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Critical care ultrasound and 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
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
Darren Klugman, John T Berger
OBJECTIVES: The following review will describe the use of focused cardiac ultrasound performed by noncardiologists and its role as an acute hemodynamic monitoring tool in pediatric cardiac critical care. DATA SOURCE: MEDLINE and PubMed. CONCLUSION: The use of focused cardiac ultrasound has grown tremendously over recent years, and is increasingly being performed and interpreted by intensivists, anesthesiologists, and emergency medicine physicians...
August 2016: Pediatric Critical Care Medicine
Yiorgos Alexandros Cavayas, Martin Girard, Georges Desjardins, André Y Denault
BACKGROUND: Acute deterioration in respiratory status commonly occurs in patients who cannot be transported for imaging studies, particularly during surgical procedures and in critical care settings. Transthoracic lung ultrasonography has been developed to allow rapid diagnosis of respiratory conditions at the bedside. Nevertheless, the thorax is not always accessible, especially in the perioperative setting. Transesophageal lung ultrasonography (TELU) can be used to circumvent this problem...
November 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
X T Wang, H Zhao, D W Liu, H M Zhang, Y Long, W Z Chai, Q Zhang
OBJECTIVE: The purpose of this study was to evaluate the significance of echocardiography for the prognosis of acute left cardiac dysfunction in critically ill patients. METHODS: A prospective cohort study was conducted in patients with acute left cardiac dysfunction in the Department of Critical Care Medicine, Peking Union Medical College Hospital from June 2013 to June 2014. Patients were divided into four groups according to the echocardiographic manifestation, including biventricular failure, left ventricular failure, coronary related segmental movement disorder, non-coronary related segmental movement disorder...
June 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Andrew J Inglis, Marek Nalos, Kwan-Hing Sue, Jan Hruby, Daniel M Campbell, Rachel M Braham, Sam R Orde
OBJECTIVE: To compare lung ultrasonography (LUS), chest xray (CXR) and physical examination (Ex) for the detection of pathological abnormalities in the lungs of critically ill patients. DESIGN, SETTING AND PARTICIPANTS: A prospective cohort study of 145 patients in the intensive care unit of a tertiary teaching hospital who were undergoing echocardiography for a clinical indication. MAIN OUTCOME MEASURES: Each patient was independently assessed by Ex, CXR and LUS on the same day...
June 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Laurent Guérin, Antoine Vieillard-Baron
Echocardiography is a noninvasive and accurate tool used in the intensive care unit to assess cardiac function and monitor hemodynamics in shocked patients. During severe sepsis or septic shock, several mechanisms can lead to hemodynamic failure and have to be quickly and precisely diagnosed to propose adequate, personalized, and timely hemodynamic therapy. Echocardiography truly provides intensivists with this diagnostic possibility, whether or not there is fluid responsiveness, cardiac dysfunction, or persistent vasoplegia...
June 2016: Clinics in Chest Medicine
Vincent Labbé, Stéphane Ederhy, Blandine Pasquet, Romain Miguel-Montanes, Cédric Rafat, David Hajage, Stéphane Gaudry, Didier Dreyfuss, Ariel Cohen, Muriel Fartoukh, Jean-Damien Ricard
BACKGROUND: To evaluate the diagnostic performances of two training programs for residents with no prior ultrasound experience to reach competences in extended basic critical care transthoracic echocardiography (CCE) including Doppler capabilities. METHODS: This is a prospective observational study in two intensive care units of teaching hospitals. Group I (five residents) completed a short training program (4-h theory; 3-h practical); group II (six residents) completed a longer training program (6-h theory; 12-h practical)...
December 2016: Annals of Intensive Care
Alexander Levitov, Heidi L Frankel, Michael Blaivas, Andrew W Kirkpatrick, Erik Su, David Evans, Douglas T Summerfield, Anthony Slonim, Raoul Breitkreutz, Susanna Price, Matthew McLaughlin, Paul E Marik, Mahmoud Elbarbary
OBJECTIVE: To establish evidence-based guidelines for the use of bedside cardiac ultrasound, echocardiography, in the ICU and equivalent care sites. METHODS: Grading of Recommendations, Assessment, Development and Evaluation system was used to rank the "levels" of quality of evidence into high (A), moderate (B), or low (C) and to determine the "strength" of recommendations as either strong (strength class 1) or conditional/weak (strength class 2), thus generating six "grades" of recommendations (1A-1B-1C-2A-2B-2C)...
June 2016: Critical Care Medicine
Jennifer G Wilson, Kristine E W Breyer
The use of point-of-care ultrasound in the intensive care unit, both for diagnostic and procedural purposes, has rapidly proliferated, and evidence supporting its use is growing. Conceptually, critical care ultrasound (CCUS) should be considered an extension of the physical examination and should not be considered a replacement for formal echocardiography or radiology-performed ultrasound. Several CCUS applications are of particular relevance to nephrologists, including focused renal ultrasound in patients at high risk for urinary tract obstruction, real-time ultrasound guidance and verification during the placement of central venous catheters, and ultrasound-augmented assessment of shock and volume status...
May 2016: Advances in Chronic Kidney Disease
Hussein D Kanji, Jessica L McCallum, Kapil M Bhagirath, Andrew S Neitzel
OBJECTIVE: The application of ultrasound to assess a patient's cardiac function and volume status is becoming commonplace in the practice of critical care. These skills have been taught through varying curricula; however, no consensus on the optimal curriculum has been established. The purpose of this systematic review is to evaluate the literature regarding critical care ultrasound curriculum development and evaluation. DATA SOURCES: Studies were identified using MEDLINE, Embase, CINAHL, PsycInfo, the Cochrane Center Register of Controlled Trials, and ERIC according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines through June 2014...
