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Cardiac + Hemodynamics

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46 papers 0 to 25 followers
https://www.readbyqxmd.com/read/28503752/point-of-care-diagnosis-of-cardiac-tamponade-identified-by-the-flow-velocity-paradoxus
#1
William Shyy, Roneesha S Knight, Aaron Kornblith, Nathan A Teismann
The presentation of cardiac tamponade is a spectrum from occult to extreme. The clinical history, physical exam, electrocardiogram, and radiographic findings of tamponade have poor sensitivities and even worse specificities. We use a clinical scenario to demonstrate how point-of-care cardiac ultrasound can diagnose impending cardiac tamponade in a clinically stable patient. The ultrasound finding we recommend is the flow velocity paradoxus, in which respiratory variation causes significant changes in transvalvular inflow velocities, which are exaggerated when tamponade is present...
November 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29175356/point-of-care-ultrasound-use-in-patients-with-cardiac-arrest-is-associated-prolonged-cardiopulmonary-resuscitation-pauses-a-prospective-cohort-study
#2
Eben J Clattenburg, Peter Wroe, Stephen Brown, Kevin Gardner, Lia Losonczy, Amandeep Singh, Arun Nagdev
OBJECTIVE: We aim to evaluate if point-of-care ultrasound use in cardiac arrest is associated with CPR pause duration. METHODS: This is a prospective cohort study of patients with cardiac arrest (CA) presenting to an urban emergency department from July 2016 to January 2017. We collected video recordings of patients with CA in designated code rooms with video recording equipment. The CAs recordings were reviewed and coded by two abstractors. The primary outcome was the difference CPR pause duration when POCUS was and was not performed...
January 2018: Resuscitation
https://www.readbyqxmd.com/read/29269162/echocardiography-in-cardiac-arrest-an-emergency-medicine-review
#3
REVIEW
Brit Long, Stephen Alerhand, Kurian Maliel, Alex Koyfman
INTRODUCTION: Cardiac arrest management primarily focuses on optimal chest compressions and early defibrillation for shockable cardiac rhythms. Non-shockable rhythms such as pulseless electrical activity (PEA) and asystole present challenges in management. Point-of-care ultrasound (POCUS) in cardiac arrest is promising. OBJECTIVES: This review provides a focused assessment of POCUS in cardiac arrest, with an overview of transthoracic (TTE) and transesophageal echocardiogram (TEE), uses in arrest, and literature support...
March 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29364925/the-predictive-value-of-bedside-ultrasound-to-restore-spontaneous-circulation-in-patients-with-pulseless-electrical-activity-a-systematic-review-and-meta-analysis
#4
REVIEW
Chunshuang Wu, Zhongjun Zheng, Libing Jiang, Yuzhi Gao, Jiefeng Xu, Xiaohong Jin, Qijiang Chen, Mao Zhang
BACKGROUND: The prognosis of pulseless electrical activity is dismal. However, it is still challengable to decide when to terminate or continue resuscitation efforts. The aim of this study was to determine whether the use of bedside ultrasound (US) could predict the restoration of spontaneous circulation (ROSC) in patients with pulseless electrical activity (PEA) through the identification of cardiac activity. METHODS: This was a systematic review and meta-analysis of studies that used US to predict ROSC...
2018: PloS One
https://www.readbyqxmd.com/read/29522655/assessment-of-left-atrial-size-in-addition-to-focused-cardiopulmonary-ultrasound-improves-diagnostic-accuracy-of-acute-heart-failure-in-the-emergency-department
#5
Maria Viviana Carlino, Fiorella Paladino, Alfonso Sforza, Claudia Serra, Filomena Liccardi, Giovanni de Simone, Costantino Mancusi
BACKGROUND: Acute dyspnea is one of the main reasons for admission to Emergency Department (ED). Availability of ultraminiaturized pocket ultrasound devices (PUD) adds diagnostic power to the clinical examination. The aim of this study was to identify an integrated ultrasound approach for diagnosis of acute heart failure (acute HF), using PUD and combining evaluation from lung, heart and inferior vena cava (IVC). METHODS: We included 102 patients presenting to the ED of "Antonio Cardarelli" Hospital in Naples (Italy) for acute dyspnea (AD)...
March 9, 2018: Echocardiography
https://www.readbyqxmd.com/read/26973178/diagnostic-accuracy-of-right-ventricular-dysfunction-markers%C3%A2-in%C3%A2-normotensive-emergency-department-patients%C3%A2-with%C3%A2-acute-pulmonary%C3%A2-embolism
#6
Anthony J Weekes, Gregory Thacker, Daniel Troha, Angela K Johnson, Jordan Chanler-Berat, H James Norton, Michael Runyon
STUDY OBJECTIVE: We determine the diagnostic accuracy of goal-directed echocardiography, cardiac biomarkers, and computed tomography (CT) in early identification of severe right ventricular dysfunction in normotensive emergency department patients with pulmonary embolism compared with comprehensive echocardiography. METHODS: This was a prospective observational study of consecutive normotensive patients with confirmed pulmonary embolism. Investigators, blinded to clot burden and biomarkers, performed qualitative goal-directed echocardiography for right ventricular dysfunction: right ventricular enlargement (diameter greater than or equal to that of the left ventricle), severe right ventricular systolic dysfunction, and septal bowing...
