UL / US

An earlier review to evaluate the quality and outcomes of studies assessing ultrasound imaging in regional anesthesia for the pediatric population considered articles published from 1994 to 2009 and showed some evidence in support of block-related outcomes (block onset, success, duration) and process-related outcomes (performance time, local anesthetic dose, and spread). At that time, strong evidence in the form of randomized controlled trials and well-designed prospective observational studies was limited, leading to a call for additional research...

PURPOSE: Anesthesia is a medical specialty where a large number of technical skills need to be mastered with the learning curve for these skills depending on both the technique and the individual involved. The transversus abdominis plane (TAP) block has demonstrated its effectiveness especially in postoperative analgesia following midline laparotomy. It is usually described as a simple technique even though little is known about the learning curve for this block. The purpose of this study was to determine the learning curve for ultrasound-guided TAP block in anesthesiologists who had no prior experience performing the block...

Chronic heart failure is a complex clinical syndrome often characterised by recurrent episodes of acute decompensation. This is acknowledged as a major public health problem, leading to a steadily increasing number of hospitalisations in developed countries. In decompensated heart failure, the redistribution of fluids into the pulmonary vascular bed leads to respiratory failure, a common cause of presentation to the emergency department. The ability to diagnose, quantify and monitor pulmonary congestion is particularly important in managing the disease...

OBJECTIVE: Subclavian vein catheterization may cause various complications. We compared the real-time ultrasound-guided subclavian vein cannulation vs. the landmark method in critical care patients. DESIGN: Prospective randomized study. SETTING: Medical intensive care unit of a tertiary medical center. PATIENTS: Four hundred sixty-three mechanically ventilated patients enrolled in a randomized controlled ISRCTN-registered trial (ISRCTN-61258470)...

BACKGROUND: Inguinal field block (IFB) is a recommended technique for pain control after inguinal hernia repair but is also underused by surgeons. Currently, there is no decisive evidence on which technique, IFB or spinal anesthesia block (SAB), provides better pain control during the first day after hernia repair. In this study, we compared ultrasound-guided IFB performed by anesthesiologists and SAB for pain control during the first day after hernia repair. METHODS: We compared static and dynamic pain scores measured with a numerical rating scale in 86 male patients scheduled for elective unilateral inguinal hernia repair with either ultrasound-guided IFB (n = 42) or SAB (n = 44)...

OBJECTIVE: To investigate the impact of a sequence of educational interventions in a one-day course on focused transthoracic echocardiography (FOTE) by anesthesia and critical care practitioners. DESIGN: A prospective analysis of the educational data. SETTING: Educational setting in two academic medical centers and a medical meeting workshop organized by one of these institutions. PARTICIPANTS: Fifty-six anesthesia and critical care providers, divided into three groups, participated separately in a FOTE training course...

BACKGROUND: Ultrasound (US)-guided short-axis approach for internal jugular vein (IJV) cannulation does not fully protect patients from inadvertent carotid artery (CA) puncture. Carotid puncture is not rare (occurring in up to 4% of all IJV cannulations) despite the use of US. OBJECTIVES: Compare the sonoanatomy of the "medial-oblique approach" probe position with the classic US-guided "short-axis" probe position, specifically: relation of internal CA and IJV; vertical and horizontal diameter of IJV; and degree of overlapping of IJV with CA...

BACKGROUND AND OBJECTIVES: Ultrasound-guided needle placement is a widely used technical skill that can be challenging to learn. The SonixGPS is a novel ultrasound needle-tracking system that has the potential to improve performance over traditional ultrasound systems. The objective of our study was to determine if the use of the SonixGPS ultrasound system improves performance of novice practitioners in ultrasound-guided needle placement compared with conventional ultrasound in the out-of-plane approach on a simulation model...

BACKGROUND: The senile lung undergoes physiologic changes that are well known but have not been investigated with ultrasound (US). Thus, the aim of our study was to compare the US appearances of the lungs in a group of healthy, nonsmoker elderly subjects with those in a group of young subjects. METHODS: One hundred elderly subjects older than 65 years of age (mean age ± SD, 79 ± 7 years) and 50 younger subjects less than 56 years of age (mean age ± SD, 33 ± 12) underwent US examination of the lungs...

STUDY OBJECTIVE: The objective was to determine if ultrasound (US) can more rapidly confirm central venous catheter (CVC) position in comparison to chest radiography (CXR) in the emergency department. METHODS: The study included a convenience sample of emergency department patients with supradiaphragmatic CVCs and a CXR for confirmation. Ultrasound was used for CVC confirmation by visualizing microbubble artifact in the right atrium after injection of saline through the distal port...

BACKGROUND: Previous meta-analyses have shown that ultrasound guidance is an effective technique for radial artery catheterization. However, these reports neglected to include several non-English language studies. Therefore, an updated meta-analysis including more eligible studies was performed to assess the effectiveness of ultrasound-guided radial artery catheterization. METHODS: Eligible studies were identified by systematically searching PubMed, EMBASE, Wanfang, and China National Knowledge Infrastructure literature databases...

PURPOSE: Early confirmation of endotracheal tube placement is of paramount importance to prevent hypoxia and its catastrophic consequences. Despite certain limitations, capnography is considered the gold standard to evaluate the proper placement of an endotracheal tube. Ultrasound is a novel tool with some definitive advantages over capnography. It enables a real-time view and can be performed quickly; furthermore, it is independent of pulmonary blood flow and does not require lung ventilation...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

OBJECTIVE: The etiologic diagnosis of acute dyspnea in the emergency department (ED) remains difficult, especially for elderly patients or those with previous cardiorespiratory medical history. This may lead to inappropriate treatment and potentially a higher mortality rate. Our objective was to evaluate the performance of cardiopulmonary ultrasound compared with usual care for the etiologic diagnosis of acute dyspnea in the ED. METHODS: Patients admitted to the ED for acute dyspnea underwent upon arrival a cardiopulmonary ultrasound performed by an emergency physician, in addition to standard care...

No abstract text is available yet for this article.

BACKGROUND: Tricuspid annular plane systolic excursion (TAPSE) is an emerging prognostic indicator in patients with acute symptomatic pulmonary embolism (PE). METHODS AND RESULTS: We prospectively examined 782 normotensive patients with PE who underwent echocardiography in a multicenter study. As compared with patients with a TAPSE of > 1.6 cm, those with a TAPSE of ≤ 1.6 cm had increased systolic pulmonary artery pressure (53.7 ± 16...

Endocarditis is a serious infection of the innermost muscle layer of the heart and can lead to significant mortality and morbidity. Echocardiography is instrumental to the timely diagnosis of this disease entity. We discuss the case of a patient presenting to the emergency department (ED) with fever of unclear etiology. The diagnosis of right-sided endocarditis was made using focused cardiac ultrasound. A 46-year-old man with a history of intravenous drug abuse presented to the ED complaining of fevers and headaches...

No abstract text is available yet for this article.

The use of ultrasound guidance has revolutionized regional anesthesia practice. Ultrasound equipment disinfection techniques vary between institutions. To date, there are no large data set publications or evidence-based guidelines that describe risk-reduction techniques for infectious complications related to the use of ultrasound guidance for peripheral nerve blockade. We retrospectively reviewed the medical charts of 7476 patients who received ultrasound-guided single-injection peripheral nerve blockade from October 2003 to August 2013 using our institution's low-level disinfection technique in combination with a sterile transparent film barrier dressing to cover the ultrasound transducer...