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JOURNAL ARTICLE
Matteo Giorgi-Pierfranceschi, Chiara Cattabiani, Nicola Mumoli, Francesco Dentali
It is well known that a number of patients affected by hemodynamic stable pulmonary embolism are admitted to the emergency department presenting chest pain without further symptoms of pulmonary embolism, such as dyspnea, cough, hemoptysis, syncope, and tachycardia, but in a few cases, the presenting symptoms are even more unusual. The gold standard for pulmonary embolism diagnosis is computed tomography pulmonary angiogram resulting in significant exposure to ionizing radiation and contrast, but recently bedside ultrasound has shown to be useful in diagnosing pulmonary embolism in the emergency department...
January 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
#2
REVIEW
Michele Umbrello, Paolo Formenti
The majority of patients admitted to the ICU require mechanical ventilation as a part of their process of care. However, mechanical ventilation itself or the underlying disease can lead to dysfunction of the diaphragm, a condition that may contribute to the failure of weaning from mechanical ventilation. However, extended time on the ventilator increases health-care costs and greatly increases patient morbidity and mortality. Nevertheless, symptoms and signs of muscle disease in a bedridden (or bed rest-only) ICU patient are often difficult to assess because of concomitant confounding factors...
April 2016: Respiratory Care
#3
REVIEW
Ron Berant, Charisse Kwan, Jason Fischer
Point-of-care ultrasound is being used more frequently in pediatric emergency medicine departments. It has become an important adjunct for clinical diagnoses and procedural guidance. We present a case series of 3 patients who presented to a pediatric emergency department and on chest radiographs had whiteout lung. Point-of-care ultrasound was able to differentiate fluid from consolidation, facilitating the appropriate investigations and interventions for these children.
December 2015: Pediatric Emergency Care
#4
JOURNAL ARTICLE
Giulio Iorio, Maria Capasso, Giuseppe De Luca, Salvatore Prisco, Carlo Mancusi, Bruno Laganà, Vincenzo Comune
Background. Despite guideline recommendations, chest radiography (CR) for the diagnosis of community-acquired pneumonia (CAP) in children is commonly used also in mild and/or uncomplicated cases. The aim of this study is to assess the reliability of lung ultrasonography (LUS) as an alternative test in these cases and suggest a new diagnostic algorithm. Methods. We reviewed the medical records of all patients admitted to the pediatric ward from February 1, 2013 to December 31, 2014 with respiratory signs and symptoms...
2015: PeerJ
#5
REVIEW
Zareth Irwin, Justin O Cook
Pulmonary ultrasound continues to develop and is ideally suited for the evaluation and treatment of respiratory emergencies. It is portable, can be performed rapidly, has no ionizing radiation, and is highly sensitive and specific for the diagnosis of pneumothorax, pneumonia, pulmonary edema, and free fluid in the chest.
February 2016: Emergency Medicine Clinics of North America
#6
REVIEW
Aymeric Le Neindre, Silvia Mongodi, François Philippart, Bélaïd Bouhemad
The use of diagnostic ultrasound by physiotherapists is not a new concept; it is frequently performed in musculoskeletal physiotherapy. Physiotherapists currently lack accurate, reliable, sensitive, and valid measurements for the assessment of the indications and effectiveness of chest physiotherapy. Thoracic ultrasound may be a promising tool for the physiotherapist and could be routinely performed at patients' bedsides to provide real-time and accurate information on the status of pleura, lungs, and diaphragm; this would allow for assessment of lung aeration from interstitial syndrome to lung consolidation with much better accuracy than chest x-rays or auscultation...
February 2016: Journal of Critical Care
#7
JOURNAL ARTICLE
Tanja Kaneko, Wolfgang Heinz
Despite the limitations (especially that ultrasound does not penetrate air containing lung tissue) ultrasound of the thorax is a very suitable method as a complementary or even primary diagnostic tool. Bedside availability and no radiation exposure are real advantages. However we always have to keep in mind that we are blind for deeper lung processes that do not have contact to the visceral pleura.This article illustrates where and how to look for pathologies and what we have to expect in patients. According to symptoms such as dyspnea, dyspnea with fever and thorax pain with and without trauma, the sonographic morphology of important illnesses in emergency situation are described...
November 2015: Deutsche Medizinische Wochenschrift
#8
JOURNAL ARTICLE
Angelo Polito, Daniele G Biasucci, Paola Cogo
We report the case of a 12-day-old newborn affected by coarctation of the aorta and intraventricular defect who underwent coarctectomy and pulmonary artery banding. On post-operative day 7, the patient suffered from pulseless electric activity due to tension pneumothorax. Point-of-care ultrasound was performed during cardiopulmonary resuscitation in an attempt to diagnose pneumothorax. The diagnosis was made without delaying or interrupting chest compressions, and the pneumothorax was promptly treated.
