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Critical care echo

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https://www.readbyqxmd.com/read/27829710/early-norepinephrine-decreases-fluid-and-ventilatory-requirements-in-pediatric-vasodilatory-septic-shock
#1
Suchitra Ranjit, Rajeswari Natraj, Sathish Kumar Kandath, Niranjan Kissoon, Balasubramaniam Ramakrishnan, Paul E Marik
AIMS: We previously reported that vasodilatation was common in pediatric septic shock, regardless of whether they were warm or cold, providing a rationale for early norepinephrine (NE) to increase venous return (VR) and arterial tone. Our primary aim was to evaluate the effect of smaller fluid bolus plus early-NE versus the American College of Critical Care Medicine (ACCM) approach to more liberal fluid boluses and vasoactive-inotropic agents on fluid balance, shock resolution, ventilator support and mortality in children with septic shock...
October 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27768664/bridging-the-gap-hybrid-cardiac-echo-in-the-critically-ill
#2
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
https://www.readbyqxmd.com/read/27746560/the-risk-of-shorter-fasting-time-for-pediatric-deep-sedation
#3
Mathew Clark, Esma Birisci, Jordan E Anderson, Christina M Anliker, Micheal A Bryant, Craig Downs, Abdallah Dalabih
BACKGROUND: Current guidelines adopted by the American Academy of Pediatrics calls for prolonged fasting times before performing pediatric procedural sedation and analgesia (PSA). PSA is increasingly provided to children outside of the operating theater by sedation trained pediatric providers and does not require airway manipulation. We investigated the safety of a shorter fasting time compared to a longer and guideline compliant fasting time. We tried to identify the association between fasting time and sedation-related complications...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27491102/implementing-universal-pulse-oximetry-screening-in-west-virginia-findings-from-year-one
#4
Collin John, John Phillips, Candice Hamilton, Allison Lastliger
BACKGROUND: In March 2012 the West Virginia legislature passed a law that mandates birth hospitals to perform pulse oximetry screening for all well-babies in the newborn nursery to improve the detection of critical congenital heart disease (CCHD). CCHD screening data collection began on September 1, 2012 at all 28 birthing hospitals. The purpose of this study was to review the first year of pulse oximetry screening outcomes and identify barriers to implementation and solutions to improve tracking and policy...
July 2016: West Virginia Medical Journal
https://www.readbyqxmd.com/read/27390667/critical-congenital-heart-disease-screening
#5
REVIEW
Mohammed A Chamsi-Pasha, Hassan Chamsi-Pasha
Critical congenital heart disease (CCHD) is a heart lesion for which neonates require early surgical intervention to survive. Without intervention, the rates of mortality and survival with significant disability are extremely high. Early diagnosis can potentially improve health outcomes in newborns with CCHD. Until recent years, no routine screening protocol existed. In the last few years, pulse oximetry screening for CCHD in newborns has been added to the list of recommended uniform screening panels and advocated by several health-care authorities...
July 2016: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/27197003/recommendations-for-genetic-testing-to-reduce-the-incidence-of-anthracycline-induced-cardiotoxicity
#6
REVIEW
Folefac Aminkeng, Colin J D Ross, Shahrad R Rassekh, Soomi Hwang, Michael J Rieder, Amit P Bhavsar, Anne Smith, Shubhayan Sanatani, Karen A Gelmon, Daniel Bernstein, Michael R Hayden, Ursula Amstutz, Bruce C Carleton
AIMS: Anthracycline-induced cardiotoxicity (ACT) occurs in 57% of treated patients and remains an important limitation of anthracycline-based chemotherapy. In various genetic association studies, potential genetic risk markers for ACT have been identified. Therefore, we developed evidence-based clinical practice recommendations for pharmacogenomic testing to further individualize therapy based on ACT risk. METHODS: We followed a standard guideline development process, including a systematic literature search, evidence synthesis and critical appraisal, and the development of clinical practice recommendations with an international expert group...
