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Bedside Echocardiography

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https://www.readbyqxmd.com/read/28443583/retrograde-cerebral-air-embolism-in-a-patient-with-intestinal-necrosis-a-case-report
#1
Onur Taydaş, Mehmet Ruhi Onur, Erhan Akpınar
BACKGROUND: Cerebral venous air embolism (CVAE) is a severe clinical condition related to unfavoured outcome in patients with neurological impairment. CVAE may occur secondary to arterial or venous interventions. A rare mechanism of CVAE is retrograde embolism that is characterized by gas flow in a direction opposite to that of the normal blood flow. CASE REPORT: A 69-year-old female was admitted to our hospital with shortness of breath and abdominal pain. Abdominal computed tomography (CT) revealed intramural gas in the bowel and free gas in the mesenteric veins and portal vein...
April 13, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28443388/utilization-of-thoracic-ultrasound-for-confirmation-of-central-venous-catheter-placement-and-exclusion-of-pneumothorax-a-novel-technique-in-real-time-application
#2
Dileep Raman, Manish Sharma, Ajit Moghekar, Xiaofeng Wang, Umur Hatipoğlu
AIM: To evaluate the safety and utility of ultrasonography as a tool to confirm central venous catheter (CVC) position and to exclude insertion-related pneumothorax in place of chest radiography (CXR) in a tertiary medical intensive care unit (ICU). METHODS: We randomized 60 consecutive medical ICU patients to conventional or ultrasound groups for CVC placement. Both groups had CVCs inserted under ultrasound guidance. The intervention group underwent real-time transthoracic echocardiography to assist in catheter positioning and chest ultrasonography for exclusion of pneumothorax...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28421173/cerebral-autoregulation-brain-injury-and-the-transitioning-premature-infant
#3
REVIEW
Zachary A Vesoulis, Amit M Mathur
Improvements in clinical management of the preterm infant have reduced the rates of the two most common forms of brain injury, such as severe intraventricular hemorrhage and white matter injury, both of which are contributory factors in the development of cerebral palsy. Nonetheless, they remain a persistent challenge and are associated with a significant increase in the risk of adverse neurodevelopment outcomes. Repeated episodes of ischemia-reperfusion represent a common pathway for both forms of injury, arising from discordance between systemic blood flow and the innate regulation of cerebral blood flow in the germinal matrix and periventricular white matter...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28407773/minimally-invasive-patient-specific-beat-by-beat-estimation-of-left-ventricular-time-varying-elastance
#4
Shaun Davidson, Chris Pretty, Antoine Pironet, Shun Kamoi, Joel Balmer, Thomas Desaive, J Geoffrey Chase
BACKGROUND: The aim of this paper was to establish a minimally invasive method for deriving the left ventricular time varying elastance (TVE) curve beat-by-beat, the monitoring of which's inter-beat evolution could add significant new data and insight to improve diagnosis and treatment. The method developed uses the clinically available inputs of aortic pressure, heart rate and baseline end-systolic volume (via echocardiography) to determine the outputs of left ventricular pressure, volume and dead space volume, and thus the TVE curve...
April 13, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28366714/correlation-between-transhepatic-and-subcostal-inferior-vena-cava-views-to-assess-inferior-vena-cava-variation-a-pilot-study
#5
Jacobo Moreno Garijo, Duminda N Wijeysundera, Jo Carroll Munro, Massimiliano Meineri
OBJECTIVES: To assess the feasibility and reliability of transthoracic echocardiography to measure inferior vena cava (IVC) diameter variation using a transhepatic view. DESIGN: Prospective cohort study. SETTING: Single-center hospital. PATIENTS: Forty consecutive patients undergoing elective cardiac surgery. INTERVENTIONS: Bedside transthoracic echocardiography. MEASUREMENTS AND MAIN RESULTS: Correlation between the two views was measured using Pearson R, while agreement was measured using the intraclass correlation coefficient (ICC)...