February 2016: Cardiology in the Young
#9
REVIEW
Christopher W C Lee, Pierre D Kory, Robert T Arntfield
Appropriate fluid resuscitation has been a major focus of critical care medicine since its inception. Currently, the most accurate method to guide fluid administration decisions uses "dynamic" measures that estimate the change in cardiac output that would occur in response to a fluid bolus. Unfortunately, their use remains limited due to required technical expertise, costly equipment, or applicability in only a subset of patients. Alternatively, point-of-care ultrasound (POCUS) has become widely used as a tool to help clinicians prescribe fluid therapy...
February 2016: Journal of Critical Care
#10
JOURNAL ARTICLE
Christos Skouras, Zoe A Davis, Joanne Sharkey, Rowan W Parks, James O Garden, John T Murchison, Damian J Mole
BACKGROUND: The value of lung ultrasonography in the diagnosis of respiratory dysfunction and severity stratification in patients with acute pancreatitis (AP) was investigated. METHODS: Over a 3-month period, 41 patients (median age: 59.1 years; 21 males) presenting with a diagnosis of potential AP were prospectively recruited. Each participant underwent lung ultrasonography, and the number of comet tails present on scans was linked with contemporaneous clinical data...
October 16, 2015: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
#11
REVIEW
Lin Chen, Zhongheng Zhang
Ultrasonography (US) has found its way into the critical care and emergency settings for the evaluation of acute respiratory failure conditions in recent years. It is useful for the diagnosis of varieties of abnormalities involving pleura and lung such as pleural effusion, alveolar interstitial syndrome, and pneumothorax (PTX). In addition to its reproducibility and timeliness, US has high sensitivity and specificity for the diagnosis of these conditions. The most widely used method for bedside evaluation of PTX is chest X-ray (CXR)...
August 2015: Quantitative Imaging in Medicine and Surgery
#12
COMPARATIVE STUDY
Cameron M Bass, Dana R Sajed, Adeyinka A Adedipe, T Eoin West
INTRODUCTION: In low-resource settings it is not always possible to acquire the information required to diagnose acute respiratory distress syndrome (ARDS). Ultrasound and pulse oximetry, however, may be available in these settings. This study was designed to test whether pulmonary ultrasound and pulse oximetry could be used in place of traditional radiographic and oxygenation evaluation for ARDS. METHODS: This study was a prospective, single-center study in the ICU of Harborview Medical Center, a referral hospital in Seattle, Washington, USA...
July 21, 2015: Critical Care: the Official Journal of the Critical Care Forum
#13
JOURNAL ARTICLE
Turandot Saul, Sebastian D Siadecki, Rachel Berkowitz, Gabriel Rose, Danielle Matilsky, Allison Sauler
BACKGROUND: M-mode or "motion" mode is a form of ultrasound imaging that is of high clinical utility in the emergency department. It can be used in a variety of situations to evaluate motion and timing, and can document tissue movement in a still image when the recording of a video clip is not feasible. OBJECTIVES: In this article we describe several straightforward and easily performed applications for the emergency physician to incorporate M-mode into his or her practice, including the evaluation for: 1) pneumothorax, 2) left ventricular systolic function, 3) cardiac tamponade, and 4) hypertrophic cardiomyopathy...
November 2015: Journal of Emergency Medicine
#14
JOURNAL ARTICLE
Joan Sanchez-de-Toledo, Luis Renter-Valdovinos, Marielle Esteves, Carla Fonseca, Ivan Villaverde, Marta Rosal
OBJECTIVE: The objective of this study was to evaluate the efficacy of a short hands-on chest ultrasound course to detect normal lung pattern, pneumothorax (PTX), and pleural effusion (PE) in a porcine animal model. METHODS: Thirty-six trainees with no previous experience in chest ultrasound participated in the study. A 1.5-hour training course covering both theory and practice was developed. All static and dynamic signs of the normal lung parenchyma, PTX, and PE were analyzed...
November 2016: Pediatric Emergency Care
#15
LETTER
Zhongheng Zhang, Lin Chen
No abstract text is available yet for this article.
March 30, 2015: Critical Care: the Official Journal of the Critical Care Forum
#16
REVIEW
Sybil Zachariah, Laleh Gharahbaghian, Phillips Perera, Nikita Joshi
Spontaneous pneumomediastinum is a rare disease process with no clear etiology, although it is thought to be related to changes in intrathoracic pressure causing chest pain and dyspnea. We present a case of a 17-year-old male with acute chest pain evaluated initially by bedside ultrasound, which showed normal lung sliding but poor visualization of the parasternal and apical cardiac views due to significant air artifact, representing air in the thoracic cavity. The diagnosis was later verified by chest radiograph...
