Tag: echocardiography

Upvote Story 5
Shock has potentially reversible causes of morbidity and mortality if appropriately diagnosed and managed. Older methods of invasive monitoring have significant limitations but are still critical for managing shock in certain patients and settings. Newer methods are easier to employ, but further validation is needed. Multiple modalities along with careful clinical assessment are often useful in distinguishing shock subtypes. Best practice standards for monitoring should... Read More | Comment
Upvote Story 5
Critical care transesophageal echocardiography is feasible, safe, and has clinical utility. It can be safely and effectively performed by fellows within the context of their critical care training with faculty supervision. Pulmonary critical care fellowship training programs should consider introducing critical care transesophageal echocardiography as a useful clinical tool. The examination was feasible in all patients in whom it was attempted, and there were no... Read More | Comment
Upvote Story 6
With the integration of bedside echocardiography into cardiac arrest, we now have a real-time tool to help us glean some of this critical missing information, as well as offer procedural guidance and prognostic data. However, it can be tough to quickly and accurately utilize POCUS in the stress-filled environment surrounding cardiac arrest. For instance, it can take time to acquire images and interpret them, which... Read More | Comment
Upvote Story 7
Among patients with severe secondary mitral regurgitation, the rate of death or unplanned hospitalization for heart failure at 1 year did not differ significantly between patients who underwent percutaneous mitral-valve repair in addition to receiving medical therapy and those who received medical therapy alone. At 12 months, the rate of the primary outcome was 54.6% (83 of 152 patients) in the intervention group and 51.3%... Read More | Comment
Upvote Story 7
Pericardial tamponade occurs when fluid within the pericardial sac impairs filling of the right-sided chambers, leading to a decrease in cardiac output and hemodynamic compromise. It is neither a clinical nor an echocardiographic diagnosis alone. Bedside echocardiography can help diagnose pericardial tamponade when there is already a degree of clinical suspicion. The core findings include: a pericardial effusion, diastolic RV collapse (high specificity), systolic RA... Read More | Comment
Upvote Story 9
Worse global longitudinal strain (GLS) (less negative) values are associated with higher mortality in patients with severe sepsis or septic shock, while such association is not valid for left ventricular ejection fraction (LVEF). More critical care research is warranted to confirm the better ability of STE in demonstrating underlying intrinsic myocardial disease compared to LVEF. We included eight studies in the primary analysis with a... Read More | Comment
Upvote Story 16
TAPSE seemed to be the most popular index in the last 2–3 years. Many studies used combinations of indices but, apart from cor pulmonale, we could not find a consistent pattern of RV assessment and definition of RV dysfunction amongst these studies. Out of 495 non-duplicated publications found, 81 studies were included in our systematic review. There has been an increasing trend of studying RV... Read More | Comment
Upvote Story 7
Right Ventricular (RV) function evaluation is key in the critically-ill patients for hemodynamic management, as fluid optimization, vasopressor strategy and respiratory support. RV failure may be diagnosed by the association of different devices and parameters, while echocardiography is crucial. The authors propose the ten key points and directions for future research in the field. RV failure (RVF) is frequent in the ICU, magnified by the... Read More | Comment
Upvote Story 6
As a result of conflicting data, echocardiographic measures of left ventricular (systolic or diastolic) or right ventricular function cannot currently provide reliable prognostic information in patients with sepsis. Natriuretic peptides and cardiac troponins are of similarly unclear utility. Heterogeneous classification of illness, treatment variability, and lack of formal diagnostic criteria for septic cardiomyopathy contribute to the conflicting results. Development of formal diagnostic criteria, and use... Read More | Comment
Upvote Story 6
In this episode, we discuss the practice of respect in the ICU. Our guest is Samuel M. Brown, MD, MS, a practicing intensivist and Director of the Center for Humanizing Critical Care at Intermountain Medical Center in Murray, Utah. Dr. Brown holds an academic appointment as Associate Professor of Medicine at the University Of Utah School Of Medicine, Murray UT. He is a prolific investigator... Read More | Comment
Upvote Story 5
Predicting which pulmonary embolism patients will do well with oral anticoagulation and which will decompensate is a bit murky, at best. The treatment of pulmonary embolism (PE) has evolved quite a bit in just the past few years. Direct oral anticoagulants mean there is no longer a need to bridge patients to warfarin, and a push to treat more patients as outpatients followed. Peripheral, subsegmental... Read More | Comment
Upvote Story 4
Our study suggests that PEP sonographers are capable of obtaining images that permit accurate assessment of LVF and IVC volume. BLEEP can be performed with focused training and oversight by a pediatric cardiologist. We conducted a prospective observational study of a convenience sample of patients who were admitted to our intensive care unit. All patients underwent BLEEP followed by an independent formal echocardiogram by an... Read More | Comment
Upvote Story 22
Though the details are still being finalized, the critical care NBE pathway will bear many similarities to the current certification process for cardiologists and cardiac anesthesiologists. In particular, the critical care track will involve a standardized examination of both knowledge (through an advanced assessment test) and practical training; applicants will need to show proof of completion of an echocardiographic portfolio, supervised locally. The goal of... Read More | Comment
Upvote Story 11
Borderline PH is common in patients undergoing RHC and is associated with significant comorbidities, progression to overt PH, and decreased survival. Small increases in mPAP, even at values currently considered normal, are independently associated with increased mortality. Prospective studies are warranted to determine whether early intervention or closer monitoring improves clinical outcomes in these patients. We identified 4343 patients (mean [SD] age, 59 [15] years,... Read More | Comment