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Margarita Oks, Krystal L Cleven, Jose Cardenas-Garcia, Jennifer Ann Schaub, Seth Koenig, Rubin I Cohen, Paul H Mayo, Mangala Narasimhan
BACKGROUND: Point-of-care ultrasonography performed by frontline intensivists offers the possibility of reducing the use of traditional imaging in the medical ICU (MICU). We compared the use of traditional radiographic studies between two MICUs: one where point-of-care ultrasonography is used as a primary imaging modality, the other where it is used only for procedure guidance. METHODS: This study was a retrospective 3-month chart review comparing the use of chest radiographs, CT scans (chest and abdomen/pelvis), transthoracic echocardiography performed by the cardiology service, and DVT ultrasonography studies performed by the radiology service between two MICUs of similar size and acuity and staffing levels...
December 2014: Chest
Concetta Pirozzi, Fabio G Numis, Antonio Pagano, Paolo Melillo, Roberto Copetti, Fernando Schiraldi
BACKGROUND: Dyspnea is one of the most frequent complaints in the Emergency Department. Thoracic ultrasound should help to differentiate cardiogenic from non-cardiogenic causes of dyspnea. We evaluated whether the diagnostic accuracy can be improved by adding a point-of-care-ultrasonography (POC-US) to routine exams and if an early use of this technique produces any advantage. METHODS: One hundred sixty-eight patients were enrolled and randomized in two groups: Group 1 received an immediate POC-US in addition to routine laboratory and instrumental tests; group 2 received an ultrasound scan within 1 h from the admission to the Emergency Department...
2014: Critical Ultrasound Journal
David J Blehar, Scott Glazier, Romolo J Gaspari
PURPOSE: Assessment of volume status remains a challenge in critical care. Our purpose was to determine if Doppler waveform analysis of carotid artery blood flow correlates with changes in volume status. MATERIALS AND METHODS: Dehydrated patients receiving an intravenous fluid bolus were enrolled with exclusions including age less than 18 years, pregnancy, vasopressor administration, or atrial fibrillation. Ultrasound examination with Doppler analysis of the carotid artery was performed with measurements taken to calculate corrected flow time (FTc)...
August 2014: Journal of Critical Care
Cidney S Hulett, Vikas Pathak, Jason N Katz, Sean P Montgomery, Lydia H Chang
BACKGROUND: The focused ultrasound examination has become increasingly recognized as a safe and valuable diagnostic tool for the bedside assessment of the critically ill patient. We implemented a dedicated on-site critical care ultrasonography curriculum with the goal of developing a model for teaching ultrasound skills to pulmonary and critical care medicine fellows. METHODS: The program was comprised of blended didactic and bedside sessions in the following topic domains: fundamentals; vascular access and diagnosis; and abdominal, thoracic, and cardiac ultrasonography...
June 2014: Annals of the American Thoracic Society
Jose Chacko, Gagan Brar
There is increasing interest in the use of ultrasound to assess and guide the management of critically ill patients. The ability to carry out quick examinations by the bedside to answer specific clinical queries as well as repeatability are clear advantages in an acute care setting. In addition, delays associated with transfer of patients out of the Intensive Care Unit (ICU) and exposure to ionizing radiation may also be avoided. Ultrasonographic imaging looks set to evolve and complement clinical examination of acutely ill patients, offering quick answers by the bedside...
May 2014: Indian Journal of Critical Care Medicine
Jose Chacko, Gagan Brar
Point of care ultrasonography, performed by acute care physicians, has developed into an invaluable bedside tool providing important clinical information with a major impact on patient care. In Part II of this narrative review, we describe ultrasound guided central venous cannulation, which has become standard of care with internal jugular vein cannulation. Besides improving success rates, real-time guidance also significantly reduces the incidence of complications. We also discuss compression ultrasonography - a quick and effective bedside screening tool for deep vein thrombosis of the lower extremity...
June 2014: Indian Journal of Critical Care Medicine
Ranjit Deshpande, Shamsuddin Akhtar, Ala Sami Haddadin
PURPOSE OF REVIEW: Use of ultrasound in the acute care setting has become more common in recent years. However, it still remains underutilized in the perioperative management of critical patients. In this review, we aim to increase the awareness of ultrasound as an important diagnostic modality that can be used in the perioperative period to improve patient care. Our main focus will be in describing the diagnostic uses of ultrasound to identify cardiac, pulmonary, airway and vascular diseases commonly encountered in acute care settings...
April 2014: Current Opinion in Anaesthesiology
Daniel J Jakobson, Iftach Shemesh
BACKGROUND: Goal-oriented ultrasound examination is gaining a place in the intensive care unit. Some protocols have been proposed but the applicability of ultrasound as part of a routine has not been studied. OBJECTIVES: To assess the influence of ultrasound performed by intensive care physicians. METHODS: This retrospective descriptive clinical study was performed in a medical-surgical intensive care unit of a university-affiliated general hospital...
November 2013: Israel Medical Association Journal: IMAJ
Raoul Breitkreutz, Marco Campo Delľ Orto, Christian Hamm, Colleen Cuca, Peter M Zechner, Tanja Stenger, Felix Walcher, Florian H Seeger
Objective. To test the influence of personalized ultrasound (PersUS) on patient management in critical care. Design of the Study. Prospective, observational, and critical care setting. Four substudies compared PersUS and mobile ultrasound, work distribution, and diagnostic and procedural quality. Patients and Interventions. 640 patient ultrasound exams including 548 focused diagnostic exams and 92 interventional procedures. Main Outcome Measures. Number of studies, physician's judgement of feasibility, time of usage per patient, and referrals to echo lab...
2013: Emergency Medicine International
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