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25 papers 0 to 25 followers
Jennifer L Martindale, Abel Wakai, Sean P Collins, Phillip D Levy, Deborah Diercks, Brian C Hiestand, Gregory J Fermann, Ian deSouza, Richard Sinert
BACKGROUND: Acute heart failure (AHF) is one of the most common diagnoses assigned to emergency department (ED) patients who are hospitalized. Despite its high prevalence in the emergency setting, the diagnosis of AHF in ED patients with undifferentiated dyspnea can be challenging. OBJECTIVES: The primary objective of this study was to perform a systematic review and meta-analysis of the operating characteristics of diagnostic elements available to the emergency physician for diagnosing AHF...
March 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Emeric Gallard, Jean-Philippe Redonnet, Jean-Eudes Bourcier, Dominique Deshaies, Nicolas Largeteau, Jeanne-Marie Amalric, Fouad Chedaddi, Jean-Marie Bourgeois, Didier Garnier, Thomas Geeraerts
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...
March 2015: American Journal of Emergency Medicine
Mohammad Al Deeb, Skye Barbic, Robin Featherstone, Jerrald Dankoff, David Barbic
OBJECTIVES: Acute dyspnea is a common presenting complaint to the emergency department (ED), and point-of-care (POC) lung ultrasound (US) has shown promise as a diagnostic tool in this setting. The primary objective of this systematic review was to determine the sensitivity and specificity of US using B-lines in diagnosing acute cardiogenic pulmonary edema (ACPE) in patients presenting to the ED with acute dyspnea. METHODS: A systematic review protocol adhering to Cochrane Handbook guidelines was created to guide the search and analysis, and we searched the following databases: PubMed, EMBASE, Ovid MEDLINE, Ovid MEDLINE In-Process & Other Non-Indexed Citations, and the Cochrane Database of Systematic Reviews...
August 2014: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Christian B Laursen, Erik Sloth, Annmarie Touborg Lassen, René dePont Christensen, Jess Lambrechtsen, Poul Henning Madsen, Daniel Pilsgaard Henriksen, Jesper Rømhild Davidsen, Finn Rasmussen
BACKGROUND: When used with standard diagnostic testing, point-of-care ultrasonography might improve the proportion of patients admitted with respiratory symptoms who are correctly diagnosed 4 h after admission to the emergency department. We therefore assessed point-of-care ultrasonography of the heart, lungs, and deep veins in addition to the usual initial diagnostic testing in this patient population. METHODS: In a prospective, parallel-group trial in the emergency department at Odense University Hospital, Odense, Denmark, patients (≥18 years) with a respiratory rate of more than 20 per min, oxygen saturation of less than 95%, oxygen therapy, dyspnoea, cough, or chest pain were randomly assigned in a 1:1 ratio with a computer-generated list to a standard diagnostic strategy (control group) or to standard diagnostic tests supplemented with point-of-care ultrasonography of the heart, lungs, and deep veins (point-of-care ultrasonography group)...
August 2014: Lancet Respiratory Medicine
Seth Koenig, Subani Chandra, Artur Alaverdian, Christopher Dibello, Paul H Mayo, Mangala Narasimhan
BACKGROUND: CT pulmonary angiography (CTPA) is considered the gold standard for the diagnosis of pulmonary embolism (PE) and is frequently performed in patients with cardiopulmonary complaints. However, indiscriminate use of CTPA results in significant exposure to ionizing radiation and contrast. We studied the accuracy of a bedside ultrasound protocol to predict the need for CTPA. METHODS: This was an observational study performed by pulmonary/critical care physicians trained in critical care ultrasonography...
April 2014: Chest
Vaishali P Shah, Michael G Tunik, James W Tsung
OBJECTIVE: To determine the accuracy of point-of-care ultrasonography for the diagnosis of pneumonia in children and young adults by a group of clinicians. DESIGN: Prospective observational cohort study. SETTING: Two urban emergency departments. PARTICIPANTS: Patients from birth to age 21 years undergoing chest radiography for suspected community-acquired pneumonia. INTERVENTION: After documenting clinical examination findings, clinicians with 1 hour of focused training used ultrasonography to diagnose pneumonia in children and young adults...
