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Point-of-care Echocardiography

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https://www.readbyqxmd.com/read/29456596/bridging-the-logistical-gap-between-ultrasound-enthusiasm-and-accreditation
#1
George Reid, Jonathan Bedford, Ben Attwood
Point-of-care ultrasound is increasingly recognised as a valuable adjunct to patient care. Trainees in intensive care medicine are expected to accredit in focused intensive care echocardiography, but the availability of trained mentors and logistical/geographical factors make this difficult within the time constraints required. As a result, many trainees who are enthusiastic about point-of-care ultrasound find it difficult to achieve accreditation. We present a secure, web-based, multi-user system which mitigates many of these difficulties and allows for clinical mentorship to take place without geographical barriers, and at a time convenient for the participants...
February 2018: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29395626/echocardiography-core-laboratory-reproducibility-of-cardiac-safety-assessments-in-cardio-oncology
#2
Michel G Khouri, Bonnie Ky, Gary Dunn, Ted Plappert, Virginia Englefield, Dawn Rabineau, Eric Yow, Huiman X Barnhart, Martin St John Sutton, Pamela S Douglas
BACKGROUND: As the potential for cancer therapy-related cardiac dysfunction is increasingly recognized, there is a need for the standardization of echocardiographic measurements and cut points to guide treatment. The aim of this study was to determine the reproducibility of cardiac safety assessments across two academic echocardiography core laboratories (ECLs) at the University of Pennsylvania and the Duke Clinical Research Institute. METHODS: To harmonize the application of guideline-recommended measurement conventions, the ECLs conducted multiple training sessions to align measurement practices for traditional and emerging assessments of left ventricular (LV) function...
January 30, 2018: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29368313/the-use-of-point-of-care-ultrasound-to-diagnose-patent-foramen-ovale-in-elective-hip-and-knee-arthroplasty-patients-and-its-association-with-postoperative-delirium
#3
Nan Gai, Ronit Lavi, Philip M Jones, Hwa Lee, Douglas Naudie, Daniel Bainbridge
PURPOSE: Hip and knee arthroplasty surgeries are associated with embolism of materials such as air, cement, and fat. Patent foramen ovale (PFO) is a common congenital cardiac condition that has been reported to lead to paradoxical embolism. This observational study aimed to investigate if the presence of a PFO was associated with an increased risk of postoperative delirium in patients undergoing primary elective hip or knee arthroplasties. METHOD: This was a prospective cohort study at a tertiary teaching hospital...
January 24, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29324494/myocardial-protection-by-glucose-insulin-potassium-in-moderate-to-high-risk-patients-undergoing-elective-on-pump-cardiac-surgery-a-randomized-controlled-trial
#4
Christoph Ellenberger, Tornike Sologashvili, Lukas Kreienbühl, Mustafa Cikirikcioglu, John Diaper, Marc Licker
BACKGROUND: Low cardiac output syndrome is a main cause of death after cardiac surgery. We sought to assess the impact of glucose-insulin-potassium (GIK) to enhance myocardial protection in moderate- to high-risk patients undergoing on-pump heart surgery. METHODS: A randomized controlled trial was performed in adult patients (Bernstein-Parsonnet score >7) scheduled for elective aortic valve replacement and/or coronary artery bypass surgery. Patients were randomized to GIK (20 IU of insulin, 10 mEq of potassium chloride in 50 mL of glucose 40%) or saline infusion given over 60 minutes on anesthetic induction...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29321822/pursuing-meaningful-end-points-for-stem-cell-therapy-assessment-in-ischemic-cardiac-disease
#5
REVIEW
Maria Dorobantu, Nicoleta-Monica Popa-Fotea, Mihaela Popa, Iulia Rusu, Miruna Mihaela Micheu
Despite optimal interventional and medical therapy, ischemic heart disease is still an important cause of morbidity and mortality worldwide. Although not included in standard of care rehabilitation, stem cell therapy (SCT) could be a solution for prompting cardiac regeneration. Multiple studies have been published from the beginning of SCT until now, but overall no unanimous conclusion could be drawn in part due to the lack of appropriate end-points. In order to appreciate the impact of SCT, multiple markers from different categories should be considered: Structural, biological, functional, physiological, but also major adverse cardiac events or quality of life...