March 2015: Western Journal of Emergency Medicine
#17
COMPARATIVE STUDY
Peiman Nazerian, Giovanni Volpicelli, Simone Vanni, Chiara Gigli, Laura Betti, Maurizio Bartolucci, Maurizio Zanobetti, Francesca Romana Ermini, Cristina Iannello, Stefano Grifoni
OBJECTIVES: Despite emerging evidences on the clinical usefulness of lung ultrasound (LUS), international guidelines still do not recommend the use of sonography for the diagnosis of pneumonia. Our study assesses the accuracy of LUS for the diagnosis of lung consolidations when compared to chest computed tomography (CT). METHODS: This was a prospective study on an emergency department population complaining of respiratory symptoms of unexplained origin. All patients who had a chest CT scan performed for clinical reasons were consecutively recruited...
May 2015: American Journal of Emergency Medicine
#18
JOURNAL ARTICLE
Felippe Leopoldo Dexheimer Neto, Juliana Mara Stormovski de Andrade, Ana Carolina Tabajara Raupp, Raquel da Silva Townsend, Fabiana Gabe Beltrami, Hélène Brisson, Qin Lu, Paulo de Tarso Roth Dalcin
OBJECTIVE: Bedside lung ultrasound (LUS) is a noninvasive, readily available imaging modality that can complement clinical evaluation. The Bedside Lung Ultrasound in Emergency (BLUE) protocol has demonstrated a high diagnostic accuracy in patients with acute respiratory failure (ARF). Recently, bedside LUS has been added to the medical training program of our ICU. The aim of this study was to investigate the accuracy of LUS based on the BLUE protocol, when performed by physicians who are not ultrasound experts, to guide the diagnosis of ARF...
2015: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
#19
MULTICENTER STUDY
Emanuele Pivetta, Alberto Goffi, Enrico Lupia, Maria Tizzani, Giulio Porrino, Enrico Ferreri, Giovanni Volpicelli, Paolo Balzaretti, Alessandra Banderali, Antonello Iacobucci, Stefania Locatelli, Giovanna Casoli, Michael B Stone, Milena M Maule, Ileana Baldi, Franco Merletti, Gian Alfonso Cibinel, Paolo Baron, Stefania Battista, Giuseppina Buonafede, Valeria Busso, Andrea Conterno, Paola Del Rizzo, Patrizia Ferrera, Paolo Fascio Pecetto, Corrado Moiraghi, Fulvio Morello, Fabio Steri, Giovannino Ciccone, Cosimo Calasso, Mimma A Caserta, Marina Civita, Carmen Condo', Vittorio D'Alessandro, Sara Del Colle, Stefania Ferrero, Giulietta Griot, Emanuela Laurita, Alberto Lazzero, Francesca Lo Curto, Marianna Michelazzo, Vincenza Nicosia, Nicola Palmari, Alberto Ricchiardi, Andrea Rolfo, Roberto Rostagno, Fabrizio Bar, Enrico Boero, Mauro Frascisco, Ilaria Micossi, Alessandro Mussa, Valerio Stefanone, Renzo Agricola, Gabriele Cordero, Federica Corradi, Cristina Runzo, Aldo Soragna, Daniela Sciullo, Domenico Vercillo, Attilio Allione, Nicoletta Artana, Fabrizio Corsini, Luca Dutto, Giuseppe Lauria, Teresa Morgillo, Bruno Tartaglino, Daniela Bergandi, Ilaria Cassetta, Clotilde Masera, Mario Garrone, Gianluca Ghiselli, Livia Ausiello, Letizia Barutta, Emanuele Bernardi, Alessia Bono, Daniela Forno, Alessandro Lamorte, Davide Lison, Bartolomeo Lorenzati, Elena Maggio, Ilaria Masi, Matteo Maggiorotto, Giulia Novelli, Francesco Panero, Massimo Perotto, Marco Ravazzoli, Elisa Saglio, Flavia Soardo, Alessandra Tizzani, Pietro Tizzani, Mattia Tullio, Marco Ulla, Elisa Romagnoli
BACKGROUND: Lung ultrasonography (LUS) has emerged as a noninvasive tool for the differential diagnosis of pulmonary diseases. However, its use for the diagnosis of acute decompensated heart failure (ADHF) still raises some concerns. We tested the hypothesis that an integrated approach implementing LUS with clinical assessment would have higher diagnostic accuracy than a standard workup in differentiating ADHF from noncardiogenic dyspnea in the ED. METHODS: We conducted a multicenter, prospective cohort study in seven Italian EDs...
July 2015: Chest
#20
JOURNAL ARTICLE
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
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