scholarly journals The role of PoCUS in the assessment of COVID-19 patients

Author(s):  
John Karp ◽  
Karina Burke ◽  
Sarah-Marie Daubaras ◽  
Cian McDermott

AbstractThe Coronavirus disease 19 (COVID-19) pandemic has increased the burden of stress on the global healthcare system in 2020. Point of care ultrasound (PoCUS) is used effectively in the management of pulmonary, cardiac and vascular pathologies. POCUS is the use of traditional ultrasound imaging techniques in a focused binary manner to answer a specific set of clinical questions. This is an imaging technique that delivers no radiation, is inexpensive, ultraportable and provides results instantaneously to the physician operator at the bedside. In regard to the pandemic, PoCUS has played a significant adjunctive role in the diagnosis and management of co-morbidities associated with COVID-19. PoCUS also offers an alternative method to image obstetric patients and the pediatric population safely in accordance with the ALARA principle. Finally, there have been numerous PoCUS protocols describing the effective use of this technology during the COVID-19 pandemic.

Sensors ◽  
2021 ◽  
Vol 21 (8) ◽  
pp. 2629
Author(s):  
Kunkyu Lee ◽  
Min Kim ◽  
Changhyun Lim ◽  
Tai-Kyong Song

Point-of-care ultrasound (POCUS), realized by recent developments in portable ultrasound imaging systems for prompt diagnosis and treatment, has become a major tool in accidents or emergencies. Concomitantly, the number of untrained/unskilled staff not familiar with the operation of the ultrasound system for diagnosis is increasing. By providing an imaging guide to assist clinical decisions and support diagnosis, the risk brought by inexperienced users can be managed. Recently, deep learning has been employed to guide users in ultrasound scanning and diagnosis. However, in a cloud-based ultrasonic artificial intelligence system, the use of POCUS is limited due to information security, network integrity, and significant energy consumption. To address this, we propose (1) a structure that simultaneously provides ultrasound imaging and a mobile device-based ultrasound image guide using deep learning, and (2) a reverse scan conversion (RSC) method for building an ultrasound training dataset to increase the accuracy of the deep learning model. Experimental results show that the proposed structure can achieve ultrasound imaging and deep learning simultaneously at a maximum rate of 42.9 frames per second, and that the RSC method improves the image classification accuracy by more than 3%.


2019 ◽  
Vol 123 (4) ◽  
pp. 706-707
Author(s):  
Lara C. Kovell ◽  
Mays T. Ali ◽  
Allison G. Hays ◽  
Thorr S. Metkus ◽  
Jose A. Madrazo ◽  
...  

Author(s):  
Mustafa J. Musa ◽  
Mohamed Yousef ◽  
Mohammed Adam ◽  
Awadalla Wagealla ◽  
Lubna Boshara ◽  
...  

: Lung ultrasound [LUS] has evolved considerably over the last years. The aim of the current review is to conduct a systematic review reported from a number of studies to show the usefulness of [LUS] and point of care ultrasound for diagnosing COVID-19. A systematic search of electronic data was conducted including the national library of medicine, and the national institute of medicine, PubMed Central [PMC] to identify the articles depended on [LUS] to monitor COVID-19. This review highlights the ultrasound findings reported in articles before the pandemic [11], clinical articles before COVID-19 [14], review studies during the pandemic [27], clinical cases during the pandemic [5] and other varying aims articles. The reviewed studies revealed that ultrasound findings can be used to help in the detection and staging of the disease. The common patterns observed included irregular and thickened A-lines, multiple B-lines ranging from focal to diffuse interstitial consolidation, and pleural effusion. Sub-plural consolidation is found to be associated with the progression of the disease and its complications. Pneumothorax was not recorded for COVID-19 patients. Further improvement in the diagnostic performance of [LUS] for COVID-19 patients can be achieved by using elastography, contrast-enhanced ultrasound, and power Doppler imaging.


Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Ada Wong ◽  
Hassan Patail ◽  
Sahar Ahmad

Introduction: Survival after in hospital (IH) cardiac arrest (CA) is at 17% suggesting that CA represents an arena of medical practice which deserves more attention. Ultrasound (US) may have a role in both intra-arrest management and peri-arrest prognosis. Very little is known about the role of ultrasound for IH CA. Hypothesis: Intra- arrest POCUS can provide prognostic value. Methods: This was a single center, prospective observational study and we included all IH CA which occurred when a provider was available to perform a standardized POCUS protocol. US and echocardiography imaging was collected during the intra- arrest period and compared with outcome measures of return of spontaneous circulation (ROSC) and survival to 24 hours post-ROSC. Results: Echocardiographic features which may reflect survivorship include cardiac standstill, right ventricle (RV) blood flow stasis, and the appearance of thrombus formation at or around the tricuspid valve. 10 of 16 (62.50%) patients with cardiac standstill alone and 1 of 3 (33.33%) RV stasis alone did not achieve ROSC. Of those that did achieve ROSC in these two groups, none of the patients survived beyond 24 hours of the CA. 11 of 19 (57.89%) patients with RV stasis in combination with cardiac standstill did not achieve ROSC, and of the remaining 8 patients that achieved ROSC, only 1 patient survived past 24 hours. The combination of cardiac standstill, RV stasis, and tricuspid valve thrombus had 2 of 3 (66.67%) patients fail to achieve ROSC, with the remaining 1 patient surviving only to 24 hours. The presence of cardiac standstill alone confers an association with death, with an odds ratio (OR) of 1.212. RV stasis plus cardiac standstill on intra-arrest POCUS confer a markedly higher OR 0.8250 in association with death. Conclusions: Our preliminary work brings to light the role of POCUS for predicting short term survivorship based on echocardiographic patient features. This may have implications for resource utilization in such events.


Author(s):  
Nuno Cardim ◽  
Alexandra Toste ◽  
Robin Nijveldt

Imaging plays a major role in the evaluation of hypertrophic cardiomyopathy (HCM) patients, offering answers to clinical questions. Imaging techniques provide a broad spectrum of information, including morphological data, functional information, and ischaemia assessment, useful in many clinical settings of HCM. The clinical diagnosis of HCM is based on unexplained left ventricular hypertrophy (LVH) by imaging, though the role of genetic diagnosis has increased. A multimodality imaging (MMI) approach is encouraged in HCM. Each technique must be selected to provide solutions to the specific problems, avoiding duplicated data, and taking into account its technical characteristics, availability, benefits, risks, and costs.


Ultrasound ◽  
2020 ◽  
Vol 28 (3) ◽  
pp. 196-201
Author(s):  
Natasha M Amorosi ◽  
Alison White

Ventricular septal rupture is a rare and potentially fatal complication of transmural myocardial infarction. Early identification utilising transthoracic echocardiography significantly improves long term outcomes in these patients. We report on a case of a 77-year-old male who presented with signs and symptoms of cardiac failure and a loud systolic murmur. The patient underwent an initial point-of-care ultrasound which revealed evidence of a transmural myocardial infarction and a high suspicion of an apical ventricular septal rupture. A complete transthoracic echocardiogram confirmed the septal rupture diagnosis and the patient subsequently underwent surgical repair of the ventricular rupture. This case highlights the role of echocardiography in decreasing adverse outcomes in patients with ventricular septal rupture.


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