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Bedside Echocardiography

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https://www.readbyqxmd.com/read/28639944/clinical-impact-and-efficacy-of-bedside-echocardiography-on-patient-management-in-pediatric-intensive-care-units-picus-a-prospective-study
#1
Sanliay Şahin, Mutlu Uysal Yazıcı, Ganime Ayar, Tülin Köksal, İbrahim İlker Çetin, Filiz Ekici, Abdullah Kocabaş
OBJECTIVE: To determine the indication and necessity of echocardiographic assessment and therapeutic interventions in critically ill children. METHODS: A total of 140 children, including 75 mechanically ventilated (MV) and 65 spontaneously breathing (SB) children, who were admitted consecutively from March to August 2013 were evaluated prospectively. Data regarding the indication for echocardiography and therapeutic approaches used were documented. For evaluating disease severity, the Pediatric Risk of Mortality Score III (PRISM) was ascertained...
June 22, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28625165/transpulmonary-thermodilution-advantages-and-limits
#2
REVIEW
Xavier Monnet, Jean-Louis Teboul
BACKGROUND: For complex patients in the intensive care unit or in the operating room, many questions regarding their haemodynamic management cannot be answered with simple clinical examination. In particular, arterial pressure allows only a rough estimation of cardiac output. Transpulmonary thermodilution is a technique that provides a full haemodynamic assessment through cardiac output and other indices. MAIN BODY: Through the analysis of the thermodilution curve recorded at the tip of an arterial catheter after the injection of a cold bolus in the venous circulation, transpulmonary thermodilution intermittently measures cardiac output...
June 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28536728/neonatologist-performed-point-of-care-functional-echocardiography-in-the-neonatal-intensive-care-unit
#3
Woei Bing Poon, Keng Yean Wong
Functional echocardiography (fECHO) refers to a bedside, limited assessment of the ductus arteriosus, myocardial performance and pulmonary or systemic haemodynamics that is brief in nature and addresses a specific clinical question or management dilemma. This point-of-care ultrasonography is increasingly used internationally and locally among neonatal units to assist with management of neonatal haemodynamic conditions. This article intends to explain the modality, its indications, interpretation and implications for management, and how it impacts long-term outcomes, particularly in chronic lung disease for premature infants born before 32 weeks of gestation...
May 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28506591/early-echocardiography-has-a-low-yield-in-patients-with-transient-ischemic-attack
#4
Elie Harmouche, Ghada A Mahmoud, Michael Ross, Jason Hockenberry, Robin Dharia, Fadi Nahab
STUDY OBJECTIVE: Current guidelines recommend patients presenting with transient ischemic attack (TIA) undergo echocardiography to evaluate for a cardiac source. However, echocardiography is not available daily at many centers. We assessed the yield from early transthoracic echocardiography (TTE) in consecutive patients with TIA evaluated in an emergency department observation unit (EDOU) protocol. METHODS: This observational cohort study took place in an academic medical center from January 1, 2011 to July 31, 2013...
May 11, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28495379/transthoracic-echocardiography-for-diagnosing-pulmonary-embolism-a-systematic-review-and-meta-analysis
#5
J Matthew Fields, Joshua Davis, Lily Girson, Arthur Au, Jacqueline Potts, Charity J Morgan, Imelda Vetter, Lee Ann Riesenberg
OBJECTIVE: Pulmonary embolism (PE) is a common diagnosis with significant mortality if not appropriately treated. The use of transthoracic echocardiography in patients with PE is common; however, its diagnostic capabilities in this use are unclear. With the increased use of ultrasonography in medical settings, it is important to understand the strengths and limitations of echocardiography for the diagnosis of PE. METHODS: We conducted a systematic review of PubMed, CINAHL, and EMBASE through 2016 for articles assessing the diagnostic accuracy of transthoracic echocardiography for PE...
May 9, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28471148/clinical-imaging-in-patients-experiencing-chest-pain
#6
Angelo Silverio, Rodolfo Citro
Non-invasive imaging modalities integrate the clinical and laboratory diagnostic work-up of patients admitted in emergency department for chest pain. Transthoracic echocardiography is the first-line imaging tool because it is rapidly and widely available, bedside feasible and cost-effective. Even when a comprensive exam is not feasible, a fast focused ultrasound exam should be performed. Contrast enhanced computed tomography is an easily accessible tool with specific application in patients suspected for pulmonary embolism (PE) and acute coronary syndrome (ACS) according to the pre-test risk assessment and to the clinical status...
May 3, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28469854/persistent-left-superior-vena-cava-in-atrial-septal-defect-sinus-venosus-type-diagnosis-with-saline-contrast-echocardiography-a-case-series
#7
Purwati Pole Rio, Hasanah Mumpuni, Dyah Wulan Anggrahini, Lucia Kris Dinarti
Persistent Left Superior Vena Cava (PLSVC) should be suspected if we find dilatation of coronary sinus. Sophisticated imaging is not always available in each health care provider. Transthoracic echocardiography (TTE) with agitated saline injections through the left and right antecubital veins provides a simple, and inexpensive, but effective study for a rapid bedside diagnosis of PSLVC.
May 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28443583/retrograde-cerebral-air-embolism-in-a-patient-with-intestinal-necrosis-a-case-report
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28279544/inferior-vena-cava-filter-limb-fracture-with-embolization-to-the-right-ventricle
#17
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
#18
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
#19
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
#20
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
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