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Critical care echo

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https://www.readbyqxmd.com/read/28400680/changes-in-b-type-natriuretic-peptide-and-related-hemodynamic-parameters-following-a-fluid-challenge-in-critically-ill-patients-with-severe-sepsis-or-septic-shock
#1
Shahed Omar, Ahmad Ali, Yahya Atiya, Rudo Lufuno Mathivha, Joel M Dulhunty
CONTEXT: Severe sepsis or septic shock. AIMS: The aim of this study is to examine the effect of a fluid challenge on the B-type natriuretic peptide (BNP) and the hemodynamic state. SETTINGS AND DESIGN: This observational study was conducted in an intensivist-led academic, mixed medical-surgical Intensive Care Unit. SUBJECTS AND METHODS: Focused transthoracic echocardiogram, plasma BNP, and hemodynamic measurements were recorded at baseline and following a 500 ml fluid challenge in thirty patients...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28284205/usage-of-3d-models-of-tetralogy-of-fallot-for-medical-education-impact-on-learning-congenital-heart-disease
#2
RANDOMIZED CONTROLLED TRIAL
Yue-Hin Loke, Ashraf S Harahsheh, Axel Krieger, Laura J Olivieri
BACKGROUND: Congenital heart disease (CHD) is the most common human birth defect, and clinicians need to understand the anatomy to effectively care for patients with CHD. However, standard two-dimensional (2D) display methods do not adequately carry the critical spatial information to reflect CHD anatomy. Three-dimensional (3D) models may be useful in improving the understanding of CHD, without requiring a mastery of cardiac imaging. The study aimed to evaluate the impact of 3D models on how pediatric residents understand and learn about tetralogy of Fallot following a teaching session...
March 11, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28271596/team-based-approach-to-identify-cardiac-toxicity-in-critically-ill-hematopoietic-stem-cell-transplant-recipients
#3
Christopher E Dandoy, Sonata Jodele, Zachary Paff, Russel Hirsch, Thomas D Ryan, John L Jefferies, Michelle Cash, Seth Rotz, Abigail Pate, Michael D Taylor, Javier El-Bietar, Kasiani C Myers, Gregory Wallace, Adam Nelson, Michael Grimley, Thomas Pfeiffer, Adam Lane, Stella M Davies, Ranjit S Chima
INTRODUCTION: We observed pulmonary hypertension (PH), pericardial effusions, and left ventricular systolic dysfunction (LVSD) in multiple critically ill hematopoietic stem cell transplant (HSCT) recipients. We implemented routine structured echocardiography screening for HSCT recipients admitted to the pediatric intensive care unit (PICU) using a standardized multidisciplinary process. METHODS: HSCT recipients admitted to the PICU with respiratory distress, hypoxia, shock, and complications related to transplant-associated thrombotic microangiopathy were screened on admission and every 1-2 weeks thereafter...
March 8, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28126563/cardiac-dysfunction-and-ferritin-as-early-markers-of-severity-in-pediatric-sepsis
#4
Cristian T Tonial, Pedro Celiny R Garcia, Louise Cardoso Schweitzer, Caroline A D Costa, Francisco Bruno, Humberto H Fiori, Paulo R Einloft, Ricardo Branco Garcia, Jefferson Pedro Piva
OBJECTIVE: The aim of this study was to verify the association of echocardiogram, ferritin, C-reactive protein, and leukocyte count with unfavorable outcomes in pediatric sepsis. METHODS: A prospective cohort study was carried out from March to December 2014, with pediatric critical care patients aged between 28 days and 18 years. Inclusion criteria were diagnosis of sepsis, need for mechanical ventilation for more than 48h, and vasoactive drugs. Serum levels of C-reactive protein, ferritin, and leukocyte count were collected on the first day (D0), 24h (D1), and 72h (D3) after recruitment...
May 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28123617/clinical-and-historical-features-of-emergency-department-patients-with-pericardial-effusions
#5
Lori Stolz, Josephine Valenzuela, Elaine Situ-LaCasse, Uwe Stolz, Nicolas Hawbaker, Matthew Thompson, Srikar Adhikari
BACKGROUND: Diagnosing pericardial effusion is critical for optimal patient care. Typically, clinicians use physical examination findings and historical features suggesting pericardial effusion to determine which patients require echocardiography. The diagnostic characteristics of these tools are not well described. The objective of this study is to determine the prevalence of historical features and sensitivity of clinical signs to inform clinicians when to proceed with echocardiogram...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28094679/a-retrospective-analysis-of-a-pediatric-tele-echocardiography-service-to-treat-triage-and-reduce-trans-pacific-transport
#6
Christopher A Rouse, Brandon T Woods, C Becket Mahnke
Introduction Tele-echocardiography can ensure prompt diagnosis and prevent the unnecessary transport of infants without critical congenital heart disease, particularly at isolated locations lacking access to tertiary care medical centers. Methods We retrospectively reviewed all infants who underwent tele-echocardiography at a remote 16-bed level IIIB NICU from June 2005 to March 2014. Tele-echocardiograms were completed by cardiac sonographers in Okinawa, Japan, and transmitted asynchronously for review by pediatric cardiologists in Hawaii...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/27924437/disability-life-writing-and-the-problem-of-dependency-in-the-autobiography-of-gaby-brimmer
#7
Rachel Adams
Independence was a core value of the movement for disability rights. People with disabilities did not have to be dependent, advocates claimed; they were robbed of autonomy by poverty, social prejudice, and architectural barriers. Recently, critics have noted that the emphasis on independence equates personhood with autonomy, reason, and self-awareness, thereby excluding those who are incapable of self-determination. The stigma of dependency is communicated to caregivers whose work is devalued and undercompensated...
March 2017: Journal of Medical Humanities
https://www.readbyqxmd.com/read/27829710/early-norepinephrine-decreases-fluid-and-ventilatory-requirements-in-pediatric-vasodilatory-septic-shock
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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