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Critical echocardiography

Jacob J Glaser, Cassandra Cardarelli, Samuel Galvagno, Thomas M Scalea, Sarah B Murthi
BACKGROUND: Point-of-care ultrasound often includes cardiac ultrasound. It is commonly used to evaluate cardiac function in critically ill patients but lacks the specific quantitative anatomic assessment afforded by standard transthoracic echocardiography (TTE). We developed the Focused Rapid Echocardiographic Examination (FREE), a hybrid between a cardiac ultrasound and TTE that places an emphasis on cardiac function rather than anatomy. We hypothesized that data obtained from FREE correlate well with TTE while providing actionable information for clinical decision making...
November 2016: Journal of Trauma and Acute Care Surgery
Kanchi Muralidhar, Deepak Tempe, Yatin Mehta, Poonam Malhotra Kapoor, Chirojit Mukherjee, Thomas Koshy, Prabhat Tewari, Naman Shastri, Satyajeet Misra, Kumar Belani
During current medical care, perioperative transesophageal echocardiography (TEE) has become a vital component of patient management, especially in cardiac operating rooms and in critical care medicine. Information derived from echocardiography has an important bearing on the patient's outcome. The Indian Association of Cardiovascular and Thoracic Anaesthesiologists (IACTA) has promoted the use of TEE during routine clinical care of patients undergoing cardiac surgery. An important mission of IACTA is to oversee training and certify anesthesiologists in the perioperative and intensive care use of TEE...
October 2016: Annals of Cardiac Anaesthesia
Reyhan Dedeoglu, Levent Saltık, Sezen Ugan Atik, Ayşe Güler Eroglu
For a newborn, surgical correction has been the primary treatment of native coarctation at most centers; however, there has been an increased use of balloon angioplasty (BA). The anterograde transvenous (AT) technique is another alternative way for coarctation (AoC) angioplasty in low weight patients with large ventricular septal defect (VSD). Four, 5-day-old to 7-month-old, infants weighing 2500, 2700, 2800, and 3400g, respectively presented to emergency unit (EU) with cyanosis, tachypnea, and loss of weight...
September 2016: Indian Heart Journal
Ana L Neves, Tiago Henriques-Coelho, Adelino Leite-Moreira, José C Areias
OBJECTIVE: The aim of this article is to evaluate the clinical utility of brain natriuretic peptide in pediatric patients, examining the diagnostic value, management, and prognostic relevance, by critical assessment of the literature. DATA SOURCES: In December 2015, a literature search was performed (PubMed access to MEDLINE citations; and included these Medical Subject Headings and text terms for the key words: "brain natriuretic peptide," "amino-terminal pro-brain natriuretic peptide," "children," "neonate/s," "newborn/s," "infant/s," and "echocardiography...
September 30, 2016: Pediatric Critical Care Medicine
Aysel Türkvatan, Alper Güzeltaş, Hasan Tahsin Tola, Yakup Ergül
Congenital pulmonary venous anomalies are not uncommon that can occur either in isolation or in association with different forms of congenital heart disease. Clinical presentation of these anomalies may vary from the relatively benign single anomalous partial pulmonary venous return to life-threatening critical obstructed total anomalous pulmonary venous return. Accurate delineation of these anomalies and accompanied cardiovascular anomalies are crucial to guide decision making in these patients. Low-dose high-pitch dual-source 256-detector multidetector computed tomographic angiography is a fast and reliable imaging modality allowing comprehensive noninvasive anatomic imaging in neonates and children with congenital pulmonary venous anomalies with lower radiation doses and should be preferred for these patients after transthoracic echocardiography...
October 6, 2016: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
Raja Joshi, Rajat Kalra, Neeraj Kumar, Neeraj Aggarwal, Reena K Joshi, Mridul Aggarwal, Rakesh Pandey
Repair of congenital heart disease in the presence of high pulmonary pressure has always been a contentious issue. Pulmonary vascular resistance (PVR) is considered important for establishing operability in these patients. However, PVR estimation is not always accurate and cannot solely be relied upon to make critical decision of operability. Clinical examination, chest X-ray, and echocardiography are also important indicators of pulmonary vascular disease. Knowledge of pits and falls of each investigation is important for appropriate management in these patients...