September 2016: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27182849/guidelines-for-the-appropriate-use-of-bedside-general-and-cardiac-ultrasonography-in-the-evaluation-of-critically-ill-patients-part-ii-cardiac-ultrasonography
#7
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
https://www.readbyqxmd.com/read/27096681/native-aortic-valve-pneumococcal-endocarditis-fulminant-presentation
#8
Kevin Domingues, Liliana Marta, Isabel Monteiro, Margarida Leal
Pneumococcal endocarditis is a rare entity, corresponding to 1 to 3% of native valve endocarditis cases. It has a typically adverse prognosis, with high mortality. There is a reported predilection for the aortic valve; thus, a common presentation is acute left heart failure. We present a case of a 60-year-old woman with a history of sinusitis, who was admitted with the diagnosis of pneumonia. She rapidly deteriorated with signs of septic shock and was transferred to the critical care unit. The transesophageal echocardiogram revealed severe aortic regurgitation due to valve vegetations...
January 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/27067863/first-case-of-a-left-atrial-dissection-after-transcatheter-aortic-valve-replacement
#9
M Rizwan Sardar, Georges I Kaddissi, Sajjad A Sabir, Simon K Topalian
The left atrial dissection is a very infrequently encountered complication after valve replacement and never seen after Transcatheter aortic valve replacement (TAVR). We present an 84-year-old female, who underwent successful transapical TAVR and consequently developed contained left atrial dissection seen on transesophageal echocardiogram. The patient remained stable throughout the procedure and was monitored in critical care unit with conservative management. Although there is low associated intraop mortality, prompt recognition is paramount with follow-up serial imaging...
June 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/26971643/perforation-of-the-anterior-mitral-leaflet-after-impella-lp-5-0-therapy-in-cardiogenic-shock
#10
Ashkan Eftekhari, Hans Eiskjær, Christian Juhl Terkelsen, Sten Lyager Nielsen, Evald Høj Christiansen, Steen Hvitfeldt Poulsen
A 52-year old man was admitted with out-of-hospital cardiac arrest, and he was resuscitated after 100 minutes. The initial hemodynamic condition was critical due to cardiogenic shock (left ventricular ejection fraction 10 % and mean arterial pressure 60 mmHg on inotropics). Acute coronary angiography did not reveal any new lesions. Due to persistent hemodynamic instability, mechanical support with Impella LP 5.0 was decided. The surgical procedure guided by fluoroscopy and transesophageal echocardiography was uncomplicated...
May 1, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/26953755/bridging-the-gap-hybrid-cardiac-echo-in-the-critically-ill
#11
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
https://www.readbyqxmd.com/read/26936041/measurement-of-pulmonary-artery-to-aorta-ratio-in-computed-tomography-is-correlated-with-pulmonary-artery-pressure-in-critically-ill-chronic-obstructive-pulmonary-disease-patients
#12
Ebru Ortaç Ersoy, Mine Durusu Tanriover, Serpil Öcal, Meltem Gulsun Akpinar, Arzu Topeli
AIM: Chronic obstructive pulmonary disease (COPD) is one of the leading chronic diseases and a common cause of death. Identification of COPD patients at high risk for complications and mortality is of utmost importance. Computed tomography (CT) can be used to measure the ratio of the diameter of the pulmonary artery (PA) to the diameter of the aorta (A), and PA/A ratio was shown to be correlated with PA pressure (PAP). However, the prognostic value of PA size remains unclear in patients with COPD...
June 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/26867411/nurse-delivered-focused-echocardiography-to-determine-intravascular-volume-status-in-a-deployed-maritime-critical-care-unit
#13
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
https://www.readbyqxmd.com/read/26825858/focused-critical-care-echocardiography-development-and-evaluation-of-an-image-acquisition-assessment-tool
#14
Jonathan Gaudet, Jason Waechter, Kevin McLaughlin, André Ferland, Tomás Godinez, Colin Bands, Paul Boucher, Jocelyn Lockyer
OBJECTIVES: Little attention has been placed on assessment tools to evaluate image acquisition quality for focused critical care echocardiography. We designed a novel assessment tool to objectively evaluate the image acquisition skills of critical care trainees learning focused critical care echocardiography and examined the tool for evidence of validity. DESIGN: Prospective observational study. SETTING: Medical-surgical ICUs at a tertiary care teaching hospital...
