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https://www.readbyqxmd.com/read/27867558/effectiveness-of-lung-ultrasonography-for-diagnosis-of-pneumonia-in-adults-a-systematic-review-and-meta-analysis
#1
Yang Xia, Yinghua Ying, Shaobin Wang, Wen Li, Huahao Shen
BACKGROUND: Pneumonia is usually presented as a forgotten killer, and an early diagnosis could largely improve the prognostic outcomes. Lung ultrasound (LUS) has been universally applied in evaluating multiple pulmonary diseases including pneumonia. However, the diagnosis accuracy of LUS for pneumonia in adults is still uncertain. Hence, we performed a systematic review of the current literature to assess the diagnosis accuracy of LUS for pneumonia in adults. METHODS: PubMed and EMBASE were searched for clinical trials that assessed the detection accuracy of LUS for pneumonia in adult patients...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27825617/point-of-care-ultrasonography-for-primary-care-physicians-and-general-internists
#2
REVIEW
Anjali Bhagra, David M Tierney, Hiroshi Sekiguchi, Nilam J Soni
Point-of-care ultrasonography (POCUS) is a safe and rapidly evolving diagnostic modality that is now utilized by health care professionals from nearly all specialties. Technological advances have improved the portability of equipment, enabling ultrasound imaging to be executed at the bedside and thereby allowing internists to make timely diagnoses and perform ultrasound-guided procedures. We reviewed the literature on the POCUS applications most relevant to the practice of internal medicine. The use of POCUS can immediately narrow differential diagnoses by building on the clinical information revealed by the traditional physical examination and refining clinical decision making for further management...
November 5, 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27833681/pilot-point-of-care-ultrasound-curriculum-at-harvard-medical-school-early-experience
#3
Joshua S Rempell, Fidencio Saldana, Donald DiSalvo, Navin Kumar, Michael B Stone, Wilma Chan, Jennifer Luz, Vicki E Noble, Andrew Liteplo, Heidi Kimberly, Minna J Kohler
INTRODUCTION: Point-of-care ultrasound (POCUS) is expanding across all medical specialties. As the benefits of US technology are becoming apparent, efforts to integrate US into pre-clinical medical education are growing. Our objective was to describe our process of integrating POCUS as an educational tool into the medical school curriculum and how such efforts are perceived by students. METHODS: This was a pilot study to introduce ultrasonography into the Harvard Medical School curriculum to first- and second-year medical students...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27818332/accuracy-of-lung-ultrasound-in-the-diagnosis-of-pneumonia-in-adults-systematic-review-and-meta-analysis
#4
Ana M Llamas-Álvarez, Eva M Tenza-Lozano, Jaime Latour-Pérez
BACKGROUND: Some studies suggest that lung ultrasound could be useful for diagnosing pneumonia; moreover, it has a more favorable safety profile and lower cost than chest X-ray (CXR) and computed tomography (CT). The aim of this study is to assess the accuracy of bedside lung ultrasound for diagnosing pneumonia in adults through a systematic review and meta-analysis. METHODS: We searched MEDLINE, Scopus, The Cochrane Library, Web of Science, DARE, HTA Database, Google Scholar, LILACS, ClinicalTrials...
November 3, 2016: Chest
https://www.readbyqxmd.com/read/27747022/ultrasound-guided-central-vascular-interventions-comments-on-the-european-federation-of-societies-for-ultrasound-in-medicine-and-biology-guidelines-on-interventional-ultrasound
#5
Christoph F Dietrich, Rudolf Horn, Susanne Morf, Liliana Chiorean, Yi Dong, Xin-Wu Cui, Nathan S S Atkinson, Christian Jenssen
Central venous access has traditionally been performed on the basis of designated anatomical landmarks. However, due to patients' individual anatomy and vessel pathology and depending on individual operators' skill, this landmark approach is associated with a significant failure rate and complication risk. There is substantial evidence demonstrating significant improvement in effectiveness and safety of vascular access by realtime ultrasound (US)-guidance, as compared to the anatomical landmark-guided approach...
September 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27785748/lung-ultrasound-will-soon-replace-chest-radiography-in-the-diagnosis-of-acute-community-acquired-pneumonia
#6
REVIEW
Jean-Eudes Bourcier, Sergiu Braga, Didier Garnier
Acute community-acquired pneumonia should be diagnosed early to avoid most complications. The common diagnostic tools were represented by blood tests and chest X-ray with CT scan coming as a second-line exploration. The presence of air in the pulmonary parenchyma has long been thought of as not explorable by ultrasound. However, since the 1990s, several teams have described a semiology of ultrasonography of pulmonary diseases. Moreover, the safety of the technique and the development of mobile and ultra-portable devices have offered it as a first-line examination by a non-radiologist physician...