October 2016: Annals of Cardiac Anaesthesia
Andrea Radinovic, Patrizio Mazzone, Giovanni Landoni, Eustachio Agricola, Damiano Regazzoli, Paolo Della Bella
BACKGROUND: Left atrial catheterization through transseptal puncture is frequently performed in cardiac catheterization procedures. Appropriate transseptal puncture is critical to achieve procedural success. AIMS: The aim of the study is to evaluate the feasibility of selective transseptal punctures, using a modified radiofrequency (RF) transseptal needle and transesophageal echocardiography (TEE), in different types of procedures that require specific sites of left atrial catheterization...
October 2016: Annals of Cardiac Anaesthesia
L Palmeri, G Gradwohl, M Nitzan, E Hoffman, Y Adar, Y Shapir, R Koppel
OBJECTIVE: Fetal echocardiography, physical examination and pulse oximetry detect only half of coarctation of aorta (CoA) cases. We aimed to quantify delayed arrival and diminished amplitude of lower extremity photoplethysmographic (PPG) pulses relative to the right hand in affected patients. STUDY DESIGN: We studied 8 CoA infants and 32 healthy controls. The pulse arrival time difference between foot and hand (f-hTD) and pulse amplitude ratio (F/H) were measured on PPG signal waveforms by digitally-determining maxima and minima of systolic decrease of light transmission...
September 29, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
J Ambrozic, K Prokselj, M Lucovnik
INTRODUCTION: The ability to judge intravascular volume is fundamental in the management of patients with severe preeclampsia. Insufficient intravascular volume can result in decreased oxygen delivery to tissues and exacerbates organ dysfunction. On the other hand, fluid excesses can lead to fluid extravasation and pulmonary edema. Outside of pregnancy, transthoracic echocardiography and lung ultrasonography have become important diagnostic and monitoring tools in critically ill patients...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Yong Zhang, Xianxian Wu, Yang Li, Haiying Zhang, Zhange Li, Ying Zhang, Longyin Zhang, Jiaming Ju, Xin Liu, Xiaohui Chen, Peter V Glybochko, Vladimir Nikolenko, Philipp Kopylov, Chaoqian Xu, Baofeng Yang
Emerging evidence has suggested the critical role of endothelial to mesenchymal transition (EndMT) in fibrotic diseases. The present study was designed to examine whether EndMT is involved in arsenic trioxide (As2O3)-induced cardiac fibrosis and to explore the underlying mechanisms. Cardiac dysfunction was observed in rats after exposure to As2O3 for 15 days using echocardiography, and the deposition of collagen was detected by Masson's trichrome staining and electron microscope. EndMT was indicated by the loss of endothelial cell markers (VE-cadherin and CD31) and the acquisition of mesenchymal cell markers (α-SMA and FSP1) determined by RT-PCR at the mRNA level and Western blot and immunofluorescence analysis at the protein level...
September 27, 2016: Scientific Reports
Yonatan Y Greenstein, Ross Littauer, Mangala Narasimhan, Paul H Mayo, Seth J Koenig
BACKGROUND: Widespread use of critical care ultrasonography (CCUS) for the management of patients in the intensive care unit requires an effective training program. The effectiveness of national and regional CCUS training courses is not known. This study describes a national level, simulation-based, three day CCUS training program and evaluates its effectiveness. METHODS: Five consecutive CCUS courses, with a total of 363 people, were studied. The three day CCUS training program consisted of didactic lectures, ultrasonography interpretation sessions, and hands-on modules with live models...
September 16, 2016: Chest
Nicolo Piazza, Darren Mylotte, Pascal Theriault Lauzier
Interventional cardiologists have traditionally relied upon fluoro-scopic imaging for percutaneous coronary interventions. Transcatheter structural heart interventions, however, require additional imaging modalities such as echocardiography and multislice computed tomography (MSCT) for pre-, intra- and post-procedural assistance. MSCT has emerged as the critical imaging modality for patient and device selection prior to transcatheter structural heart interventions. MSCT is unique as it provides a complete 3-dimensional (3D) dataset of the heart and vasculature that is amenable to multiplanar reconstruction for 2-dimensional (2D) or volume-rendered interpretations...