February 3, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28331645/propylene-glycol-toxicity-in-adolescent-with-refractory-myoclonic-status-epilepticus
#6
Kara A Bjur, Bryan C Cannon, Anthony L Fine, Matthew J Ritter, Kerry E Schueler, Michael E Nemergut
Propylene glycol (PG) is a solvent commonly used in medications that, while benign at low doses, may cause toxicity in adults and children at high doses. We describe a case and the physiologic sequelae of propylene glycol toxicity manifested in a critically ill adolescent male with refractory myoclonic status epilepticus aggressively treated with multiple PG-containing medications (lorazepam, phenobarbital, and pentobarbital)-all within accepted dosing guidelines and a total daily PG exposure previously recognized to be safe...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28317398/cardiac-transplantation-towards-a-new-noninvasive-approach-of-cardiac-allograft-rejection
#7
REVIEW
Sophie I Mavrogeni, George Athanasopoulos, Aggeliki Gouziouta, Evangelos Leontiadis, Stamatis Adamopoulos, Genovefa Kolovou
Cardiac allograft rejection (CAR) may occur after transplantation and remains silent, until hemodynamic deterioration takes place. Endomyocardial biopsy (EMB) is applied to early detect CAR. Although, flexible bioptoms have decreased the incidence of lethal complications, EMB remains an invasive procedure carrying risk of tamponade and permanent heart block. Therefore, a new non-invasive approach is needed. Areas covered: AlloMap molecular expression testing and graft-derived cell-free DNA (GcfDNA) test can be used as blood indices of acute and chronic CAR, respectively...
April 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28295525/advantages-and-pitfalls-of-pocket-ultrasound-vs-daily-chest-radiography-in-the-coronary-care-unit-a-single-user-experience
#8
Colin T Phillips, Warren J Manning
BACKGROUND: Pocket ultrasonography may enhance patient diagnosis and care. We sought to assess pocket ultrasound in detecting common conditions in the coronary care unit (CCU) compared to portable daily chest radiography (CXR) and conventional transthoracic echocardiography (TTE). METHODS: An experienced pocket ultrasound user performed a pocket ultrasound examination for interstitial edema, pneumonia, central line seen in the right ventricle, pleural and pericardial effusions, left atrial enlargement, and cardiomegaly...
March 14, 2017: Echocardiography
https://www.readbyqxmd.com/read/28291128/the-use-of-ultrasound-in-obstetric-anesthesia
#9
Carolyn F Weiniger, Limor Sharoni
PURPOSE OF REVIEW: The current review considers an array of recent applications for point-of-care ultrasound in clinical practice including diagnostic and therapeutic procedures that may be relevant for the obstetric anesthesiologist. The rapid advancement of technology and clinical applications for bedside ultrasound in obstetric anesthesiology requires an appraisal of the limitations and uses. RECENT FINDINGS: The review presents the most recent literature describing ultrasound-guided airway assessments, airway management, cricothyroidotomy, transthoracic echocardiography, gastric volume assessments, point-of-care lung ultrasound diagnoses, intracranial pressure assessments, vascular access, neuraxial blocks, and transversus abdominis plane blocks...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28279544/inferior-vena-cava-filter-limb-fracture-with-embolization-to-the-right-ventricle
#10
Bradley S Jackson, Mykel Sepula, Jared T Marx, Chad M Cannon
BACKGROUND: Inferior vena cava (IVC) filter and filter limb embolization is a known phenomenon, with a prevalence of up to 25% for certain filter types. Most commonly, the site of embolization is to the heart. Point-of-care ultrasound is an easily accessible imaging modality that should be utilized when considering IVC filter complications. CASE REPORT: A 28-year-old woman with a history of metastatic sarcoma and IVC filter placement for deep venous thrombosis presented to the Emergency Department (ED) for chest pain...