December 2016: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/27784331/lung-ultrasound-a-promising-tool-to-monitor-ventilator-associated-pneumonia-in-critically-ill-patients
#7
REVIEW
Guyi Wang, Xiaoying Ji, Yongshan Xu, Xudong Xiang
Ventilator-associated pneumonia (VAP) is the most frequent intensive care unit (ICU)-acquired infection that is independently associated with mortality. Accurate diagnosis and timely treatment have been shown to improve the prognosis of VAP. Chest X-ray or computed tomography imaging are used for conventional assessment of VAP, but these methods are impractical for real-time measurement in critical patients. Therefore, lung ultrasound (LUS) has been increasingly used for the assessment of VAP in the ICU. Traditionally, LUS has seemed unsuitable for the detection of lung parenchyma owing to the high acoustic impedance of air; however, the fact that the reflection and reverberation in the detection region of the ultrasound reflect the underlying pathology of lung diseases has led to the increased use of ultrasound imaging as a standard of care supported by evidence-based and expert consensus in the ICU...
October 27, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27783380/common-pitfalls-in-point-of-care-ultrasound-a-practical-guide-for-emergency-and-critical-care-physicians
#8
REVIEW
Pablo Blanco, Giovanni Volpicelli
BACKGROUND: Point-of-care ultrasonography (POCUS) is a widely used tool in emergency and critical care settings, useful in the decision-making process as well as in interventional guidance. While having an impressive diagnostic accuracy in the hands of highly skilled operators, inexperienced practitioners must be aware of some common misinterpretations that may lead to wrong decisions at the bedside. OBJECTIVES: This article provides a revision list of common POCUS misdiagnoses usually found in practice and offers useful tips to recognize and avoid them...
December 2016: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/27688631/diagnosing-obstructive-shock-echocardiography-is-the-third-eye-of-a-vigilant-intensivist
#9
Aditya Lyall, Supradip Ghosh, Kirtee Mishra
Training in echocardiography is essential for an intensivist. We present a rapidly fatal case of obstructive shock where a vigilant intensivist could diagnose left atrial mass obstructing the mitral inflow as the etiology of shock.
September 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27682813/diaphragmatic-dysfunction-is-characterized-by-increased-duration-of-mechanical-ventilation-in-subjects-with-prolonged-weaning
#10
Zhihua Lu, Qiuping Xu, Yuehua Yuan, Ge Zhang, Feng Guo, Huiqing Ge
BACKGROUND: Diaphragmatic dysfunction is often underdiagnosed and is among the risk factors for failed weaning. The purpose of this study was to determine the prevalence of diaphragmatic dysfunction diagnosed by B-mode ultrasonography and to determine whether prolonged weaning subjects with diaphragmatic dysfunction have increased duration of mechanical ventilation compared with those without diaphragmatic dysfunction. METHODS: This was a prospective observational study in mechanically ventilated subjects who failed ≥3 spontaneous breathing trials or required >7 d of weaning after the first spontaneous breathing trial...
October 2016: Respiratory Care
https://www.readbyqxmd.com/read/27620292/assessment-of-diaphragmatic-dysfunction-in-the-critically-ill-patient-with-ultrasound-a-systematic-review
#11
Massimo Zambon, Massimiliano Greco, Speranza Bocchino, Luca Cabrini, Paolo Federico Beccaria, Alberto Zangrillo
PURPOSE: Diaphragmatic dysfunction (DD) has a high incidence in critically ill patients and is an under-recognized cause of respiratory failure and prolonged weaning from mechanical ventilation. Among different methods to assess diaphragmatic function, diaphragm ultrasonography (DU) is noninvasive, rapid, and easy to perform at the bedside. We systematically reviewed the current literature assessing the usefulness and accuracy of DU in intensive care unit (ICU) patients. METHODS: Pubmed, Cochrane Database of Systematic Reviews, Embase, Scopus, and Google Scholar Databases were searched for pertinent studies...
September 12, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27645689/effectiveness-of-a-critical-care-ultrasonography-course
#12
Yonatan Y Greenstein, Ross Littauer, Mangala Narasimhan, Paul H Mayo, Seth J Koenig
BACKGROUND: Widespread use of critical care ultrasonography (CCUS) for the management of patients in the intensive care unit requires an effective training program. The effectiveness of national and regional CCUS training courses is not known. This study describes a national level, simulation-based, three day CCUS training program and evaluates its effectiveness. METHODS: Five consecutive CCUS courses, with a total of 363 people, were studied. The three day CCUS training program consisted of didactic lectures, ultrasonography interpretation sessions, and hands-on modules with live models...
September 16, 2016: Chest
https://www.readbyqxmd.com/read/27581823/the-efficacy-of-bedside-chest-ultrasound-from-accuracy-to-outcomes
#13
Mark Hew, Tunn Ren Tay
For many respiratory physicians, point-of-care chest ultrasound is now an integral part of clinical practice. The diagnostic accuracy of ultrasound to detect abnormalities of the pleura, the lung parenchyma and the thoracic musculoskeletal system is well described. However, the efficacy of a test extends beyond just diagnostic accuracy. The true value of a test depends on the degree to which diagnostic accuracy efficacy influences decision-making efficacy, and the subsequent extent to which this impacts health outcome efficacy...