September 18, 2016: EuroIntervention
Beth Dunlap, George Weyer
Pulmonary hypertension is a common, complex group of disorders that result from different pathophysiologic mechanisms but are all defined by a mean pulmonary arterial pressure of 25 mm Hg or greater. Patients often initially present to family physicians; however, because the symptoms are typically nonspecific or easily attributable to comorbid conditions, diagnosis can be challenging and requires a stepwise evaluation. There is limited evidence to support screening of asymptomatic individuals. Echocardiography is recommended as the initial step in the evaluation of patients with suspected pulmonary hypertension...
September 15, 2016: American Family Physician
S Orde, S J Huang, A S McLean
Echocardiography is developing rapidly. Speckle tracking echocardiography is the latest semi-automatic tool that has potential to quantitatively describe cardiac dysfunction that may be unrecognised by conventional echocardiography. It is a non-Doppler, angle-independent, feasible and reproducible method to evaluate myocardial function in both non-critically ill and critically ill populations. Increasingly it has become a standard measure of both left and right ventricle function in specific patient groups, e...
September 2016: Anaesthesia and Intensive Care
Yahya Acar, Onur Tezel, Necati Salman, Erdem Cevik, Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-Bordomás, Mustafa Z Mahmoud, Abdelmoneim Sulieman, Abbas Ali, Alrayah Mustafa, Ihab Abdelrahman, Mustafa Bahar, Osama Ali, H Lester Kirchner, Gregor Prosen, Ajda Anzic, Paul Leeson, Maryam Bahreini, Fatemeh Rasooli, Houman Hosseinnejad, Gabriel Blecher, Robert Meek, Diana Egerton-Warburton, Edina Ćatić Ćuti, Stanko Belina, Tihomir Vančina, Idriz Kovačević, Nadan Rustemović, Ikwan Chang, Jin Hee Lee, Young Ho Kwak, Do Kyun Kim, Chi-Yung Cheng, Hsiu-Yung Pan, Chia-Te Kung, Ela Ćurčić, Ena Pritišanac, Ivo Planinc, Marijana Grgić Medić, Radovan Radonić, Abiola Fasina, Anthony J Dean, Nova L Panebianco, Patricia S Henwood, Oliviero Fochi, Moreno Favarato, Ezio Bonanomi, Ivan Tomić, Youngrock Ha, Hongchuen Toh, Elizabeth Harmon, Wilma Chan, Cameron Baston, Gail Morrison, Frances Shofer, Angela Hua, Sharon Kim, James Tsung, Isa Gunaydin, Zeynep Kekec, Mehmet Oguzhan Ay, Jinjoo Kim, Jinhyun Kim, Gyoosung Choi, Dowon Shim, Ji-Han Lee, Jana Ambrozic, Katja Prokselj, Miha Lucovnik, Gabrijela Brzan Simenc, Asta Mačiulienė, Almantas Maleckas, Algimantas Kriščiukaitis, Vytautas Mačiulis, Andrius Macas, Sharad Mohite, Zoltan Narancsik, Hugon Možina, Sara Nikolić, Jan Hansel, Rok Petrovčič, Una Mršić, Simon Orlob, Markus Lerchbaumer, Niklas Schönegger, Reinhard Kaufmann, Chun-I Pan, Chien-Hung Wu, Sarah Pasquale, Stephanie J Doniger, Sharon Yellin, Gerardo Chiricolo, Maja Potisek, Borut Drnovšek, Boštjan Leskovar, Kristine Robinson, Clara Kraft, Benjamin Moser, Stephen Davis, Shelley Layman, Yusef Sayeed, Joseph Minardi, Irmina Sefic Pasic, Amra Dzananovic, Anes Pasic, Sandra Vegar Zubovic, Ana Godan Hauptman, Ana Vujaklija Brajkovic, Jaksa Babel, Marina Peklic, Vedran Radonic, Luka Bielen, Peh Wee Ming, Nur Hafiza Yezid, Fatahul Laham Mohammed, Zainal Abidin Huda, Wan Nasarudin Wan Ismail, W Yus Haniff W Isa, Hashairi Fauzi, Praveena Seeva, Mohd Zulfakar Mazlan
A1 Point-of-care ultrasound examination of cervical spine in emergency departmentYahya Acar, Onur Tezel, Necati SalmanA2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasoundYahya Acar, Necati Salman, Onur Tezel, Erdem CevikA3 Pseudoaneurysm of the femoral artery after cannulation of a central venous line. Should we always use ultrasound in these procedures?Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA4 Ultrasound-guided supraclavicular subclavian vein catheterization...
