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Ultrasound And Critical Care

M Toscano, G Spadetta, P Pulitano, M Rocco, V Di Piero, O Mecarelli, E Vicenzini
No abstract text is available yet for this article.
2018: BioMed Research International
Taylor M Douglas, Andrea R Levine, Peter P Olivieri, Michael T McCurdy, Alfred Papali, Marc T Zubrow, Karen M Rodick, Julie M Hurley, Avelino C Verceles
BACKGROUND: Nurses' and other non-physician providers have demonstrated proficiency at obtaining images in the tele-ultrasound system. However, use of this skill requires comfort with the procedure and willingness to incorporate it into practice. OBJECTIVES: To assess 1) level of comfort of non-physician providers performing tele-ultrasound before and after brief training and 2) feasibility of implementing an educational programme that improves level of comfort...
December 1, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Sherif Assaad, Wolf B Kratzert, Albert C Perrino
PURPOSE OF REVIEW: Excessive accumulation of extravascular lung water (EVLW) resulting in pulmonary edema is the most feared complication following thoracic surgery and lung transplant. ICUs have long relied on chest radiography to monitor pulmonary status postoperatively but the increasing recognition of the limitations of bedside plain films has fueled development of newer technologies, which offer earlier detection, quantitative assessments, and can aide in preoperative screening of surgical candidates...
November 29, 2018: Current Opinion in Anaesthesiology
Prashant Parulekar, Ed Neil-Gallacher, Alex Harrison
Acute kidney injury is common in critically ill patients, with ultrasound recommended to exclude renal tract obstruction. Intensive care unit clinicians are skilled in acquiring and interpreting ultrasound examinations. Intensive Care Medicine Trainees wish to learn renal tract ultrasound. We sought to demonstrate that intensive care unit clinicians can competently perform renal tract ultrasound on critically ill patients. Thirty patients with acute kidney injury were scanned by two intensive care unit physicians using a standard intensive care unit ultrasound machine...
November 2018: Journal of the Intensive Care Society
Varun Mehta, Rajesh Kumar, Siddharth Parkash, Sanjeev Singla, Arshdeep Singh, Jagdeep Chaudhary, Hardeep Bains
BACKGROUND/AIMS: Necrotizing pancreatitis has morbidity and mortality rates exceeding most of the other acute medical emergencies despite the best possible medical and surgical care. Early surgical intervention has a high operative risk. MATERIALS AND METHODS: This prospective open-label study was designed to evaluate the role of percutaneous catheter drainage (PCD) of pancreatic necrosis as primary treatment of acute necrotizing pancreatitis. An ultrasound/computed tomography-guided drainage was performed with 10 or 12 Fr catheters using a 0...
November 16, 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Agustín Carámbula, Antonella Visca, Silvana D'Amico, Martín Angulo
Atrophy and weakness of the respiratory and peripheral muscles is a common problem in the intensive care unit (ICU). It is difficult to diagnose, particularly in the early stages of critical disease. Consequently, many cases are detected only in advanced stages, for example, when difficulties in mechanical ventilation weaning are encountered. The aim of this review is to describe the main tools that are currently available for evaluation of peripheral and respiratory muscles in the ICU. Techniques of varying complexity and specificity are discussed, and particular emphasis is placed on those with greater relevance in daily clinical practice, such as ultrasound...
November 16, 2018: Archivos de Bronconeumología
Abu Bakkar Siddique, Janet Perkins, Tapas Mazumder, Mohammad Rifat Haider, Goutom Banik, Tazeen Tahsina, Md Jahurul Islam, Shams El Arifeen, Ahmed Ehsanur Rahman
INTRODUCTION: Antenatal care (ANC) has long been considered a critical component of the continuum of care during pregnancy, with the potential to contribute to the survival and thriving of women and newborns. Although ANC utilization has increased in over the past decades, adequate coverage and content of ANC contacts have fallen under increased scrutiny. The objectives of this article are to describe the coverage and content of ANC contacts in the context of rural Bangladesh. METHODS: A community-based, cross-sectional household survey was conducted in two sub-districts of Netrokona district, Bangladesh in 2016...