February 2013: JAMA Pediatrics
James W Tsung, David O Kessler, Vaishali P Shah
BACKGROUND: Emergency department visits quadrupled with the initial onset and surge during the 2009 H1N1 influenza pandemic in New York City from April to June 2009. This time period was unique in that >90% of the circulating virus was surveyed to be the novel 2009 H1N1 influenza A according to the New York City Department of Health. We describe our experience using lung ultrasound in a case series of patients with respiratory symptoms requiring chest X-ray during the initial onset and surge of the 2009 H1N1 influenza pandemic...
2012: Critical Ultrasound Journal
Michael Blaivas
No abstract text is available yet for this article.
June 2012: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Giovanni Volpicelli, Mahmoud Elbarbary, Michael Blaivas, Daniel A Lichtenstein, Gebhard Mathis, Andrew W Kirkpatrick, Lawrence Melniker, Luna Gargani, Vicki E Noble, Gabriele Via, Anthony Dean, James W Tsung, Gino Soldati, Roberto Copetti, Belaid Bouhemad, Angelika Reissig, Eustachio Agricola, Jean-Jacques Rouby, Charlotte Arbelot, Andrew Liteplo, Ashot Sargsyan, Fernando Silva, Richard Hoppmann, Raoul Breitkreutz, Armin Seibel, Luca Neri, Enrico Storti, Tomislav Petrovic
BACKGROUND: The purpose of this study is to provide evidence-based and expert consensus recommendations for lung ultrasound with focus on emergency and critical care settings. METHODS: A multidisciplinary panel of 28 experts from eight countries was involved. Literature was reviewed from January 1966 to June 2011. Consensus members searched multiple databases including Pubmed, Medline, OVID, Embase, and others. The process used to develop these evidence-based recommendations involved two phases: determining the level of quality of evidence and developing the recommendation...
April 2012: Intensive Care Medicine
Khaled Alrajhi, Michael Y Woo, Christian Vaillancourt
BACKGROUND: A pneumothorax is a potentially life-threatening condition. Although CT scan is the reference standard for diagnosis, chest radiographs are commonly used to rule out the diagnosis. We compared the test characteristics of ultrasonography and supine chest radiography in adult patients clinically suspected of having a pneumothorax, using CT scan or release of air on chest tube placement as reference standard. METHODS: We searched for English literature in MEDLINE and EMBASE and performed hand searches...
March 2012: Chest
Nektaria Xirouchaki, Eleftherios Magkanas, Katerina Vaporidi, Eumorfia Kondili, Maria Plataki, Alexandros Patrianakos, Evaggelia Akoumianaki, Dimitrios Georgopoulos
PURPOSE: To compare the diagnostic performance of lung ultrasound and bedside chest radiography (CXR) for the detection of various pathologic abnormalities in unselected critically ill patients, using thoracic computed tomography (CT) as a gold standard. METHODS: Forty-two mechanically ventilated patients scheduled for CT were prospectively studied with a modified lung ultrasound protocol. Four pathologic entities were evaluated: consolidation, interstitial syndrome, pneumothorax, and pleural effusion...
September 2011: Intensive Care Medicine
Gregor Prosen, Petra Klemen, Matej Štrnad, Stefek Grmec
INTRODUCTION: We studied the diagnostic accuracy of bedside lung ultrasound (the presence of a comet-tail sign), N-terminal pro-brain natriuretic peptide (NT-proBNP) and clinical assessment (according to the modified Boston criteria) in differentiating heart failure (HF)-related acute dyspnea from pulmonary (chronic obstructive pulmonary disease (COPD)/asthma)-related acute dyspnea in the prehospital setting. METHODS: Our prospective study was performed at the Center for Emergency Medicine, Maribor, Slovenia, between July 2007 and April 2010...
2011: Critical Care: the Official Journal of the Critical Care Forum
R Gentry Wilkerson, Michael B Stone
OBJECTIVES: Supine anteroposterior (AP) chest radiographs in patients with blunt trauma have poor sensitivity for the identification of pneumothorax. Ultrasound (US) has been proposed as an alternative screening test for pneumothorax in this population. The authors conducted an evidence-based review of the medical literature to compare sensitivity of bedside US and AP chest radiographs in identifying pneumothorax after blunt trauma. METHODS: MEDLINE and EMBASE databases were searched for trials from 1965 through June 2009 using a search strategy derived from the following PICO formulation of our clinical question: patients included adult (18 + years) emergency department (ED) patients in whom pneumothorax was suspected after blunt trauma...