September 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/24198915/anatomic-variants-mimicking-pathology-on-echocardiography-differential-diagnosis
#7
REVIEW
Mi-Jeong Kim, Hae Ok Jung
Differentiation of normal from abnormal findings is critical in echocardiography. Anatomic variants occurring in normal cardiac developments often simulate pathologic entities. This review focuses on the differential diagnosis of normal anatomic structures from pathologic ones in echocardiography.
September 2013: Journal of Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/29372430/emergency-physician-use-of-tissue-doppler-bedside-echocardiography-in-detecting-diastolic-dysfunction-an-exploratory-study
#8
Marina Del Rios, Joseph Colla, Pavitra Kotini-Shah, Joan Briller, Ben Gerber, Heather Prendergast
INTRODUCTION: This study evaluates the agreement between emergency physician (EP) assessment of diastolic dysfunction (DD) by a simplified approach using average peak mitral excursion velocity (e'A ) and an independent cardiologist's diagnosis of DD by estimating left atrial (LA) pressure using American Society of Echocardiography (ASE) guidelines. METHODS: This was a secondary analysis of 48 limited bedside echocardiograms (LBE) performed as a part of a research study of patients presenting to the Emergency Department (ED) with elevated blood pressure but without decompensated heart failure...
January 25, 2018: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28883036/how-to-interpret-an-echocardiography-report-for-the-non-imager
#9
REVIEW
Manish Bansal, Partho P Sengupta
No abstract text is available yet for this article.
November 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27236328/accuracy-of-point-of-care-ultrasound-to-identify-the-source-of-infection-in-septic-patients-a-prospective-study
#10
Francesca Cortellaro, Laura Ferrari, Francesco Molteni, Paolo Aseni, Marta Velati, Linda Guarnieri, Katia Barbara Cazzola, Silvia Colombo, Daniele Coen
Sepsis is a rapidly evolving disease with a high mortality rate. The early identification of sepsis and the implementation of early evidence-based therapies have been recognized to improve outcome and decrease sepsis-related mortality. The aim of this study was to compare the accuracy of the standard diagnostic work-up of septic patients with an integrated approach using early point of care ultrasound (POCUS) to identify the source of infection and to speed up the time to diagnosis. We enrolled a consecutive sample of adult patients admitted to the ED who met the Surviving Sepsis Campaign (SSC) criteria for sepsis...
April 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28758715/serial-sonographic-assessment-of-pulmonary-edema-in-patients-with-hypertensive-acute-heart-failure
#11
Jennifer L Martindale, Michael Secko, John F Kilpatrick, Ian S deSouza, Lorenzo Paladino, Andrew Aherne, Ninfa Mehta, Alyssa Conigiliaro, Richard Sinert
OBJECTIVES: Objective measures of clinical improvement in patients with acute heart failure (AHF) are lacking. The aim of this study was to determine whether repeated lung sonography could semiquantitatively capture changes in pulmonary edema (B-lines) in patients with hypertensive AHF early in the course of treatment. METHODS: We conducted a feasibility study in a cohort of adults with acute onset of dyspnea, severe hypertension in the field or at triage (systolic blood pressure ≥ 180 mm Hg), and a presumptive diagnosis of AHF...
February 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28851499/the-cardiac-arrest-sonographic-assessment-casa-exam-a-standardized-approach-to-the-use-of-ultrasound-in-pea
#12
LETTER
Kevin F Gardner, Eben J Clattenburg, Peter Wroe, Amandeep Singh, Daniel Mantuani, Arun Nagdev
No abstract text is available yet for this article.
April 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28285867/a-modified-lung-and-cardiac-ultrasound-protocol-saves-time-and-rules-in-the-diagnosis-of-acute-heart-failure
#13
Frances M Russell, Robert R Ehrman
BACKGROUND: Multiorgan ultrasound (US), which includes evaluation of the lungs and heart, is an accurate method that outperforms clinical gestalt for diagnosing acutely decompensated heart failure (ADHF). A known barrier to ultrasound use is the time needed to perform these examinations. OBJECTIVE: The primary goal of this study was to determine the test characteristics of a modified lung and cardiac US (LuCUS) protocol for the accurate diagnosis of ADHF. METHODS: This was a secondary analysis of a prospective observational study that enrolled adult patients presenting to the emergency department with undifferentiated dyspnea...