2018: PloS One
Mette M Berger, Olivier Pantet, Nathalie Jacquelin-Ravel, Mélanie Charrière, Sabine Schmidt, Fabio Becce, Régine Audran, François Spertini, Luc Tappy, Claude Pichard
BACKGROUND & AIMS: Individualized supplemental parenteral nutrition (SPN) providing measured energy expenditure from day 4 reduced infectious complications in a previous study including 305 intensive care (ICU) patients. The study aimed at investigating the metabolic, and immune responses underlying the clinical response of the previous trial. METHODS: Randomized controlled trial enrolling 23 critically ill patients on day 3 (D3) of admission to the ICU who were fed less than 60% of their energy target by the enteral nutrition (EN) alone: allocation to either continued EN or to SPN to a target validated by indirect calorimetry...
November 5, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Julio E González-Aguirre, Claudia Paola Rivera-Uribe, Erick Joel Rendón-Ramírez, Rogelio Cañamar-Lomas, Juan Antonio Serna-Rodríguez, Roberto Mercado-Longoría
INTRODUCTION: Invasive respiratory support is a cornerstone of Critical Care Medicine, however, protocols for withdrawal of mechanical ventilation are still far from perfect. Failure to extubation occurs in up to 20% of patients, despite a successful spontaneous breathing trial (SBT). METHODS: We prospectively included ventilated patients admitted to medical and surgical intensive care unit in a university hospital in northern Mexico. At the end of a successful SBT, we measured diaphragmatic shortening fraction (DSF) by the formula: diaphragmatic thickness at the end of inspiration - diaphragmatic thickness at the end of expiration/diaphragmatic thickness at the end of expiration×100, and the presence of B-lines in five regions of the right and left lung...
November 13, 2018: Archivos de Bronconeumología
Tiffany M Abramson, Laith Alreshaid, Tarina Kang, Thomas Mailhot, Talib Omer
Intraosseous (IO) needles are used in critically ill patients when it is not possible to quickly obtain venous access. While they allow for immediate access, IO infusions are associated with complications including fractures, infections, and compartment syndrome. We present a case where point-of-care ultrasound was used to quickly identify a malfunctioning IO needle that resulted in compartment syndrome of the lower extremity.
November 2018: Clinical practice and cases in emergency medicine
Hongmin Zhang, Wei He, Xiaoting Wang, Yangong Chao, Lina Zhang, Ran Zhu, Wanhong Yin, Lixia Liu, Jun Wu, Dawei Liu
OBJECTIVE: Focused cardiac ultrasound (FCU) can provide useful information for the management of shock and acute respiratory distress syndrome. This study aimed to determine whether a 2-day focused cardiac ultrasound training course could enable critical care physicians to interpret ultrasound images in terms of left ventricular ejection fraction (LVEF), ratio of right ventricular end-diastolic area to left ventricular end-diastolic area (R/LVEDA), and septal kinetics. DESIGN: A prospective analysis of an image test score...
October 18, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Kimihiko Kichikawa, Shigeo Ichihashi, Hiroyoshi Yokoi, Takao Ohki, Masato Nakamura, Kimihiro Komori, Shinsuke Nanto, Erin E O'Leary, Aaron E Lottes, Scott A Snyder, Michael D Dake
PURPOSE: A prospective, multicenter post-market surveillance study in Japan evaluated the 2-year safety and effectiveness of the DES in real-world patients with complex femoropopliteal artery lesions. METHODS: There were no exclusion criteria, and consecutive symptomatic patients with femoropopliteal lesions treated with the DES were enrolled in the study. Clinically driven target lesion revascularization (TLR) was defined as reintervention performed for > 50% diameter stenosis after recurrent clinical symptoms of peripheral arterial disease...
November 8, 2018: Cardiovascular and Interventional Radiology
Jeffrey Gardecki, Kishan Patel, Omid Rowshan
Thoracic ultrasound has become an increasingly valuable tool in the evaluation of critically ill patients in the emergency department (ED). The utility of point-of-care ultrasound (POCUS) to identify suspected pneumothorax, pulmonary edema, pleural effusion and pneumonia has been well established (Pagano et al.; Brogi et al.; Cortellaro et al.; Irwin and Cook [1-4]). The 2014 American College of Emergency Physicians (ACEP) Ultrasound Imaging Compendium included lung and pleural ultrasound with the primary indication of identifying pneumothorax and pleural effusion as part of the core POCUS indications for all emergency physicians [5]...
