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https://www.readbyqxmd.com/read/29693936/cardiac-point-of-care-using-ultrasound
#1
Mitsuharu Kodaka
Patients with cardiac disease have high mortality rates, mainly owing to shock. Therefore, evaluation of cardiac function is one of the most challenging issues in the intensive and critical care unit. Cardiac point-of-care tests using ultrasound, such as focus assessed transthoracic echo (FATE) and rapid ultrasound in shock (RUSH). are useful for diagnosis and initial care of such patients. The author will introduce first a basic FATE protocol of how to scan from position 1-4, including subcostal 4-chamber, apical 4-chamber, parasternal long and short axis, and pleural scanning...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29650485/providing-transthoracic-echocardiography-training-for-intensive-care-unit-trainees-an-educational-improvement-initiative
#2
Catherine M Kuza, M Tariq Hanifi, Melissa Koç, Matthias Stopfkuchen-Evans
OBJECTIVE: Transthoracic echocardiography (TTE) is important in the management of critically ill patients, yet it has not been incorporated into many residency programs' curricula. Our objective is to determine if trainees undergoing a 60-minute training session on TTE have improved knowledge, ultrasound skills, and increases the utilization of TTE during their rotation in the intensive care unit (ICU). We will also compare the results of participants with prior TTE exposure to TTE-naïve trainees...
April 9, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29650397/assessment-of-five-different-probes-for-lung-ultrasound-in-critically-ill-patients-a-pilot-study
#3
Xavier Bobbia, Margaux Chabannon, Thierry Chevallier, Jean Emmanuel de La Coussaye, Jean Yves Lefrant, Sarah Pujol, Pierre-Géraud Claret, Laurent Zieleskiewicz, Claire Roger, Laurent Muller
INTRODUCTION: The present study was aimed at comparing the diagnosis concordance of five echo probes of lung ultrasound (LUS) with CT scans in intensive care and emergency patients with acute respiratory failure. MATERIALS: This prospective, observational, pilot study involved 10 acute patients in whom a thoracic CT scan was performed. An expert performed an LUS reference exam using five different probes: three probes with a high-quality conventional echo machine (cardiac phased-array probe, abdominal convex probe, linear probe) and two probes (cardiac and linear) with a pocket ultrasound device (PUD)...
April 3, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29581907/pregnancy-after-prosthetic-aortic-valve-replacement-how-do-we-monitor-prosthetic-valvular-function-during-pregnancy
#4
Nicole Sahasrabudhe, Nickolas Teigen, Diana S Wolfe, Cynthia Taub
Background: With modern medicine, many women after structural heart repair are deciding to experience pregnancy. There is a need for further study to identify normal echocardiographic parameters to better assess prosthetic valvular function in pregnancy. In addition, a multidisciplinary approach is essential in managing pregnant patients with complex cardiac conditions. Case: A 22-year-old nulliparous woman with an aortic valve replacement 18 months prior to her pregnancy presented to prenatal care at 20-week gestation...
2018: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29577030/eus-guided-gall-bladder-drainage-in-severe-liver-disease-a-single-center-experience-in-critically-ill-cirrhotics
#5
Kapil Dev Jamwal, Manoj Kumar Sharma, Rakhi Maiwall, Barjesh Kumar Sharma, Shiv Kumar Sarin
Background and Aims : Acute calculous cholecystitis with impending gall bladder perforation in severe liver diseases including decompensated cirrhosis and acute-on-chronic liver failure (ACLF) is difficult to manage, due to the procedures such as cholecystectomy and per cutaneous cholecystostomy being associated with high risk and complications in these patients. Methods : Four cases of severe liver disease with acute calculous cholecystitis who presented to the Institute of Liver and Biliary Sciences (New Delhi, India) for further management were included in the study if they underwent endoscopic ultrasound-guided gall bladder drainage (EUS-GBD)...
March 28, 2018: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/29505486/adapting-the-consolidated-framework-for-implementation-research-to-create-organizational-readiness-and-implementation-tools-for-project-echo
#6
Eva Serhal, Amanda Arena, Sanjeev Sockalingam, Linda Mohri, Allison Crawford
The Project Extension for Community Healthcare Outcomes (ECHO) model expands primary care provider (PCP) capacity to manage complex diseases by sharing knowledge, disseminating best practices, and building a community of practice. The model has expanded rapidly, with over 140 ECHO projects currently established globally. We have used validated implementation frameworks, such as Damschroder's (2009) Consolidated Framework for Implementation Research (CFIR) and Proctor's (2011) taxonomy of implementation outcomes, combined with implementation experience to (1) create a set of questions to assess organizational readiness and suitability of the ECHO model and (2) provide those who have determined ECHO is the correct model with a checklist to support successful implementation...
