Tag: ultrasound

Upvote Story 5
This case report shows that junctional rhythm can cause deterioration of SAM, LVOTO, and MR, and can lead to unstable hemodynamics in a patient with right ventricular failure after MVR. Atrial pacing can resolve SAM, LVOTO, and MR and can improve hemodynamics in a patient with unstable normal sinus rhythm. TEE in the ICU can play a pivotal role in clinical decision-making. Given that there... Read More | Comment
Upvote Story 4
In this article, we review physiologic principles of global oxygen delivery, and discuss the bedside approach to assessing the adequacy of oxygen delivery in critically ill patients. Although there have been technological advances in the assessment of oxygen delivery, we revisit and emphasize the importance of a ‘tried and true’ method – the physical examination. Also potentially important in the evaluation of oxygen delivery is... Read More | Comment
Upvote Story 7
Although real-time ultrasound guidance during central venous catheter insertion has become a standard of care, postinsertion chest radiograph remains the gold standard to confirm central venous catheter tip position and rule out associated lung complications like pneumothorax. Transthoracic echocardiography and lung ultrasound are noninferior to chest x-ray for screening of pneumothorax and accurate central venous catheter positioning. Thus, the point of care use of ultrasound... Read More | Comment
Upvote Story 5
For the identification of acute respiratory distress syndrome (ARDS) using the Berlin definition, both chest radiography and lung ultrasound were equally related to mortality. The Berlin definition using lung ultrasound helped identify patients at higher risk of death, even if these patients did not fulfill the conventional Berlin definition using chest radiography. However, the moderate overlap of patients when chest imaging modalities differed suggests that... 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 4
Seventy-six physicians responded to the study cases (228 clinical cases resolved). Among the respondents, 28 (37%) were female, 64 (84%) were EPs, and the mean age was 37±8 years. The mean NUDs, respectively, when physicians had OCD, OLD, and both were 2.9±1.8, 2.2±1.7, 2.2±1.8 (p = 0.02). Ultrasound data and ultrasound frequency of use were the only variables related to the NUD. Higher frequency of ultrasound use by... Read More | Comment
Upvote Story 6
The implementation of ultrasound protocols during catheter placement has demonstrated multiple advantages that increase accuracy and allow medical teams to reduce operative time, potential complications, and procedure costs. The wide use of lung and cardiac ultrasound in perioperative medicine enables earlier diagnosis of some acute complications, allowing prompt intervention and control of damage. The application of this algorithm optimizes the use of bedside ultrasound as... Read More | Comment
Upvote Story 6
So here is Part 1 of the as promised portable ultrasound reviews. The aim, to un-muddy the water a bit for you all over choice and functionality. There are so many put there at the moment, we wanted to test them on the shop floor…are they the true ITU workhorses you need to keep in your pocket? All reviews are clearly done by myself, unless... Read More | Comment
Upvote Story 9
This meta-analysis demonstrates that chest radiograph has a low sensitivity and reasonable specificity compared with CT for detecting lung pathology in critically ill patients. The studies also investigating lung ultrasound, showed lung ultrasound to be clearly superior to chest radiograph in terms of sensitivity with similar specificity, thereby opting to be the first-line diagnostic tool in these patients. In the meta-analysis, we included 10 full-text... Read More | Comment
Upvote Story 7
Of the studied ultrasound nICP methods, ONSD is the best estimator of Intracranial Pressure (ICP). The novel combination of ONSD ultrasonography and vTCD of the straight sinus is a promising and easily available technique for identifying critically ill patients with intracranial hypertension. This was a prospective, single-cohort observational study of patients admitted to a tertiary neurocritical care unit. Patients with brain injury requiring invasive ICP... Read More | Comment
Upvote Story 6
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. Following some rules in technique and interpretation, and always integrating POCUS findings into the broader clinical context, most POCUS misdiagnosis can be avoided, and thus patients’ safety can be enhanced. Being aware of a list of common pitfalls may help... Read More | Comment
Upvote Story 6
Among these critically ill patients, muscle wasting occurred early and rapidly during the first week of critical illness and was more severe among those with multiorgan failure compared with single organ failure. These findings may provide insights into skeletal muscle wasting in critical illness. Survivors of critical illness experience significant skeletal muscle weakness and physical disability, which can persist for at least 5 years. Muscle... Read More | Comment
Upvote Story 5
The way we communicate and learn has been revolutionized by technology. Almost all of us carry a smartphone these days, so we are never more than a phone call, message or text away from family, friends and colleagues. This blog is the first of three from the authors examining how social media (SoMe) transgresses the usual borders and may, in the future, play an important... Read More | Comment
Upvote Story 4
Methods to monitor lean body mass in the ICU are under constant development, improving upon bedside usability and offering new modalities to measure. This provides clinicians with valuable markers with which to identify patients at high nutritional risk and to evaluate metabolic support during critical illness. Computed tomography scan analysis, musculoskeletal ultrasound, and bioelectrical impedance analysis are emerging as powerful clinical tools to monitor lean... Read More | Comment
Upvote Story 7
I think most people in our field have had some or all of these thoughts. I feel guilty thinking them and certainly have a hard time verbalizing to other team members. Point of Care Ultrasound (POCUS) has swept the medical world over the last few years, particularly in Emergency Medicine and Critical Care. It is even now being incorporated into Internal Medicine residencies and will... Read More | Comment