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echocardiography in intensive care

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https://www.readbyqxmd.com/read/29159487/management-of-cardiopulmonary-assist-devices-in-critically-ill-patients-using-point-of-care-transthoracic-echocardiography-a-case-series
#1
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/29158684/right-and-left-ventricular-function-in-hospitalized-children-with-respiratory-syncytial-virus-infection
#2
Thorsten Horter, Britt Nakstad, Omid Ashtari, Anne Lee Solevåg
Background: Extrapulmonary manifestations including cardiac dysfunction have been demonstrated in children with respiratory syncytial virus (RSV) infection requiring intensive care. The aim of this study was to examine cardiac function in hospitalized children with moderate RSV infection admitted to a regular pediatric ward. Methods: We used echocardiography to determine cardiac output, and right and left ventricular function in 26 patients (aged 2 weeks to 24 months) with RSV infection...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29142568/echocardiographic-evaluation-of-cardiovascular-complications-after-birth-asphyxia-in-term-neonates
#3
Mohsen Shahidi, Ghodratollah Evazi, Abdorrahim Afkhamzadeh
Objectives: After birth asphyxia, a variety of hemodynamic disorders may be noted in the neonatal intensive care unit; these require appropriate recognition and management. The present study was designed to demonstrate the prevalence of heart complications amongst asphyxiated newborns. Methods: Through a cohort study, 29 asphyxiated term neonates were followed since birth until amelioration of pulmonary hypertension and compared with 31 well born neonates. Both groups were evaluated for their heart anatomy and hemodynamic with meticulous assessment through echocardiography...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29133025/perivalvular-mitral-abscess-fistulised-to-the-pericardial-cavity-revealing-staphylococcal-endocarditis
#4
Paul Desaint, Anthony Chauvat, Thomas Garaud, Olivier Andremont, Gaëtan Plantefève, Hervé Mentec, Damien Contou
BACKGROUND: Fistula to the pericardial cavity is a very rare complication of perivalvular abscess during infective endocarditis, with Staphylococcus aureus being the most commonly associated microorganism. METHODS: We report a fatal septic shock due to a mitral endocarditis revealed by a myocardial abscess fistulised toward the pericardial cavity. RESULTS: A 66-year-old female without previous valvular disease was admitted to intensive care for severe sepsis...
October 31, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29131350/leiomyosarcoma-of-the-inferior-vena-cava-presenting-as-a-cardiac-mass
#5
Maryam Nabati, Soheil Azizi
Primary tumors of the inferior vena cava (IVC) are rare. The most common primary malignancy is leiomyosarcoma (LMS), with a severe prognosis. Right-atrium (RA) involvement is seen in about 20 percent of cases. We report the case of a 53-year-old woman admitted to the intensive care unit because of progressive dyspnea with lower limb edema. Echocardiography demonstrated a large mass in the RA. At open-heart surgery, the tumor appeared located in the IVC infrahepatic segment, completely obstructing the lumen and extending into the suprahepatic portion and the RA...
November 13, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29131022/an-echocardiographic-screening-program-helps-to-identify-pulmonary-hypertension-in-extremely-low-birthweight-infants-with-and-without-bronchopulmonary-dysplasia-a-single-center-experience
#6
Katrin Mehler, Floris E Udink Ten Cate, Titus Keller, Ursula Bangen, Angela Kribs, André Oberthuer
BACKGROUND: Pulmonary hypertension (PH) affects 1 in 6 infants with a birthweight <1,000 g (extremely low birthweight; ELBW) and is frequently associated with bronchopulmonary dysplasia (BPD). If untreated, the mortality rates of the disease are high. OBJECTIVES: The aim of this study was to characterize risk factors for PH in ELBW infants and to describe the timing of onset of the disease by setting up a screening program. METHODS: ELBW infants treated at the Department of Neonatology (level III neonatal intensive care unit at the University of Cologne Medical Centre, Germany) between January 2010 and March 2015 were included...
November 8, 2017: Neonatology
https://www.readbyqxmd.com/read/29128166/right-ventricle-dysfunction-and-pre-implantation-vasopressors-in-refractory-ards-supported-by-vv-ecmo
#7
Chiara Lazzeri, Manuela Bonizzoli, Giovanni Cianchi, Stefano Batacchi, Cristiana Guetti, Morena Cozzolino, Pasquale Bernardo, Adriano Peris
BACKGROUND: Acute respiratory distress syndrome (ARDS) has been shown to be frequently associated with haemodynamic instability requiring the use of vasopressors. To date, there is still some uncertainty in the use of veno-venous Extracorporeal Membrane Oxygenation (VV-ECMO) in haemodynamically unstable ARDS patients. METHODS: We therefore assessed whether patients receiving pre ECMO vasopressors had a worse prognosis and, furthermore, we reviewed the factors associated with the use of pre ECMO vasopressors in 92 consecutive patients with refractory ARDS treated with VV-ECMO...