March 1, 2018: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/29479265/pulse-oximetry-screening-in-newborns-to-enhance-detection-of-critical-congenital-heart-disease
#7
Michael Narvey, Kenny K Wong, Anne Fournier
Pulse oximetry screening is safe, noninvasive, easy to perform and proven to enhance detection of critical congenital heart disease in newborns. However, this test has yet to be adopted as routine practice in Canada. The present practice point highlights essential details and recommendations for screening, which research has shown to be highly specific, with low false-positive rates. Optimal screening for critical congenital heart disease should include prenatal ultrasound, physical examination and pulse oximetry screening...
November 2017: Paediatrics & Child Health
https://www.readbyqxmd.com/read/29446334/leveraging-behavioral-health-expertise-practices-and-potential-of-the-project-echo-approach-to-virtually-integrating-care-in-underserved-areas
#8
Brant Hager, Michael Hasselberg, Eric Arzubi, Jonathan Betlinski, Mark Duncan, Jennifer Richman, Lori E Raney
This column describes Project ECHO (Extension for Community Healthcare Outcomes), a teleconsultation, tele-education, telementoring model for enhancing primary care treatment of underserved patients with complex medical conditions. Numerous centers have adapted ECHO to support primary care treatment of behavioral health disorders. Preliminary evidence for behavioral health ECHO programs suggests positive impacts on providers, treatment planning, and emergency department costs. ECHO has the potential to improve access to effective and cost-effective behavioral health care by virtually integrating behavioral health knowledge and support in sites where specialty providers are not available...
April 1, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29402160/medically-timed-death-as-an-enactment-of-good-death-an-ethnographic-study-of-three-european-intensive-care-units
#9
Gitte H Koksvik
The article is based on ethnographic observation and semistructured interviews with personnel in three European adult intensive care units. Intensive care is a domain of contemporary biomedicine centered on invasive and intense efforts to save lives in acute, critical conditions. It echoes our culture's values of longevity. Nevertheless, mortality rates are elevated. Many deaths follow from nontreatment decisions. Medicalized dying in technological medical settings are often presented as unnatural, impersonal, and undesirable ways of dying...
January 1, 2018: Omega
https://www.readbyqxmd.com/read/29137093/an-incidental-encounter-of-a-rare-high-take-off-right-coronary-artery-a-case-report
#10
Xicheng Deng, Peng Huang, Wenjuan Chen, Xiaohui Yang, Qianjun Liu, Yunbin Xiao, Cheng He
RATIONALE: High take-off of the coronary arteries is a rare cardiac anatomic anomaly, which may occur independently or with other congenital heart defects. In the clinical setting, it is noteworthy as a cause of sudden cardiac death. Further, it is vital to identify such anomalies to avoid intraoperative catastrophes in surgeries for congenital heart defects. PATIENT CONCERNS: A II/6 systolic heart murmur on physical examination was incidentally found in a 9-year-old boy; he was confirmed to have a secundum-type atrial septal defect on echocardiography...
November 2017: Medicine (Baltimore)
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
#11
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: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29017631/infants-born-with-critical-chd-in-arizona-and-capacities-of-birth-centres-for-screening-and-management
#12
Lydia Villa, Brent Bjornsen, Heather Giacone, Erica M Weidler, Ekta Bajaj, Andrew Muth, Melanie Kennedy, Timothy Flood, Dianna Contreras, Joseph Spadafino, Ashish Shah
OBJECTIVES: The aims of this study were to identify locations of births in Arizona with critical CHD, as well as to assess the current use of pulse-oximetry screening and capacities of birth centres to manage a positive screen. Study design Infants (n=487) with a potentially critical CHD were identified from the Arizona Department of Health Services from 2012 and 2013; charts were retrospectively reviewed. Diagnosis was confirmed using echocardiographies. ArcGIS was used to generate maps to visualise the location of treating facility and mother's residence...
February 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/28982720/routes-to-diagnosis-of-heart-failure-observational-study-using-linked-data-in-england
#13
Alex Bottle, Dani Kim, Paul Aylin, Martin R Cowie, Azeem Majeed, Benedict Hayhoe
OBJECTIVE: Timely diagnosis and management of heart failure (HF) is critical, but identification of patients with suspected HF can be challenging, especially in primary care. We describe the journey of people with HF in primary care from presentation through to diagnosis and initial management. METHODS: We used the Clinical Practice Research Datalink (primary care consultations linked to hospital admissions data and national death registrations for patients registered with participating primary care practices in England) to describe investigation and referral pathways followed by patients from first presentation with relevant symptoms to HF diagnosis, particularly alignment with recommendations of the National Institute for Health and Care Excellence guideline for HF diagnosis...