June 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28851498/point-of-care-ultrasound-leads-to-diagnostic-shifts-in-patients-with-undifferentiated-hypotension
#14
Hamid Shokoohi, Keith S Boniface, Michelle Zaragoza, Ali Pourmand, James P Earls
OBJECTIVE: To assess the impact of an ultrasound hypotension protocol in identifying life-threatening diagnoses that were missed in the initial evaluation of patients with hypotension and shock. METHODS: A subset of cases from a previously published prospective study of hypotensive patients who presented at the Emergency Department in a single, academic tertiary care hospital is described. An ultrasound-trained emergency physician performed an ultrasound on each patient using a standardized hypotension protocol...
December 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/12208411/disturbed-right-ventricular-ejection-pattern-as-a-new-doppler-echocardiographic-sign-of-acute-pulmonary-embolism
#15
COMPARATIVE STUDY
Marcin Kurzyna, Adam Torbicki, Piotr Pruszczyk, Barbara Burakowska, Anna Fijałkowska, Jaroslaw Kober, Karina Oniszh, Paweł Kuca, Witold Tomkowski, Janusz Burakowski, Liliana Wawrzyńska
Transthoracic echocardiography (TTE) is frequently performed in patients with suspected acute pulmonary embolism (APE) to search for right ventricular (RV) pressure overload. We prospectively assessed the diagnostic value of a new Doppler echocardiographic sign of APE based on the disturbed RV ejection pattern ("60/60 sign") and compared its diagnostic performances with that of the presence of RV pressure overload, as well as with "McConnell sign" based on RV regional wall motion abnormalities. We assessed 100 consecutive patients with clinical suspicion of APE, including those with previous cardiorespiratory diseases...
September 1, 2002: American Journal of Cardiology
https://www.readbyqxmd.com/read/28525778/inferior-vena-cava-collapsibility-detects-fluid-responsiveness-among-spontaneously-breathing-critically-ill-patients
#16
Keith A Corl, Naomi R George, Justin Romanoff, Andrew T Levinson, Darin B Chheng, Roland C Merchant, Mitchell M Levy, Anthony M Napoli
PURPOSE: Measurement of inferior vena cava collapsibility (cIVC) by point-of-care ultrasound (POCUS) has been proposed as a viable, non-invasive means of assessing fluid responsiveness. We aimed to determine the ability of cIVC to identify patients who will respond to additional intravenous fluid (IVF) administration among spontaneously breathing critically-ill patients. METHODS: Prospective observational trial of spontaneously breathing critically-ill patients...
October 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/25889146/feasibility-and-accuracy-of-bedside-transthoracic-echocardiography-in-diagnosis-of-acute-proximal-aortic-dissection
#17
COMPARATIVE STUDY
Dorota Sobczyk, Krzysztof Nycz
STUDY OBJECTIVE: The purpose of the present study was to establish the accuracy of transthoracic echocardiography (TTE) in diagnosis of acute type A aortic dissection in comparison to computed tomography (CT), with reference to the intraoperative image. METHODS: The retrospective analysis included 178 patients referred to the cardiac surgery unit in our center due to acute type A dissection between 01-01-2008 and 31-12-2013, who underwent both TTE and CT. Intraoperative image was considered as a reference...
March 25, 2015: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/26575653/bedside-ultrasound-reduces-diagnostic-uncertainty-and-guides-resuscitation-in-patients-with-undifferentiated-hypotension
#18
Hamid Shokoohi, Keith S Boniface, Ali Pourmand, Yiju T Liu, Danielle L Davison, Katrina D Hawkins, Rasha E Buhumaid, Mohammad Salimian, Kabir Yadav
OBJECTIVES: Utilization of ultrasound in the evaluation of patients with undifferentiated hypotension has been proposed in several protocols. We sought to assess the impact of an ultrasound hypotension protocol on physicians' diagnostic certainty, diagnostic ability, and treatment and resource utilization. DESIGN: Prospective observational study. SETTING: Emergency department in a single, academic tertiary care hospital. SUBJECTS: A convenience sample of patients with a systolic blood pressure less than 90 mm Hg after an initial fluid resuscitation, who lacked an obvious source of hypotension...
December 2015: Critical Care Medicine
https://www.readbyqxmd.com/read/25572643/diagnostic-performance-of-cardiopulmonary-ultrasound-performed-by-the-emergency-physician-in-the-management-of-acute-dyspnea
#19
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
https://www.readbyqxmd.com/read/28453186/emergency-physicians-are-able-to-detect-right-ventricular-dilation-with-good-agreement-compared-to-cardiology
#20
MULTICENTER STUDY
Matt A Rutz, Julie M Clary, Jeffrey A Kline, Frances M Russell
OBJECTIVE: Focused cardiac ultrasound (FOCUS) is a useful tool in evaluating patients presenting to the emergency department (ED) with acute dyspnea. Prior work has shown that right ventricular (RV) dilation is associated with repeat hospitalizations and shorter life expectancy. Traditionally, RV assessment has been evaluated by cardiologist-interpreted comprehensive echocardiography. The primary goal of this study was to determine the inter-rater reliability between emergency physicians (EPs) and a cardiologist for determining RV dilation on FOCUS performed on ED patients with acute dyspnea...
July 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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