Intensive Care Unit-Acquired Weakness (ICUAW): Usefulness of Bedside Ultrasound

2021 ◽  
pp. 949-973
Author(s):  
Paolo Formenti ◽  
Michele Umbrello ◽  
Davide Chiumello
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bedside Ultrasound

scholarly journals Sonographic Assessment of Intravascular Fluid Estimate (SAFE) Score by Using Bedside Ultrasound in the Intensive Care Unit

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Keith Killu ◽  
Victor Coba ◽  
Dionne Blyden ◽  
Semeret Munie ◽  
Darlene Dereczyk ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Scoring System ◽  
Venous Pressure ◽  
Tertiary Care ◽  
Bedside Ultrasound ◽  
Volume Status ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Volume Score

Objective. The objective of the study was to use an ultrasound-based numerical scoring system for assessment of intravascular fluid estimate (SAFE) and test its validity. Methods. A prospective, observational study was carried out in the surgical intensive care unit (ICU) of an urban tertiary care teaching hospital. Patient’s intravascular volume status was assessed using the standard methods of heart rate, blood pressure, central venous pressure, cardiac output, lactate and saturation of venous oxygen, and others. This was compared with assessment using bedside ultrasound evaluation of the cardiac function, inferior vena cava, lungs, and the internal jugular vein. Applying a numerical scoring system was evaluated by Fisher’s exact testing and multinomial logistic model to predict the volume status based on ultrasound scores and the classification accuracy. Results. 61 patients in the ICU were evaluated. 21 (34.4% of total) patients diagnosed with hypovolemia, and their ultrasound volume score was −4 in 14 (66.7%) patients, −3 in 5 (23.8%) patients, and 0 in 2 (9.5%) patients (p<0.001). 18 (29.5% of total) patients diagnosed with euvolemia, and their ultrasound volume score was 0 in 11 (61.1%) patients, +1 in 4 (22.2%) patients, and −1 in 1 (5.6%) patient (p<0.001). 22 (36.1% of total) patients diagnosed with hypervolemia, and their ultrasound volume score was +4 in 4 (18.2%) patients, +3 in 15 (68.2%) patients, and  + 1 in 1 (4.6%) patient (p<0.001). We found a strong association between standard measures and the ultrasound score (p<0.001). Conclusion. Using the SAFE scoring system to identify the IVV status in critically ill patients significantly correlates with the standard measures. A SAFE score of −4 to −2 more likely represents hypovolemia, −1 to +1 more likely represents euvolemia, and +2 to +4 more likely to be hypervolemia.

scholarly journals Bedside Ultrasound in Intensive Care Unit (ICU): Impact of Size, Image Quality and Boot Time

2017 ◽  
Vol 43 ◽  
pp. S110
Author(s):  
Thomas Amelang ◽  
Natalie Herth ◽  
Henry Schäfer ◽  
David Heftrig
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Image Quality ◽  
Bedside Ultrasound

scholarly journals Efficacy of an 8-week Bedside Ultrasound Training Program for Surgical Residents in the Intensive Care Unit

2021 ◽  
Author(s):  
Kyoung Moo Im ◽  
Eun Young Kim
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Training Program ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Bedside Ultrasound ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Post Graduate ◽  
Surgical Residents

Abstract BackgroundBedside ultrasound has become one of the most important non-invasive and readily available diagnostic tools especially for critically ill patients. However, the current ultrasound training program is not standardized and is mostly unavailable to all surgical residents equally. The aim of this study was to assess and evaluate the effectiveness of our new training program in bedside ultrasound for surgical residents.MethodsPostgraduate residents (years 1 to 4) from the department of general surgery in a tertiary hospital attended the newly designed, 8-week training course in bedside ultrasound for critically ill patients at the surgical intensive care unit. Didactic and experimental lectures in basic ultrasound physics and machine usage were delivered, followed by daily hands-on ultrasound training to patients. Each participant prospectively documented their ultrasound findings and completed self-assessment of ultrasound skills using a Likert scale.Results44 residents were enrolled in the current study and only 36.4% of them were previously exposed to bedside ultrasound experience. Following the course completion, the proficiency levels and the objective structured assessment of ultrasound skill (OSAUS) scores showed significant improvement in all elements (P < 0.001). The mean differences in pre- and post-course score between post-graduate years were recorded, except for proficiency in peritoneal cavity (P = 0.163). Post-hoc analysis revealed that post-graduate year 2 residents showed a higher improvement in most elements. The training program showed improvement in post-course scores, whether or not residents had previous experience.ConclusionsOur results revealed that the knowledge and confidence of surgical residents in bedside ultrasound could be improved via short-term and impact training curriculum. The authors believe that such education should be encouraged for all surgical residents to enhance competency in performing bedside ultrasound evaluation of critically ill patients.

scholarly journals Discrepancies in measuring bladder volumes with bedside ultrasound and bladder scanning in the intensive care unit: A pilot study

2017 ◽  
Vol 19 (2) ◽  
pp. 122-126 ◽  
Author(s):  
Donna M Prentice ◽  
Carrie Sona ◽  
Brian T Wessman ◽  
Enyo A Ablordeppey ◽  
Warren Isakow ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Urine Volume ◽  
Mean Difference ◽  
Bladder Volume ◽  
Bedside Ultrasound ◽  
Surgical Trauma ◽  
Dialysis Patients ◽  
Ultrasound Measurements ◽  
Bladder Scanner

Objective Intensive care unit patients are at risk for catheter-associated urinary tract infection. Earlier removal of catheters may be possible with accurate measurement of bladder volume. The purpose was to compare measured bladder volumes with bedside ultrasound, bladder scanner, and urine volume. Design Prospective correlational descriptive study. Setting Surgical/trauma intensive care unit and medical intensive care unit. Patients Renal dialysis patients with less than 100 ml of urine in 24 h prior to urinary catheter removal and patients with suspected catheter obstruction. Measurements and main results A physician trained in ultrasound and an advanced practice registered nurse trained in bladder scanning measured bladder volume; each blinded to the other’s measurement. Device used first (ultrasound or bladder scanner) alternated daily. The intensive care unit team determined need for intermittent catheterization or treatment for suspected obstruction. Fifty-one measurements from 13 patients were obtained with results reported in milliliters. Ultrasound measurements were a mean volume of 72.1 ± 127 (range: 1.7–666) and the bladder scanner measurements were 117 ± 131 (0–529). On six occasions in five dialysis patients, urine volume measurement was available. The mean difference in ultrasound–urine volume mean difference was 0.5 ± 37.8 (range: −68 to 38.2) and the bladder scanner–urine volume was 132 ± 167 (−72 to 397). Two patients with suspected catheter obstructions had ultrasound, bladder scanner, urine volume measurements, respectively: (1) 539, 51, >300 (began voiding before catheter replaced); (2) 666, 68, 1000 with catheter replacement. Conditions leading to greatest differences were obesity, indwelling catheter and ascites. Conclusions These results demonstrate the inaccuracy of the bladder scanner. Ultrasound measurements appear more accurate. To remove urinary catheters in patients with minimal to low urine output, serial ultrasound measurements can be used to monitor bladder volumes and return of renal function.

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