September 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/27568582/a-whole-body-approach-to-point-of-care-ultrasound
#14
Mangala Narasimhan, Seth J Koenig, Paul H Mayo
Ultrasonography is an essential imaging modality in the ICU used to diagnose and guide the treatment of cardiopulmonary failure. Critical care ultrasonography requires that all image acquisition, image interpretation, and clinical applications of ultrasonography are personally performed by the critical care clinician at the point of care and that the information obtained is combined with the history, physical, and laboratory information. Point-of-care ultrasonography is often compartmentalized such that the clinician will focus on one body system while performing the critical care ultrasonography examination...
October 2016: Chest
https://www.readbyqxmd.com/read/27543137/echocardiography-in-shock-management
#15
REVIEW
Anthony S McLean
Echocardiography is pivotal in the diagnosis and management of the shocked patient. Important characteristics in the setting of shock are that it is non-invasive and can be rapidly applied.In the acute situation a basic study often yields immediate results allowing for the initiation of therapy, while a follow-up advanced study brings the advantage of further refining the diagnosis and providing an in-depth hemodynamic assessment. Competency in basic critical care echocardiography is now regarded as a mandatory part of critical care training with clear guidelines available...
August 20, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27523885/ultrasonography-in-the-emergency-department
#16
REVIEW
Micah R Whitson, Paul H Mayo
Point-of-care ultrasonography (POCUS) is a useful imaging technique for the emergency medicine (EM) physician. Because of its growing use in EM, this article will summarize the historical development, the scope of practice, and some evidence supporting the current applications of POCUS in the adult emergency department. Bedside ultrasonography in the emergency department shares clinical applications with critical care ultrasonography, including goal-directed echocardiography, echocardiography during cardiac arrest, thoracic ultrasonography, evaluation for deep vein thrombosis and pulmonary embolism, screening abdominal ultrasonography, ultrasonography in trauma, and guidance of procedures with ultrasonography...
August 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27524204/critical-care-ultrasonography-in-acute-respiratory-failure
#17
REVIEW
Philippe Vignon, Xavier Repessé, Antoine Vieillard-Baron, Eric Maury
Acute respiratory failure (ARF) is a leading indication for performing critical care ultrasonography (CCUS) which, in these patients, combines critical care echocardiography (CCE) and chest ultrasonography. CCE is ideally suited to guide the diagnostic work-up in patients presenting with ARF since it allows the assessment of left ventricular filling pressure and pulmonary artery pressure, and the identification of a potential underlying cardiopathy. In addition, CCE precisely depicts the consequences of pulmonary vascular lesions on right ventricular function and helps in adjusting the ventilator settings in patients sustaining moderate-to-severe acute respiratory distress syndrome...
August 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27473425/lung-ultrasound-for-monitoring-cardiogenic-pulmonary-edema
#18
Francesca Cortellaro, Elisa Ceriani, Monica Spinelli, Carlo Campanella, Ilaria Bossi, Daniele Coen, Giovanni Casazza, Chiara Cogliati
Several studies address the accuracy of lung ultrasound (LUS) in the diagnosis of cardiogenic pulmonary edema (CPE) evaluating the interstitial syndrome, which is characterized by multiple and diffuse vertical artifacts (B-lines), and correlates with extravascular lung water. We studied the potential role of LUS in monitoring CPE response to therapy, by evaluating the clearance of interstitial syndrome within the first 24 h after Emergency Department (ED) admission. LUS was performed at arrival (T0), after 3 (T3) and 24 (T24) hours...
July 29, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27402396/diagnostic-bedside-ultrasonography-for-acute-respiratory-failure-and-severe-hypoxemia-in-the-medical-intensive-care-unit-basics-and-comprehensive-approaches
#19
Justin K Lui, Gisela I Banauch
Bedside goal-directed ultrasound is a powerful tool for rapid differential diagnosis and monitoring of cardiopulmonary disease in the critically ill patient population. The bedside intensivist is in a unique position to integrate ultrasound findings with the overall clinical situation. Medically critically ill patients who require urgent bedside diagnostic assessment fall into 2 categories: (1) acute respiratory failure and (2) hemodynamic derangements. The first portion of this review outlines the diagnostic role of bedside ultrasound in the medically critically ill patient population for the diagnosis and treatment of acute respiratory failure, acute respiratory distress, and severe hypoxemia...
July 8, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27398039/ultrasound-for-the-pulmonary-consultant
#20
REVIEW
Astha Chichra, Mina Makaryus, Parag Chaudhri, Mangala Narasimhan
Bedside ultrasonographic assessment of the lung and pleura provides rapid, noninvasive, and essential information in diagnosis and management of various pulmonary conditions. Ultrasonography helps in diagnosing common conditions, including consolidation, interstitial syndrome, pleural effusions and masses, pneumothorax, and diaphragmatic dysfunction. It provides procedural guidance for various pulmonary procedures, including thoracentesis, chest tube insertion, transthoracic aspiration, and biopsies. This article describes major applications of ultrasonography for the pulmonary consultant along with illustrative figures and videos...
2016: Clinical Medicine Insights. Circulatory, Respiratory and Pulmonary Medicine
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