June 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26815747/the-outcome-of-cardiac-dysfunction-in-critically-ill-trauma-patients-myocardial-contusion-complicated-by-refractory-hypotension
#15
Rade B Vukmir
BACKGROUND: This work attempted to define the care and course of those most severely affected patients in the setting of blunt chest trauma, who had hypotension refractory to routine fluid resuscitation. METHODS: Twenty-three critically ill blunt trauma ICU patients were resuscitated and enrolled with ongoing hypotension required placement of a pulmonary artery catheter. The REF(®)Explorer (Baxter, Edwards, Anaheim, CA) catheter was placed in the right heart measuring pressure, volume and oxygen utilization information, as well as recording Injury Severity Score, EKG, CXR, CPK/MB and echocardiography over the initial 72-h time period...
June 2008: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/26713977/hemodynamic-monitoring-of-the-injured-patient-from-central-venous-pressure-to-focused-echocardiography
#16
REVIEW
Aaron Strumwasser, Heidi Frankel, Sarah Murthi, Damon Clark, Orlando Kirton
No abstract text is available yet for this article.
March 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26693336/critical-care-echo-rounds-extracorporeal-membrane-oxygenation
#17
Kelly Victor, Nicholas A Barrett, Stuart Gillon, Abigail Gowland, Christopher I S Meadows, Nicholas Ioannou
UNLABELLED: Extracorporeal membrane oxygenation (ECMO) is an advanced form of organ support indicated in selected cases of severe cardiovascular and respiratory failure. Echocardiography is an invaluable diagnostic and monitoring tool in all aspects of ECMO support. The unique nature of ECMO, and its distinct effects upon cardio-respiratory physiology, requires the echocardiographer to have a sound understanding of the technology and its interaction with the patient. In this article, we introduce the key concepts underpinning commonly used modes of ECMO and discuss the role of echocardiography...
June 1, 2015: Echo Research and Practice
https://www.readbyqxmd.com/read/26693334/measuring-and-monitoring-quality-in-satellite-echo-services-within-critical-care-an-exploration-of-best-practice
#18
Toby C Thomas, Claire L Colebourn
The subspecialty of critical care echocardiography is a rapidly developing area of cardiac imaging. The United Kingdom Committee for Critical Care Echocardiography was set up in 2009 to examine the remit of echocardiography in critical care, and a successful collaboration between the British Society of Echocardiography (BSE) and the Intensive Care Society has resulted in the establishment of two new critical care accreditation processes: Focused Intensive Care Echocardiography and Advanced Critical Care Echocardiography...
June 1, 2015: Echo Research and Practice
https://www.readbyqxmd.com/read/26693304/critical-care-echo-rounds-echo-in-cardiac-arrest
#19
Andreas Zafiropoulos, Kaleab Asrress, Simon Redwood, Stuart Gillon, David Walker
UNLABELLED: Management of medical cardiac arrest is challenging. The internationally agreed approach is highly protocolised with therapy and diagnosis occurring in parallel. Early identification of the precipitating cause increases the likelihood of favourable outcome. Echocardiography provides an invaluable diagnostic tool in this context. Acquisition of echo images can be challenging in cardiac arrest and should occur in a way that minimises disruption to cardiopulmonary resuscitation (CPR)...
December 1, 2014: Echo Research and Practice
https://www.readbyqxmd.com/read/26693291/critical-care-echo-rounds-haemodynamic-instability
#20
Ashraf Roshdy, Nadia Francisco, Alejandro Rendon, Stuart Gillon, David Walker
UNLABELLED: The use of echocardiography, whilst well established in cardiology, is a relatively new concept in critical care medicine. However, in recent years echocardiography's potential as both a diagnostic tool and a form of advanced monitoring in the critically ill patient has been increasingly recognised. In this series of Critical Care Echo Rounds, we explore the role of echocardiography in critical illness, beginning here with haemodynamic instability. We discuss the pathophysiology of the shock state, the techniques available to manage haemodynamic compromise, and the unique role which echocardiography plays in this complex process...
September 1, 2014: Echo Research and Practice
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