoval
PURPOSE: To report our initial experience of fully percutaneous deep venous arterialization (pDVA) for the treatment of chronic critical limb ischemia (cCLI) after failed distal angioplasty. MATERIALS AND METHODS: pDVA was performed in five consecutive patients by creating an arteriovenous fistula (AVF) between a below the knee artery and its satellite deep vein. In this early experience, only patients with failed prior interventional attempts at establishing flow with no distal targets for an arterial bypass were selected...
July 17, 2018: Cardiovascular and Interventional Radiology
Peter Korsten, Eirini Mavropoulou, Susanne Wienbeck, David Ellenberger, Daniel Patschan, Michael Zeisberg, Radovan Vasko, Björn Tampe, Gerhard A Müller
RATIONALE: Central venous catheter (CVC) placement is a standard procedure in critical care. Ultrasound guidance during placement is recommended by current guidelines, but there is no consensus on the best method for evaluating the correct CVC tip position. Recently, the "rapid atrial swirl sign" (RASS) has been investigated in a limited number of studies. OBJECTIVES: We performed a prospective diagnostic accuracy study of focused echocardiography for the evaluation of CVC tip position in our medical ICU and IMC units...
2018: PloS One
Chunyan Zhu, Bao Liu, Tianjun Yang, Qing Mei, Aijun Pan, Dongsheng Zhao
OBJECTIVE: To investigate the effect of early rehabilitation physiotherapy on muscle quality and function in critical patients. METHODS: A prospective randomized controlled study was performed. Adult critically ill patients admitted to intensive care unit (ICU) of Anhui Provincial Hospital from October 1st, 2016 to August 31st, 2017 who had been hospitalized for more than 7 days and had acute physiology and chronic health evaluation II (APACHE II) > 8 were enrolled, and they were divided into treatment group and control group according to random number table method...
June 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Xin Ding, Da-Wei Liu, Yan-Gong Cao, Hong-Min Zhang, Huan Chen, Hua Zhao, Xiao-Ting Wang
No abstract text is available yet for this article.
July 20, 2018: Chinese Medical Journal
Qing Zhang, Jian-Hua Sun, Jia-Tao Liu, Xiao-Ting Wang, Da-Wei Liu
Background: Jejunal feeding tube allows the nutrition of critical care patients more easy and safe. However, its placement remains a challenge. This study aimed to introduce a jejunal feeding tube through an ultrasound-guided antral progressive water injection method and subsequently to examine its efficacy. Methods: Between April 2016 and April 2017, 54 patients hospitalized in the Department of Critical Care Medicine, Peking Union Medical College Hospital, China who needed nutritional support through a jejunal feeding tube were recruited for this study...
July 20, 2018: Chinese Medical Journal
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