December 26, 2017: World Journal of Stem Cells
https://www.readbyqxmd.com/read/29310938/evaluation-of-the-clinical-utility-of-transesophageal-echocardiography-and-invasive-monitoring-to-assess-right-ventricular-function-during-and-after-pulmonary-endarterectomy
#6
Thomas P Sullivan, James E Moore, Andrew A Klein, David P Jenkins, Lynne K Williams, Andrew Roscoe, Wendy Tsang
OBJECTIVE: Patients undergoing pulmonary endarterectomy (PEA) have impaired right ventricular function. The authors sought to assess the clinical utility of commonly used perioperative echocardiographic and right heart catheter measurements in patients undergoing PEA. DESIGN: A single-center prospective observational study. SETTING: The study was conducted in a quaternary care cardiac surgical center in the United Kingdom. PARTICIPANTS: Patients undergoing PEA between April 2015 and January 2016...
September 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29285810/von-willebrand-factor-revisited
#7
Senan J Yasar, Obai Abdullah, William Fay, Sudarshan Balla
Degenerative aortic valve stenosis is the most common valvular heart disease seen in developed countries. Since the implementation of transcatheter aortic valve replacement, there has been a surge of efforts to improve procedural technique as well as reduce mortality. Until recently, the mainstay method of assessment of valve implantation as well as paravalvular regurgitation has relied heavily on imaging techniques including transesophageal echocardiography and aortic root angiography. There has been a lot of scientific inquiry to identify biomarkers in the management of patients with aortic stenosis...
December 28, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29284171/post-tavi-follow-up-with-mdct-of-the-valve-prosthesis-technical-application-regular-findings-and-typical-local-post-interventional-complications
#8
Martin Soschynski, Fabio Capilli, Philipp Ruile, Franz-Josef Neumann, Mathias Langer, Tobias Krauss
BACKGROUND:  Transcatheter aortic valve implantation (TAVI) has evolved into an alternative procedure to surgical valve replacement for high-risk patients with aortic valve stenosis. Despite technical innovations, there is still a risk of complications during and after the intervention. After a TAVI procedure, ECG-gated multidetector computed tomography (MDCT) plays an important role in the early diagnosis of local complications. In this article, we explain for the first time how the technical acquisition of MDCT in the region of the aortic root is performed as post-interventional control of the TAVI prosthesis...
December 28, 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/29273259/contemporary-application-of-point-of-care-echocardiography-in-the-emergency-department
#9
REVIEW
Jordan Chenkin, Clare L Atzema
Point-of-care echocardiography is revolutionizing the management of patients presenting with undifferentiated shock and cardiac arrest in the emergency department (ED). Its primary purpose is to aid the clinician in rapidly ruling in and ruling out life-threatening diagnoses at the bedside. In addition, it has become an important component of the clinical examination for stable patients seen in the ED with nonspecific signs and symptoms such as shortness of breath or syncope. Although first described to facilitate the diagnosis of pericardial effusions and cardiac standstill, ED echocardiography has since evolved and is now widely used by emergency physicians to help diagnose other important cardiovascular pathologic conditions that may be contributing to undifferentiated shock, such as left ventricular failure and right ventricular dilatation resulting from pulmonary embolism...