March 6, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28269217/non-invasive-monitoring-of-pulmonary-artery-pressure-at-the-bedside
#11
M Proenca, F Braun, E Muntane, J Sola, A Adler, M Lemay, J-Ph Thiran, S F Rimoldi
Current solutions for the monitoring of pulmonary artery pressure (PAP) in patients suffering from pulmonary hypertension are limited to invasive means. Non-invasive alternatives, such as Doppler echocardiography, are incompatible with continuous monitoring due to their dependency on qualified personnel to perform the measurements. In the present study, a novel non-invasive and unsupervised approach based on the use of electrical impedance tomography (EIT) is presented. The approach was evaluated in three healthy subjects undergoing hypoxia-induced variations in PAP...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227447/non-invasive-monitoring-of-pulmonary-artery-pressure-at-the-bedside
#12
M Proenca, F Braun, E Muntane, J Sola, A Adler, M Lemay, J-Ph Thiran, S F Rimoldi, M Proenca, F Braun, E Muntane, J Sola, A Adler, M Lemay, J-Ph Thiran, S F Rimoldi, S F Rimoldi, E Muntane, J Sola, M Lemay, A Adler, J-Ph Thiran, F Braun
Current solutions for the monitoring of pulmonary artery pressure (PAP) in patients suffering from pulmonary hypertension are limited to invasive means. Non-invasive alternatives, such as Doppler echocardiography, are incompatible with continuous monitoring due to their dependency on qualified personnel to perform the measurements. In the present study, a novel non-invasive and unsupervised approach based on the use of electrical impedance tomography (EIT) is presented. The approach was evaluated in three healthy subjects undergoing hypoxia-induced variations in PAP...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28197055/pericardial-effusion-and-cardiac-tamponade-following-percutaneously-inserted-central-line-insertion-in-an-extremely-low-birth-weight-baby-case-report-and-successful-management
#13
Avinash V Desai, Abnish Kumar, Praful Shanbhag, Forum Shah
Pericardial effusion and cardiac tamponade are rare complications of percutaneously inserted central lines (PICLs), in extremely low-birth-weight babies. This particular complication carries a high degree of mortality, if not suspected and diagnosed. Bedside echocardiography proves not only diagnostic but also can be lifesaving in these conditions. Here, we wish to report such a baby who suddenly deteriorated and showed cardiovascular instability 2 days after the insertion of PICL. Immediate bedside echocardiography helped pick up the effusion which was drained using a subxiphoid percutaneous approach...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28188323/contrast-echocardiography-for-detection-of-myocardial-perfusion-abnormalities-a%C3%A2-clinical-perspective
#14
N Karogiannis, R Senior
Myocardial contrast echocardiography (MCE) is a well-established imaging technique in the assessment of patients with known or suspected coronary artery disease. The use of ultrasound contrast agents has optimized the evaluation of left ventricular function and, moreover, permits simultaneous assessment of the myocardial perfusion. This technique utilizes microbubbles that remain in the intravascular space and the contrast intensity reflects the concentration of the microbubbles in the myocardium. A homogeneous opacification of the myocardium after destruction of the microbubbles during high-power imaging is regarded as normal perfusion and absence of CAD...
February 10, 2017: Herz
https://www.readbyqxmd.com/read/28151822/clinical-significance-of-portal-hypertension-diagnosed-with-bedside-ultrasound-after-cardiac-surgery
#15
André Y Denault, William Beaubien-Souligny, Mahsa Elmi-Sarabi, Roberto Eljaiek, Ismail El-Hamamsy, Yoan Lamarche, Alexandra Chronopoulos, Jean Lambert, Josée Bouchard, Georges Desjardins
BACKGROUND: Portal venous flow pulsatility detected by Doppler ultrasound is a sign of congestive heart failure in noncritically ill patients. The assessment of portal and splenic venous flows has never been reported in patients undergoing cardiac surgery. METHODS: This is a case series performed in patients undergoing cardiac surgery between February 2014 and February 2015 in which portal and/or splenic venous flows were assessed by the attending anesthesiologist during surgery or by the intensivist after surgery using transthoracic echography in 9 patients or transesophageal echocardiography in 5 patients...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28117110/hemorrhagic-pericardial-cyst-diagnosis-accelerated-by-emergency-physician-echocardiography-a-case-report
#16
Michael F Yip, Brooks M Walsh
BACKGROUND: The differential diagnosis for chest pain in the emergency department is broad and includes both benign and life-threatening conditions-with pericardial cyst as a rare example. Emergency physician-performed point-of-care focused cardiac ultrasound (FOCUS) is increasingly recognized as a useful modality in the evaluation of patients with chest pain. CASE REPORT: We report a case of hemorrhagic pericardial cyst in a young woman presenting with chest pain in which findings on FOCUS contradicted findings on chest x-ray study and thus, accelerated diagnosis and definitive treatment...