August 2016: Critical Care Medicine
Jacob Glaser, Cassandra Cardarelli, Samuel Galvagno, Thomas Scalea, Sarah Murthi
BACKGROUND: Point-of-care ultrasound (POCUS) often includes cardiac ultrasound (CU). 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 Evaluation (FREE) - a hybrid between a CU and TTE that places an emphasis on cardiac function rather than anatomy. We hypothesized that data obtained from FREE correlates well with TTE while providing actionable information for clinical decision-making...
March 7, 2016: Journal of Trauma and Acute Care Surgery
S Hutchings, L Bisset, L Cantillon, P Keating-Brown, S Jeffreys, C Muzvidziwa, E Richmond, P Rees
Focused echocardiography is increasingly used by clinicians to guide fluid resuscitation. The UK Defence Medical Services (DMS) have adopted focused echocardiography as a tool to guide flow assessment and resuscitation in deployed critical care. We aimed to explore whether two focused echo techniques, namely Inferior Vena Cava (IVC) and Left Ventricular Outflow Tract Velocity Time integer (LVOT VTi) respiratory variability could be taught to a group of critical care nurses without previous exposure to ultrasound imaging...
2015: Journal of the Royal Naval Medical Service
Mark Favot, Cheryl Courage, Robert Ehrman, Lyudmila Khait, Phillip Levy
Echocardiography has become a critical tool in the evaluation of patients presenting to the emergency department (ED) with acute cardiovascular diseases and undifferentiated cardiopulmonary symptoms. New technological advances allow clinicians to accurately measure left ventricular (LV) strain, a superior marker of LV systolic function compared to traditional measures such as ejection fraction, but most emergency physicians (EPs) are unfamiliar with this method of echocardiographic assessment. This article discusses the application of LV longitudinal strain in the ED and reviews how it has been used in various disease states including acute heart failure, acute coronary syndromes (ACS) and pulmonary embolism...
January 2016: Western Journal of Emergency Medicine
Nicole T Townsend, John Kendall, Carlton Barnett, Thomas Robinson
BACKGROUND: Simulation training and competency-based assessment are the evolving standard for surgical education. The Focused Assessment Diagnostic Echocardiography (FADE) examination is a bedside, limited transthoracic ultrasound to assess cardiac function, anatomy, and volume status. FADE can be used to noninvasively evaluate and guide resuscitation of critically ill patients. The purpose of this study was to determine the learning curve for surgical residents to perform and interpret the results of the FADE examination using simulation and competency-based assessment...
March 2016: Journal of Surgical Education
Zouheir Bitar, Ossama Maadarani, Khaled Almerri
BACKGROUND: Echocardiography and the N-terminal pro-brain-type natriuretic peptide (NT-proBNP) level are important tests for assessing left ventricular function in patients presenting to the emergency department with acute dyspnea. Chest ultrasound is becoming an important tool in diagnosing acute pulmonary edema. AIM: To assess the diagnostic accuracy of chest ultrasound examination using echocardiography and a curvilinear probe for detecting B-lines in patients presenting with acute pulmonary edema compared with assessment using NT-proBNP...
December 2015: Annals of Intensive Care
Robert Arntfield, Jacob Pace, Michael Hewak, Drew Thompson
BACKGROUND: Emergency physicians frequently employ transthoracic echocardiography (TTE) to assist in diagnosis and therapy for patients with circulatory failure or arrest. In critically ill patients, transesophageal echocardiography (TEE) offers several advantages over TTE, including reliable, continuous image acquisition and superior image quality. Despite these advantages, TEE is not widely used by emergency physicians. OBJECTIVE: Report the feasibility, findings, and clinical influence observed from the first described TEE program implemented in an emergency department (ED) point-of-care ultrasound program...
February 2016: Journal of Emergency Medicine
Kazuhiro Nishigami
Focus assessed transthoracic echocardiography and focused cardiac ultrasound are point-of-care echo protocols for the evaluation of cardiac disease in the emergency room; however, these protocols may not adequately assess aortic dissection, pulmonary embolism, and acute coronary syndrome in patients with killer chest pain. Here, I present an echocardiography protocol focused on screening for these critical cardiovascular diseases. This protocol (termed EASY screening) consists of the assessment of effusion in the pericardial space, aortic abnormalities, the size and shape of the ventricles and asynergy of the left ventricle...
December 2015: Journal of Echocardiography
Heidi L Frankel, Andrew W Kirkpatrick, Mahmoud Elbarbary, Michael Blaivas, Himanshu Desai, David Evans, Douglas T Summerfield, Anthony Slonim, Raoul Breitkreutz, Susanna Price, Paul E Marik, Daniel Talmor, Alexander Levitov
OBJECTIVE: To establish evidence-based guidelines for the use of bedside ultrasound by intensivists and specialists in the ICU and equivalent care sites for diagnostic and therapeutic purposes for organs of the chest, abdomen, pelvis, neck, and extremities. METHODS: The Grading of Recommendations, Assessment, Development and Evaluation system was used to determine the strength of recommendations as either strong or conditional/weak and to rank the "levels" of quality of evidence into high (A), moderate (B), or low (C) and thus generating six "grades" of recommendation (1A-1B-1C-2A-2B-2C)...
November 2015: Critical Care Medicine
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