September 1, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29250515/basics-of-functional-echocardiography-in-children-and-neonates
#10
REVIEW
Cécile Tissot, Vincent Muehlethaler, Nicole Sekarski
Functional echocardiography has become an invaluable tool in the pediatric and neonatal intensive care unit. "Point-of-care," "target," or "focus" echocardiography allows bedside cardiac ultrasound evaluation of the hemodynamic status of the patient, helps in directing treatment, thus improves patients care. In order to be able to perform functional echocardiography, it is essential to understand the principles of ultrasound, to know the echocardiographic equipment and settings necessary to acquire the images...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29229143/myocardial-functional-changes-in-transfemoral-versus-transapical-aortic-valve-replacement
#11
Niraj Asthana, Aditya Mantha, Eric H Yang, William Suh, Olcay Aksoy, Richard J Shemin, Gabriel Vorobiof, Peyman Benharash
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has greatly expanded the treatment options available for patients with severe aortic stenosis at high surgical risk. MATERIALS AND METHODS: We compared changes in myocardial function in TAVR with a transfemoral (TF) versus a transapical (TA) approach at a major tertiary hospital from 2012-2016. Traditional echocardiographic measures of cardiac structure and function were tracked, alongside the use of two-dimensional speckle tracking echocardiography to measure myocardial strain and strain rates...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29223692/recent-technological-advancements-in-cardiac-ultrasound-imaging
#12
REVIEW
Jaydev K Dave, Maureen E Mc Donald, Praveen Mehrotra, Andrew R Kohut, John R Eisenbrey, Flemming Forsberg
About 92.1 million Americans suffer from at least one type of cardiovascular disease. Worldwide, cardiovascular diseases are the number one cause of death (about 31% of all global deaths). Recent technological advancements in cardiac ultrasound imaging are expected to aid in the clinical diagnosis of many cardiovascular diseases. This article provides an overview of such recent technological advancements, specifically focusing on tissue Doppler imaging, strain imaging, contrast echocardiography, 3D echocardiography, point-of-care echocardiography, 3D volumetric flow assessments, and elastography...
November 23, 2017: Ultrasonics
https://www.readbyqxmd.com/read/29212621/stenotic-lesions-and-the-maximum-diameter-of-coronary-artery-aneurysms-in-kawasaki-disease
#13
Etsuko Tsuda, Nobuyuki Tsujii, Yohsuke Hayama
OBJECTIVES: To determine the prevalence of subsequent stenotic lesions based on the maximum diameter of the largest coronary artery aneurysm in patients with Kawasaki disease and the threshold value of coronary artery diameter associated with risk of developing stenotic lesion. STUDY DESIGN: There were 214 patients (160 males) who had at least 1 aneurysm in a selective coronary angiogram (CAG) done <100 days after the onset of Kawasaki disease were studied. We measured the maximal coronary artery aneurysm diameter in 3 major branches in the initial CAGs...
December 4, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29202259/bedside-lung-ultrasound-in-the-care-of-the-critically-ill
#14
Máté Rudas, Sam Orde, Marek Nalos
OBJECTIVE: To describe the technique and review the utility of bedside lung ultrasound in acute care. SUMMARY: Lung ultrasound is a useful point-of-care investigation in acute care, especially in patients with dyspnoea or haemodynamic instability. Although normal lung parenchyma is not accessible to ultrasound, distinctive artefacts arising from parietal and visceral pleura indirectly imply the presence of normal lung. As aeration of lung tissue reduces with disease process, visual assessment of several pathologic entities by ultrasound becomes possible...
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29192421/the-state-of-critical-care-ultrasound-training-in-europe-a-survey-of-trainers-and-a-comparison-of-available-accreditation-programmes
#15
Laura Galarza, Adrian Wong, Manu L N G Malbrain
BACKGROUND: Although critical care ultrasound (CCUS) in the Intensive Care Unit has been increasing exponentially for diagnostic and therapeutic purposes, the lack of a uniform formal training structure and programme has posed the question of whether scans have been appropriately performed or reported, and whether there exists proper clinical governance to ensure a high standard of care. METHODS: An online survey was sent to the representatives of various national intensive care societies via the European Society of Intensive Care Medicine CoBaTrICE committee...