April 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28099422/relationship-between-perfusion-index-and-patent-ductus-arteriosus-in-preterm-infants
#17
Enrique Gomez-Pomar, Majd Makhoul, Philip M Westgate, Katrina T Ibonia, Abhijit Patwardhan, Peter J Giannone, Henrietta Bada, Elie G Abu Jawdeh
BACKGROUND: Perfusion index (PI) is a noninvasive measure of perfusion. ΔPI (difference between pre and post-ductal PI) may identify hemodynamically significant PDA. However, studies are limited to brief and intermittent ΔPI sampling. Our objective is to assess the value of continuous high resolution ΔPI monitoring in the diagnosis of PDA. METHODS: Continuous ΔPI monitoring in preterm infants was prospectively performed using two high resolution pulse oximeters...
January 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28073853/resuscitation-of-prolonged-cardiac-arrest-from-massive-pulmonary-embolism-by-extracorporeal-membrane-oxygenation
#18
Yun Seok Kim, Wookjin Choi, Jaecheol Hwang
Extracorporeal cardiopulmonary resuscitation can be used as a rescue strategy in cases of prolonged cardiac arrest caused by massive pulmonary embolism. We present a case of a male patient who was in prolonged cardiac arrest following massive pulmonary embolism. Veno-arterial extracorporeal membrane oxygenation was initiated approximately 93 min after prolonged cardiopulmonary resuscitation. After resuscitation, bedside echocardiography and a chest computed tomography angiogram revealed a massive pulmonary embolism during extracorporeal membrane oxygenation support...
January 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28041756/trauma-induced-acute-myocardial-infarction-due-to-delayed-dissection-of-the-left-anterior-descending-coronary-artery
#19
Magdalena Wilczynska-Golonka, Pawel Rostoff, Aleksander Siniarski, Agnieszka Skrzypek, Andrzej Gackowski, Ewa Konduracka, Jadwiga Nessler
Acute myocardial infarction is a very rare, life-threatening complication of blunt chest trauma. A 27-year-old man with no previous medical history was admitted to the emergency department due to multiple trauma following a car accident. After 48h following the accident, the patient's condition rapidly deteriorated, with severe dyspnea at rest, tachycardia, and increasing chest pain. A 12-lead ECG showed a sinus tachycardia at 120bpm with significant ST-segment elevation in leads V1 to V5, pathologic Q wave in I, aVL, and QS complex in leads V1 to V4...
December 27, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28031691/cardiac-tamponade-after-right-ventricular-perforation-caused-by-screw-in-lead
#20
Lovel Giunio, Teo Boric, Cristijan Bulat, Dragan Dragicevic, Mislav Lozo
A 69-year-old man was admitted after syncope followed with chest pain and signs of cardiac tamponade. He had undergone permanent dual-chamber pacemaker implantation 3 weeks earlier. Transthoracic echocardiography (TTE) confirmed a pericardial effusion, and urgent pericardial drainage was performed. Right ventricular perforation caused by active-fixation (screw-in) lead was verified by multislice computed tomography. The lead was extracted under fluoroscopy and bedside TTE monitoring in the operating room with cardiothoracic surgery backup...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
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