September 2016: Critical Ultrasound Journal
John H Boyd, Demetrios Sirounis, Julien Maizel, Michel Slama
BACKGROUND: In critically ill patients at risk for organ failure, the administration of intravenous fluids has equal chances of resulting in benefit or harm. While the intent of intravenous fluid is to increase cardiac output and oxygen delivery, unwelcome results in those patients who do not increase their cardiac output are tissue edema, hypoxemia, and excess mortality. Here we briefly review bedside methods to assess fluid responsiveness, focusing upon the strengths and pitfalls of echocardiography in spontaneously breathing mechanically ventilated patients as a means to guide fluid management...
September 4, 2016: Critical Care: the Official Journal of the Critical Care Forum
J Vockley, J Charrow, J Ganesh, M Eswara, G A Diaz, E McCracken, R Conway, G M Enns, J Starr, R Wang, J E Abdenur, J Sanchez-de-Toledo, D L Marsden
Long-chain fatty acid oxidation disorders (LC-FAOD) can cause cardiac hypertrophy and cardiomyopathy, often presenting in infancy, typically leading to death or heart transplant despite ongoing treatment. Previous data on triheptanoin treatment of cardiomyopathy in LC-FAOD suggested a clinical benefit on heart function during acute failure. An additional series of LC-FAOD patients with critical emergencies associated with cardiomyopathy was treated with triheptanoin under emergency treatment or compassionate use protocols...
August 27, 2016: Molecular Genetics and Metabolism
Angelo Squeri, Stefano Censi, Claudio Reverberi, Nicola Gaibazzi, Marco Baldelli, Simone Maurizio Binno, Enrico Properzi, Stefano Bosi
BACKGROUND: Accurate quantification of left ventricular (LV) volumes [end-diastolic volume (EDV) and end-systolic volume (ESV)] and ejection fraction (EF) is of critical importance. The development of real-time three-dimensional echocardiography (RT3DE) has shown better correlation than two-dimensional (2D) echocardiography with magnetic resonance imaging (MRI) measurements. The aim of our study was to assess the accuracy of RT3DE and 64-slice computed tomography (CT) in the evaluation of LV volumes and function using MRI as the reference standard in a real-world population with various types of heart disease with different chamber geometry...
September 2, 2016: Journal of Echocardiography
Göksel Çinier, Ahmet Öz, Ahmet Ilker Tekkesin, Mert İlker Hayıroğlu, Muhammed Keskin, Şahin Avsar
Factor V Leiden (FVL) mutation is the most common hereditary thrombophilia. Association of this mutation with venous thrombosis is well established. However, there are several conflicting results regarding the association of FVL with arterial thrombosis, acute coronary syndrome, and intracardiac thrombosis. In this case report, we present a 44-yearold male patient with a medical history of both arterial and venous thrombosis who came to our emergency department with chest pain. After the initial evaluation he was diagnosed as having acute coronary syndrome and transthoracic echocardiography revealed an intracardiac apical thrombus...
September 28, 2016: International Heart Journal
Makoto Kaneko, Jun-Ichi Suzuki, Norio Aoyama, Ryo Watanabe, Asuka Yoshida, Yuka Shiheido, Yuichi Izumi, Mitsuaki Isobe
Recent studies have indicated that periodontopathic bacteria might accelerate the development of cardiac fibrosis. Porphyromonas gingivalis (P. gingivalis), a major periodontal bacterium, is mainly recognized by Toll-like receptor-2 (TLR-2). However, the role of TLR-2 in the acceleration of cardiac fibrosis via infections caused by periodontal bacteria has not yet been investigated. Here we investigated the role TLR-2 has in periodontal pathogen-induced cardiac fibrosis. TLR-2 knockout (KO) and wild type (WT) male C57BL/6 mice were subjected to a transverse aortic constriction (TAC) surgical procedure 2 weeks after chamber implantation...
September 1, 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
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