December 1, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29180495/handheld-echocardiography-current-state-and-future-perspectives
#16
REVIEW
Mohammed A Chamsi-Pasha, Partho P Sengupta, William A Zoghbi
Echocardiography is the primary imaging modality for diagnosing cardiac conditions. Over the past 2 decades, technological advancements have resulted in the emergence of miniaturized handheld ultrasound equipment that is compact and battery operated, and handheld echocardiography can be readily performed at the point of care with reasonable image quality. The simplicity of use, availability at the patient's bedside, easy transportability, and relatively low cost have encouraged physicians to use these devices for prompt medical decision making...
November 28, 2017: Circulation
https://www.readbyqxmd.com/read/29159487/management-of-cardiopulmonary-assist-devices-in-critically-ill-patients-using-point-of-care-transthoracic-echocardiography-a-case-series
#17
Babar Fiza, Michael Tang, Michael Maile
Point-of-care transthoracic echocardiography is increasingly being utilized by the intensive care physicians in the management of hemodynamically unstable patients. However, its use in the management of critically ill patients requiring cardiopulmonary mechanical device support remains to be well described. In this case series, we present two case reports where point-of-care echocardiography was successfully used by the intensive care team in diagnosing and managing problems related to cardiopulmonary assist device malposition...
November 21, 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29143161/point-of-care-b-type-natriuretic-peptide-and-portable-echocardiography-for-assessment-of-patients-with-suspected-heart-failure-in-primary-care-rationale-and-design-of-the-three-part-handheld-bnp-program-and-results-of-the-training-study
#18
Caroline Morbach, Thomas Buck, Christian Rost, Sebastian Peter, Stephan Günther, Stefan Störk, Christiane Prettin, Raimund Erbel, Georg Ertl, Christiane E Angermann
BACKGROUND: Patients with suspected heart failure (HF) often present first to general practitioners (GPs). Timely and accurate HF diagnosis and reliable prognostic information have remained unmet goals in primary care, where patient evaluation often relies on clinical assessment only. The Handheld-BNP program investigates whether additional use of portable echocardiography (ECHO) and point-of-care determination of B-type natriuretic peptide (BNP) improves the accuracy of HF diagnosis and aids risk prediction in primary care...
November 15, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29128035/bedside-identification-of-massive-pulmonary-embolism-with-point-of-care-transesophageal-echocardiography
#19
Tomislav Jelic, Melanie Baimel, Jordan Chenkin
BACKGROUND: Pulmonary embolism can be difficult to diagnose, particularly in those who are hemodynamically unstable and cannot be imaged to confirm the diagnosis. Echocardiography can allow for rapid assessment of patients in shock, but requires adequate transthoracic windows to obtain clinically useful information. Emergency physician-performed transesophageal echocardiography (TEE) may be a useful tool when transthoracic echocardiography fails. CASE REPORT: An 86-year-old woman presented to the emergency department after a fall at home...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29115044/a-leg-ulcer-with-pulsating-varicose-veins%C3%A2-%C3%A2-from-the-legs-to-the-heart
#20
Sabrina Johanna Swoboda, Hauke Schumann, Dimitra Kiritsi
We present the case of a 58-year-old man who presented to our wound care centre with a 7 -month history of a progressive unilateral leg ulcer. He reported intermittent, heavy bleeding at the ulcer. The duplex sonography showed a bilateral incompetence of the saphenofemoral junctions and the entire course of the great saphenous veins and, surprisingly, also a bilateral reversed arterial-like pulsating flow in the great and small saphenous veins as well as in the deep veins of the lower extremities. During cardiac examination by auscultation and echocardiography, we detected a previously undescribed severe tricuspid insufficiency with strongly reduced systolic ejection of both the left and the right ventricle and repercussions on the peripheral venous system as a cause for the pulsating veins...
November 7, 2017: International Wound Journal
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