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KEY POINTS

It specifically deals with findings of immediate clinical relevance throughout the body. New emergency applications of ultrasound in the abdomen, the vessels, the head and the heart are considered.

INTRODUCTION TO BEDSIDE ULTRASOUND

The major topic, the lung, is extensively discussed. Interventional ultrasound forms part of nearly every chapter.

General ultrasound in the critically ill / Edition 1

Flow charts simplify daily concerns: acute dyspnea, shock, unexplained fever, etc. The strong points and pitfalls of ultrasound are reviewed. Technical notes are mingled with general considerations. Benefiting from the extensive experience of an intensivist intimately familiar with ultrasound, this book accurately answers most daily problems arising in the critically ill. All in all, General ultrasound in the critically ill provides a key for practicing a kind of visual medicine. Since Daniel Lichtenstein has been an intensivist in a medical ICU which already occupied a pioneering place in echocardiography.

He has from the beginning devoted his efforts to the development of general ultrasound. He regularly publishes studies on lung ultrasound, his main topic, in the international literature. Table of contents Forewords. ISBN: Titolo: General Ultrasound in the Critically ill. Autori: Lichtenstein. Editore: Springer Verlag. Edizione: II Lingua: Inglese. Finitura: Copertina rigida.

Introduction

Pagine: Peso: 0. Per inviare la segnalazione inserisci il tuo nome e l'indirizzo email del destinatario. Per segnalare la pagina devi prima inserire la sequenza di caratteri mostrata in figura. Toggle navigation. For instance, as data revealed in Fig 1 , has included The Fig 1 and Fig 2 have provided the information that Nevertheless, we could adapt those similar researches and discoveries into our study and our utilized experiment design which based on the advanced and detailed CCUS exam.

Moreover, by comparing with other monitoring or imaging equipments, the ultrasound device can visually focus on both heart and lung at the bedside, which highlights the valuable of the CCUS. In this study, only Actually, there are many other methods in the position to evaluate the volume status and responsiveness, such as the respiratory variations of aortic blood flow, respiratory variations of common carotid artery blood flow, passive leg raising test, etc[ 47 ].

However, it was reasonable that they did not choose the parameters, since some of these variables were not well proved to be reliable by large sample trials,. In this setting, we have the amount of works to do when discussing the volume assessment by ultrasound. Fluid overload was significantly associated with higher mortality and morbidity among ICU patients, while discharge the excess fluid promptlymay contribute a better outcome [ 49 , 50 ]. In this study, we found a high rate of fluid overload by IVC exam Furthermore, our study showed that the CCUS on admission contribute to predicting the patient outcome.

Nevertheless, other parameters may contribute to a worse outcome, such as high LUS score, severe LV dysfunction, etc. This study also has couple limitations. First, being designed as a retrospective study, although we have two attendings to double check the data and identify the variables strictly according the standard and guidelines, the results still might be affected by the sampling error, and the prognosis analysis was not as credible as a prospective cohort study.

Moreover, the objects of this study were extracted from the leading largest teaching hospital in Western China. The third, the high-quality bedside ultrasound needs well-trained physicians and guided by the well-defined protocol. Despite those limitations, this study has provided a significant sample of relevant information about the cardiorespiratory epidemic characteristic assessed by admission ultrasound exam, which showed a full sight of the ICU patients on admission and may be valuable for the clinical diagnosis and therapy plan decision making and subsequent design of clinical trials related to CCUS.

A well designed prospective cohort study might be conducted to address those limitations we mentioned above. Hence, it merits more attention in clinical decision making. Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field. Methods We have described and analyzed the epidemic characteristics of hemodynamics and lung pathology assessed by CCUS on ICU admission, which based on our database of cases from the biggest medical center in Western China, between November and October Results The mean age of the patients was Conclusion CCUS examination on ICU admission which performed by the experienced physician provide valuable information to assist the caregivers in understanding the comprehensive outlook of the characteristics of hemodynamics and lung pathology.

Funding: The authors received no specific funding for this work. Introduction Focused Critical care ultrasound examinations CCUS in the critical care setting have been adopted widely and becoming an extension of the clinical critical care hemodynamic monitoring, lung pathology diagnosis and other organ function assessment because of their rapid, precise detection capabilities [ 1 — 9 ]. Results Demographic and clinical characteristic The study included cases that admitted to ICU with in one year period.

Download: PPT. Table 1. Demographic and clinical characteristics on admission and the outcome of the studied subjects.

General ultrasound in the critically ill / Edition 1

Fig 1. Completion proportion and findings of ultrasound examination on admission. Fig 2. Abnormal findings in lung ultrasound examination on admission. Fig 3. Volume status estimated by IVC examination on admission. Table 4.

Univariate correlation analysis: Correlation coefficients r and p values. Table 5. Multivariate analysis between the cardiorespiratory ultrasonic variables and clinical indexes and ICU mortality. Supporting information. S1 Table. Project database. References 1. Beaulieu Y. Bedside echocardiography in the assessment of the critically ill. Crit Care Med. CHEST,, — J Am Soc Echocardiogr,, International evidence-based recommendations for point-of-care lung ultrasound.

Intensive Care Med,,— Hemodynamic monitoring by echocardiography in the ICU:the role of the new echo techniques. Current Opinion in Critical Care,, — Measurement of kidney perfusion in critically ill Patients. Crit Care, ,17 2 Renal perfusion assessment by renal Doppler during fluid challenge in sepsis. Schmidt GA.

ICU ultrasound. The coming boom. Deep impact of ultrasound in the intensive care unit: the "ICU-sound" protocol. Routine transthoracic echocardiography in a general Intensive Care Unit: an 18 month survey in patients. European Journal of Internal Medicine ; e37— Impact of echocardiography on patient management in the intensive care unit: an audit of district general hospital practice. British Journal of Anaesthesia ; —4. Unsuspected clinically important findings detected with a small portable ultrasound device in patients admitted to a general medicine service.

J Am Soc Echocardiogr ; —5. Focused echocardiography: a systematic review of diagnostic and clinical decision-making in anaesthesia and critical care. Integrated cardiopulmonary sonography: a useful tool for assessment of acute pulmonary edema in the intensive care unit.

Background

J Ultrasound Med. Lichtenstein DA. Point-of-care multiorgan ultrasonography for the evaluation of undifferentiated hypotension in the emergency department. Intensive Care Med. View Article Google Scholar Mok KL. J Intensive Care. Clinically integrated multi-organ point-of-care ultrasound for undifferentiated respiratory difficulty, chest pain, or shock: a critical analytic review.

Ultrasound assessment of lung aeration loss during a successful weaning trial predicts postextubation distress. Early fluid loading in acute respiratory distress syndrome with septic shock deteriorates lung aeration without impairing arterial oxygenation: a lung ultrasound observational study. Crit Care. Eur Heart J Cardiovasc Imaging.

Bedside Ultrasound Basic Cardiac US

Role of echocardiography in the treatment of cardiac tamponade. Krishnan S, Schmidt GA.

Lichtenstein General Ultrasound in the Critically ill Springer Verlag

Acute right ventricular dysfunction: real-time management with echocardiography. Chest, , 3 — Assessment of left ventricular function by intensivists using hand-held echocardiography. Recommendations for chamber quantification. Eur J Echocardiogr. Echocardiographic assessment of left ventricular systolic function: from ejection fraction to torsion. Heart Fail Rev.


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Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr,,— Vignon P. Ventricular diastolic abnormalities in the critically ill.