January 2010: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Daniel A Lichtenstein, Gilbert A Mezière, Jean-François Lagoueyte, Philippe Biderman, Ivan Goldstein, Agnès Gepner
BACKGROUND: The risk of pulmonary edema is the main limiting factor in fluid therapy in the critically ill. Interstitial edema is a subclinical step that precedes alveolar edema. This study assesses a bedside tool for detecting interstitial edema, lung ultrasound. The A-line is a horizontal artifact indicating a normal lung surface. The B-line is a kind of comet-tail artifact indicating subpleural interstitial edema. The relationship between anterior interstitial edema detected by lung ultrasound and the pulmonary artery occlusion pressure (PAOP) value was investigated...
October 2009: Chest
Stefano Parlamento, Roberto Copetti, Stefano Di Bartolomeo
OBJECTIVES: The aim of this study is to assess the ability of bedside lung ultrasound (US) to confirm clinical suspicion of pneumonia and the feasibility of its integration in common emergency department (ED) clinical practice. METHODS: In this study we performed lung US in adult patients admitted in our ED with a suspected pneumonia. Subsequently, a chest radiograph (CXR) was carried out for each patient. A thoracic computed tomographic (CT) scan was made in patients with a positive lung US and a negative CXR...
May 2009: American Journal of Emergency Medicine
Michael Blaivas, James W Tsung
OBJECTIVE: Determining the correct position of endotracheal tubes in critically ill patients may be complicated by external factors such as noise, body habitus, and the need for ongoing resuscitation. Multiple detection techniques have been developed to determine the correct endotracheal tube position, recently including the use of sonography to evaluate lung expansion and diaphragmatic excursion. These techniques have also been applied to diagnosis of right endobronchial main stem intubation, which may be confused with a unilateral pneumothorax in some cases...
May 2008: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Daniel A Lichtenstein, Gilbert A Mezière
BACKGROUND: This study assesses the potential of lung ultrasonography to diagnose acute respiratory failure. METHODS: This observational study was conducted in university-affiliated teaching-hospital ICUs. We performed ultrasonography on consecutive patients admitted to the ICU with acute respiratory failure, comparing lung ultrasonography results on initial presentation with the final diagnosis by the ICU team. Uncertain diagnoses and rare causes (frequency<2%) were excluded...
July 2008: Chest
Giovanni Volpicelli, Luciano Cardinale, Giorgio Garofalo, Andrea Veltri
This review discusses the usefulness of bedside lung ultrasound in the diagnostic distinction between different causes of acute dyspnea in the emergency setting, particularly focusing on differential diagnosis of pulmonary edema and exacerbation of chronic obstructive pulmonary disease (COPD). This is possible using a simple unit and easy-to-acquire technique performed by radiologists and clinicians. Major advantages include bedside availability, absence of radiation, high feasibility and reproducibility, and cost efficiency...
May 2008: Emergency Radiology
Giovanni Volpicelli, Alessandro Mussa, Giorgio Garofalo, Luciano Cardinale, Giovanna Casoli, Fabio Perotto, Cesare Fava, Mauro Frascisco
OBJECTIVES: To assess the potential of bedside lung ultrasound to diagnose the radiologic alveolar-interstitial syndrome (AIS) in patients admitted to an emergency medicine unit and to estimate the occurrence of ultrasound pattern of diffuse and multiple comet tail artifacts in diseases involving lung interstitium. METHODS: The ultrasonic feature of multiple and diffuse comet tail artifacts B line was investigated in each of 300 consecutive patients within 48 hours after admission to our emergency medicine unit...
October 2006: American Journal of Emergency Medicine
Michael Blaivas, Matthew Lyon, Sandeep Duggal
BACKGROUND: Supine anteroposterior (AP) chest radiography may not detect the presence of a small or medium pneumothorax (PTX) in trauma patients. OBJECTIVES: To compare the sensitivity and specificity of bedside ultrasound (US) in the emergency department (ED) with supine portable AP chest radiography for the detection of PTX in trauma patients, and to determine whether US can grade the size of the PTX. METHODS: This was a prospective, single-blinded study with convenience sampling, based on researcher availability, of blunt trauma patients at a Level 1 trauma center with an annual census of 75,000 patients...
September 2005: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
2016-06-26 19:55:30
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