October 31, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29127152/objective-cardiovascular-assessment-in-the-neonatal-intensive-care-unit
#8
REVIEW
Eugene M Dempsey, Afif Faisal El-Khuffash
Traditionally, cardiovascular well-being was essentially based on whether the mean blood pressure was above or below a certain value. However, this singular crude method of assessment provides limited insight into overall cardiovascular well-being. Echocardiography has become increasingly used and incorporated into clinical care. New objective modality assessments of cardiovascular status continue to evolve and are being evaluated and incorporated into clinical care. In this review article, we will discuss some of the recent advances in objective assessment of cardiovascular well-being, including the concept of multimodal monitoring...
November 10, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29126689/the-feasibility-and-impact-of-routine-combined-limited-transthoracic-echocardiography-and-lung-ultrasound-on-diagnosis-and-management-of-patients-admitted-to-icu-a-prospective-observational-study
#9
Kavi Haji, Darsim Haji, David J Canty, Alistair G Royse, Dhaksha Tharmaraj, Meor Azraee, Lynda Hopkins, Collin F Royse
OBJECTIVES: Limited transthoracic echocardiography (TTE) and lung ultrasound increasingly is performed in the intensive care unit (ICU), though used in a goal-directed rather than routine manner. DESIGN: Prospective observational study. SETTINGS: Tertiary ICU. PARTICIPANTS: Ninety-three critically ill participants within 24 hours of admission to ICU. METHODS: A treating intensivist documented a clinical diagnosis and management plan before and after combined limited TTE and lung ultrasound...
August 18, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29118832/the-impact-of-focused-echocardiography-using-the-focused-intensive-care-echo-protocol-on-the-management-of-critically-ill-patients-and-comparison-with-full-echocardiographic-studies-by-bse-accredited-sonographers
#10
David P Hall, Helen Jordan, Shirjel Alam, Michael A Gillies
Introduction: Focused echocardiography is widely used to assist clinical decision-making in critically ill patients. In the UK, the Focused Intensive Care Echo protocol is recommended by the Intensive Care Society to ensure consistency of approach and guarantee training standards. Concerns remain about the reliability of information attained by non-expert clinicians in focused echocardiography, particularly when this is used to alter clinical management. Methods: A prospective, observational evaluation of 60 consecutive patients undergoing Focused Intensive Care Echo studies in a single ICU...
August 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29116972/low-cardiac-output-syndrome-after-adult-cardiac-surgery-predictive-value-of-peak-systolic-global-longitudinal-strain
#11
Philippe Amabili, Sabeha Benbouchta, Laurence Roediger, Marc Senard, Marie Bernard Hubert, Anne-Françoise Donneau, Jean-François Brichant, Gregory A Hans
BACKGROUND: Peak systolic global longitudinal strain (GLS) is increasingly used to quantify left ventricular systolic function. The primary objective of this study was to assess whether GLS obtained during intraoperative transesophageal echocardiogram, performed before cardiopulmonary bypass, improves the prediction of postoperative low cardiac output syndrome (LCOS) after adult cardiac surgery. METHODS: GLS from 275 patients undergoing on-pump cardiac surgery was calculated retrospectively using two-dimensional- speckle tracking echocardiography (aCMQ module from Qlab software version 10...
November 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29110981/distributive-shock-in-a-neonate-with-diffuse-infantile-hepatic-hemangioma
#12
James Brown, Rajan Arora, Usha Sethuraman
BACKGROUND: Hemangiomas are common cutaneous findings on healthy infants. These vascular malformations are generally benign, though in rare circumstances they can potentially be fatal. This is particularly true when the hemangiomas are large or numerous and occurring in visceral organs. Previously unrecognized visceral hemangiomas are part of the differential for any neonate presenting unexpectedly in shock. CASE REPORT: A 10-day-old neonate presented to the pediatric emergency department with difficulty breathing...
October 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29092664/the-perspective-of-the-intensivist-on-inotropes-and-postoperative-care-following-pediatric-heart-surgery-an-international-survey-and-systematic-review-of-the-literature
#13
Peter P Roeleveld, J C A de Klerk
INTRODUCTION: Inotropes are frequently being used in children undergoing heart surgery to prevent or treat low cardiac output syndrome (LCOS). There is only limited evidence that inotropes actually positively influence postoperative outcome. Our aim was to describe the current international practice variation in the use of inotropes following congenital heart surgery. METHODS: We developed an online survey regarding the postoperative use of inotropes. We sent an invitation to all 197 registered members of the Pediatric Cardiac Intensive Care Society (PCICS) to participate in the survey...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29071529/beat-by-beat-estimation-of-the-left-ventricular-pressure-volume-loop-under-clinical-conditions
#14
Shaun Davidson, Chris Pretty, Shun Kamoi, Thomas Desaive, J Geoffrey Chase
This paper develops a method for the minimally invasive, beat-by-beat estimation of the left ventricular pressure-volume loop. This method estimates the left ventricular pressure and volume waveforms that make up the pressure-volume loop using clinically available inputs supported by a short, baseline echocardiography reading. Validation was performed across 142,169 heartbeats of data from 11 Piétrain pigs subject to two distinct protocols encompassing sepsis, dobutamine administration and clinical interventions...