October 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28974140/echodynamics-interpretation-limitations-and-clinical-integration
#14
Ashraf Roshdy
Echodynamics refers to the use of echocardiography as hemodynamic tool mostly in intensive and acute care settings. It implies a smooth drift from the classic cardiology use to a more critical care adjusted use. A more personalized approach is advocated in critical care, and echo is one way to reach such goal. Correct application necessitates optimum understanding, interpretation, and finally integration into patients' clinical management. As more critical care doctors are advancing from basic focused echo examinations to a more advanced one, this article is trying to underlie many pitfalls of critical care echocardiography in order to guide better practice...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28953498/diagnostic-accuracy-of-point-of-care-ultrasound-performed-by-pulmonary-critical-care-physicians-for-right-ventricle-assessment-in-patients-with-acute-pulmonary-embolism
#15
Jason Filopei, Samuel O Acquah, Eric E Bondarsky, David J Steiger, Navitha Ramesh, Madeline Ehrlich, Paru Patrawalla
OBJECTIVES: Risk stratification for acute pulmonary embolism using imaging presence of right ventricular dysfunction is essential for triage; however, comprehensive transthoracic echocardiography has limited availability. We assessed the accuracy and timeliness of Pulmonary Critical Care Medicine Fellow's performance of goal-directed echocardiograms and intensivists' interpretations for evaluating right ventricular dysfunction in acute pulmonary embolism. DESIGN: Prospective observational study and retrospective chart review...
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28866972/comparison-of-continous-wave-doppler-ultrasound-monitor-and-echocardiography-to-assess-cardiac-output-in-intensive-care-patients
#16
COMPARATIVE STUDY
Ahmad Elgendy, Ian M Seppelt, Andrew S Lane
BACKGROUND: Continuous-wave Doppler (CWD) ultrasound through the left ventricular outflow tract is one modality used for non-invasive cardiac output measurement. The ultrasonic cardiac output monitor (USCOM) is a relatively new monitor which uses a small, transcutaneous ultrasound probe to measure cardiac output with CWD via the suprasternal window. It is faster and less complex to train new users than conventional echocardiography. In addition to stroke volume (SV), the USCOM can calculate stroke volume variation (SVV) and the Smith-Madigan inotropy index (SMII), which is an estimate of the pre-load independent contractility of the myocardium...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28828036/lack-of-access-to-mental-health-services-contributing-to-the-high-suicide-rates-among-veterans
#17
Ronald D Hester
The United States has become a country that is constantly at war. This situation has created a crisis amongst our veterans. The current uneven access to appropriate mental health services that returning U.S. veterans encounter echoes the disparities in access to quality mental health services for the general population. The information presented here shows that the shortcomings of our health care system in addressing the mental health needs for our returning veterans may lead to the high suicide rates. Addressing the problem of inadequate access to quality mental health services is critical in any efforts to reforming the U...
2017: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/28749481/evaluation-of-critical-congenital-heart-defects-screening-using-pulse-oximetry-in-the-neonatal-intensive-care-unit
#18
K Van Naarden Braun, R Grazel, R Koppel, S Lakshminrusimha, J Lohr, P Kumar, B Govindaswami, M Giuliano, M Cohen, N Spillane, P Jegatheesan, D McClure, D Hassinger, O Fofah, S Chandra, D Allen, R Axelrod, J Blau, S Hudome, E Assing, L F Garg
OBJECTIVE: To evaluate the implementation of early screening for critical congenital heart defects (CCHDs) in the neonatal intensive care unit (NICU) and potential exclusion of sub-populations from universal screening. STUDY DESIGN: Prospective evaluation of CCHD screening at multiple time intervals was conducted in 21 NICUs across five states (n=4556 infants). RESULTS: Of the 4120 infants with complete screens, 92% did not have prenatal CHD diagnosis or echocardiography before screening, 72% were not receiving oxygen at 24 to 48 h and 56% were born ⩾2500 g...
October 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28566819/neonates-with-critical-congenital-heart-defects-impact-of-fetal-diagnosis-on-immediate-and-short-term-outcomes
#19
Sylvia Michael Colaco, Tanuja Karande, Prashant Raviprakash Bobhate, Rashmi Jiyani, Suresh G Rao, Snehal Kulkarni
BACKGROUND: Fetal echocardiography is being increasingly used for prenatal diagnosis of congenital cardiac malformations, but its impact on the neonatal outcomes in low- and middle-income countries is still unknown. AIMS: The objective of this study is to determine the impact of fetal echocardiography on immediate postnatal and short-term outcome in a tertiary pediatric cardiac center. STUDY DESIGN: This is a prospective study. MATERIALS AND METHODS: One hundred consecutive patients with critical congenital heart defects (CHD) requiring active medical or surgical interventions in the 1st month of life were included in the study...
May 2017: Annals of Pediatric Cardiology
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
#20
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
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