October 26, 2018: American Journal of Emergency Medicine
David Kinas, Michael Dalley, Kayla Guidry, Mark A Newberry, David A Farcy
We describe a case of a young male who presents to the emergency department with severe sepsis and decompensated heart failure with underlying Methamphetamine-Associated Cardiomyopathy that was previously undiagnosed. This presentation is unique because Methamphetamine-Associated Cardiomyopathy is an uncommonly reported condition that presented in a complex clinical scenario of severe sepsis and decompensated congestive heart failure. We discuss how we used point-of-care ultrasound (POCUS) in this case to identify an unsuspected disease process and how it changed our initial resuscitation strategy and management...
2018: Case Reports in Emergency Medicine
G De Bernardo, D Sordino, C De Chiara, M Riccitelli, F Esposito, M Giordano, A Tramontano
Necrotizing enterocolitis is the most common cause of the postnatal critical conditions and remains one of the dominant cause of newborns' death in Neonatal Intensive Care. The morbidity and mortality associated with necrotizing enterocolitis remains largely unchanged and the incidence of necrotizing enterocolitis continues to increase. There is no general agreement regarding the surgical treatment of the necrotizing enterocolitis. In this paper, we want to evaluate the results obtained in our centre from different types of necrotizing enterocolitis's surgical treatment and to analyse the role of traditional X-ray versus ultrasound doppler imaging in the evolutionary phases of necrotizing enterocolitis...
November 2, 2018: Current Pediatric Reviews
Michael Gottlieb, Kimbia Arno, Matthew Kuhns, Teresa M Chan
Introduction: There are over 200 emergency medicine (EM) residency programs in the United States. While there are basic criteria defined by the Accreditation Council for Graduate Medical Education (ACGME), there can be significant variation between programs with regard to rotation distribution. Therefore, it would be valuable to have a benchmark for programs to understand their rotation mix in the context of the national landscape. This study aimed to provide a breakdown of the length and percentage of EM residency programs with each clinical rotation in the United States...
October 2018: AEM education and training
Ryan Furdock, Kirsten Brouillet, Scott J Luhmann
DESIGN: Retrospective analyses of congenital scoliosis patients at 2 tertiary care pediatric hospitals. OBJECTIVE: This study objectives were (1) to report the rates of anomalies of 10 organ systems in congenital scoliosis patients and (2) to determine whether the presence of a single organ system anomaly increases the rate of nonspinal organ system defects. SUMMARY OF BACKGROUND DATA: Intraspinal, cardiac, renal, and gastrointestinal anomalies have been reported to occur at higher rates in congenital scoliosis than the normal population...
October 29, 2018: Journal of Pediatric Orthopedics
Francesco Mojoli, Bélaid Bouhemad, Silvia Mongodi, Daniel Lichtenstein
Point-of-care ultrasound is increasingly used at the bedside to integrate the clinical assessment of the critically ill; in particular, lung ultrasound greatly developed in the last decade. This review describes basic lung ultrasound signs and focuses on their applications in critical care. Lung semiotic is made both of artifacts (derived by air/tissue interface) and real images (i.e. effusions and consolidations), both providing significant information to identify the main acute respiratory disorders. Lung ultrasound signs, either alone or combined to other point-of-care ultrasound techniques, are helpful in the diagnostic approach to patients with acute respiratory failure, circulatory shock or cardiac arrest...
October 29, 2018: American Journal of Respiratory and Critical Care Medicine
Timothy Witalka, Matthew Smith, Sangil Lee
Ventricular pseudoaneurysm rupture is a rare finding in emergency departments in the era of percutaneous coronary intervention. It is an infrequent complication after acute myocardial infarction. We present a case of ventricular pseudoaneurysm rupture and examine current literature on the pathophysiology and imaging guidelines on the topic. The patient is a 58-year-old male that presented to the emergency department with dizziness and syncope. Imaging in the emergency department included computed tomography of the chest and an ultrasound that showed pseudoaneurysm with hemopericardium and early cardiac tamponade...
October 1, 2018: American Journal of Emergency Medicine
David Canty, Jennifer Barth, Yang Yang, Nathan Peters, Andrew Palmer, Alistair Royse, Colin Royse
PURPOSE: Focused cardiac ultrasound (FCU) training in critical care is restricted by availability of instructors. Supervised training may be substituted by self-directed learning with an ultrasound simulator guided by automated electronic learning, enabling scalability. MATERIALS AND METHODS: We prospectively compared learning outcomes in novice critical care physicians after completion of a supervised one-and-a-half-day workshop model with a self-guided course utilizing a simulator over four weeks...
October 12, 2018: Journal of Critical Care
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