October 25, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29063125/-structured-bedside-ultrasound-in-intensive-care-medicine
#15
D Hempel, R Pfister, G Michels
The so-called point-of-care ultrasound (POCUS) is of increasing importance for diagnostics and therapy control in intensive care medicine. Based on focused thorax sonography, echocardiography, and abdominal sonography, the most important working and differential diagnoses can be demonstrated or excluded depending on the leading symptom. Sonographic-based algorithms allow a structured evaluation especially of patients with the common leading symptoms dyspnea and thoracic pain.
November 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29058296/research-and-application-of-transnasal-transesophageal-echocardiography-probe
#16
Lei Wang, Jing Zhang, Shao-Ping Zheng, Lin He, Jing Wang, Xin-Fang Wang, Ming-Xing Xie
The intubation of conventional transesophageal echocardiography (TEE) probes into patients causes serious esophagus irritation, and thus the use of TEE probes in pediatric practice is limited. In this study, we aimed at the development of a special probe which could be inserted through the nasopharyngeal cavity into the esophagus to obtain the same high-quality echocardiography images as those obtained by conventional TEE and improve patients' experience. During the examination, the patients felt relaxed for a longer time and cooperated with the sonographers in the process of cardiac catheterization conducted in the surgery room or the intensive care unit (ICU), resulting in improved accuracy of the diagnosis and timely administration of appropriate treatment...
October 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/29054227/life-threatening-cardiac-perforation-after-posterior-spondylodesis
#17
Michaela Andrä, Harald Baumer, Florian Mittergradnegger, Michael Laschitz, Tadej Petek, Wolfgang Wandschneider
This reports presents a case of a 62-year-old woman with hemorrhagic hypovolemic shock, respiratory distress, and pericardial effusion secondary to right atrial perforation caused by a cement embolus after dorsal spondylodesis. Despite optimal intensive care support for a supposed pulmonary embolism, the patient's condition markedly deteriorated. On delayed embolus recognition by contrast-enhanced computed tomography and transesophageal echocardiography, she had to undergo cardiac surgery. Cardiac involvement is a rare but important complication, with few cases described after vertebroplasty and none after spondylodesis...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29050845/high-rate-of-isolated-right-ventricular-dysfunction-in-patients-with-non-significant-computed-tomographic-pulmonary-angiography
#18
Frances M Russell, Jeffrey A Kline, Timothy Lahm
BACKGROUND: Right ventricular (RV) dysfunction and pulmonary hypertension (PH) are commonly unrecognized in the emergency department (ED), but are associated with poor outcomes. Prior research has found a 30% prevalence of isolated RV dysfunction in ED patients after non-significant computed tomographic pulmonary angiography (CTPA). We aimed to prospectively define the prevalence of RV dysfunction and/or PH in short of breath ED patients, and assess outcomes. METHODS: Prospective observational study of patients with a non-significant CTPA...
October 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29030027/comparison-of-right-ventricular-measurements-by-perioperative-transesophageal-echocardiography-as-a-predictor-of-hemodynamic-instability-following-cardiac-surgery
#19
Pei-Chi Ting, An-Hsun Chou, Chia-Chih Liao, Victor Chien-Chia Wu, Feng-Chun Tsai, Jaw-Ji Chu, Min-Wen Yang, Shi-Chuan Chang
BACKGROUND: The relationship between perioperative right ventricular (RV) performance and hemodynamic instability after cardiac surgery seemed less portrayed. Therefore, we sought to elucidate this relationship and compare the accuracy of different RV systolic indices in predicting outcome of cardiac surgery. METHODS: This study enrolled consecutive patients referred for cardiac surgeries. Exclusion criteria were non-sinus rhythm or contraindications to transesophageal echocardiography (TEE)...
October 10, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29022204/the-relationship-between-single-and-two-dimensional-indices-of-left-ventricular-size-using-hemodynamic-transesophageal-echocardiography-in-trauma-and-burn-patients
#20
Duraid Younan, T Mark Beasley, David C Pigott, C Blayke Gibson, John P Gullett, Jeffrey Richey, Jean-Francois Pittet, Ahmed Zaky
BACKGROUND: Conventional echocardiographic technique for assessment of volume status and cardiac contractility utilizes left ventricular end-diastolic area (LVEDA) and fractional area of change (FAC), respectively. Our goal was to find a technically reliable yet faster technique to evaluate volume status and contractility by measuring left ventricular end-diastolic diameter (LVEDD) and fractional shortening (FS) in a cohort of mechanically ventilated trauma and burn patients using hemodynamic transesophageal echocardiographic (hTEE) monitoring...
October 11, 2017: Critical Ultrasound Journal
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