Exploring the Conditions of Atelectasis in General Anesthesia Patients at Different Time Nodes and Different Chest Areas by Ultrasound Images

2021 ◽  
Vol 11 (2) ◽  
pp. 601-605
Author(s):  
Yu Tang ◽  
Yanchao Yang ◽  
Yannis Oannidis ◽  
Kathe Rin
Keyword(s):  
General Anesthesia ◽  
Lung Ultrasound ◽  
Lung Ventilation ◽  
Normal Lung ◽  
Ultrasound Images ◽  
Pleural Line ◽  
Left Posterior ◽  
Research Objects ◽  
Posterior Area ◽  
Lateral Area

Objective: To find a more convenient and effective method for monitoring the conditions and changes of atelectasis, the Lung Ultrasound (LUS) scores of general anesthesia patients at different time nodes and different chest areas were evaluated under ultrasound images to determine the conditions of atelectasis of the patients. Methods: Patients who underwent general anesthesia were included as research objects. After general anesthesia, LUS was performed on 12 different chest areas of patients respectively on 1 day preoperatively (T1), 30 minutes (min) after extubation of general anesthesia (T2), 24 hours (h) postoperatively (T3), and 48 h postoperatively (T4). The LUS scores were recorded and compared. Results: Among the lung ultrasound images of the classic case, at T1, the patient was in normal lung ventilation; at T2, the pleural line of patient was intermittently irregular, indicating a decrease in lung ventilation; at T3, a small consolidation plaque was seen under the pleural line; at T4, the consolidation continued to develop, and the decrease in lung ventilation was aggravated. The total scores of T2 were significantly higher than those of T1 (P < 0.05), while the total scores of T2, T3, and T4 were not significantly different (P > 0.05). The LUS scores of all chest areas at T2, T3, and T4 were significantly higher than those at T1 (P < 0.05), in which the increase in the LUS scores of lower left lateral area, left Posterolateral Alveolar and/or Pleural Syndrome (PLAPS) area, lower left posterior area, lower right lateral area, right PLAPS area, and lower right posterior area were particularly significant. Conclusion: The lung ultrasound images of general anesthesia patients suggested the onset of atelectasis, which could last up to 24 h postoperatively. The most severe areas of atelectasis included the lower lateral areas, the PLAPS areas, and the lower posterior areas.

scholarly journals Use of lung ultrasound for diagnosis and monitoring of coronavirus disease 2019 pneumonia: A case report

2020 ◽  
Vol 8 ◽  
pp. 2050313X2095891
Author(s):  
Debo Yun ◽  
Yan Cui ◽  
Yuan Geng ◽  
Yujiao Yang
Keyword(s):  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Early Diagnosis ◽  
Lung Ultrasound ◽  
Nasopharyngeal Swab ◽  
Ultrasound Images ◽  
Healthcare Settings ◽  
Pleural Line ◽  
Ultrasound Findings ◽  
Spread Of Infection

Knowledge of lung ultrasound characteristics of coronavirus disease 2019 pneumonia might be useful for early diagnosis and clinical monitoring of patients, and lung ultrasound can help to control the spread of infection in healthcare settings. In this case report, a 36-year-old man with severe acute respiratory syndrome coronavirus 2 infection was diagnosed by reverse transcription-polymerase chain reaction testing of a nasopharyngeal swab. The lung ultrasound findings for this patient were the interstitial-alveolar damage showing bilateral, diffuse pleural line abnormalities, subpleural consolidations, white lung areas and thick, irregular vertical artifacts. When the patient recovered from the severe acute respiratory syndrome coronavirus 2 infection, lung ultrasound images showed a normal pleural line with A-lines regularly reverberating. Performing lung ultrasound at the bedside minimizes the need to move the patient, thus reducing the risk of spreading infection among healthcare staff. Lung ultrasound is useful for early diagnosis and evaluation of the severity of coronavirus disease 2019 pneumonia and for monitoring its progress over the course of the disease.

scholarly journals Analysis of Difference of Double Lung Ultrasound in Patients with Single Lung Ventilation

2021 ◽  
pp. 1-3
Author(s):  
Xin Zheng ◽  
Yang Su ◽  
Haitao Yang ◽  
Xin Zheng
Keyword(s):  
Lung Injury ◽  
Pulmonary Edema ◽  
Lung Ultrasound ◽  
Lung Ventilation ◽  
Ultrasound Images ◽  
Short Term ◽  
One Lung Ventilation ◽  
Single Lung Ventilation ◽  
The Difference ◽  
Bilateral Lung

Objective: To retrospectively analyse the lung ultrasound images of 60 patients undergoing thoracoscopic partial pneumonectomy and compare the difference of bilateral lung ultrasound images. Results: B3 lines were predominant in ventilating side lung, B7 lines and atelectasis were predominant in operative side lung. Conclusion: Short-term lung injury after one-lung ventilation is mainly on the ventilation side, and the main manifestation is pulmonary edema.

scholarly journals Use of lung ultrasound in neonates during the COVID-19 pandemic

2020 ◽  
Vol 53 (6) ◽  
pp. 401-404
Author(s):  
Marcia Wang Matsuoka ◽  
Silvia Maria Sucena da Rocha ◽  
Maria Augusta Bento Cicaroni Gibelli ◽  
Carla Marques Nicolau ◽  
Werther Brunow de Carvalho ◽  
...  
Keyword(s):  
Respiratory Symptoms ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Ultrasound Examination ◽  
Neonatal Period ◽  
Ultrasound Images ◽  
Normal Pattern ◽  
Pleural Thickening ◽  
Pleural Line ◽  
B Lines

Abstract In the current pandemic, caused by infection with severe acute respiratory syndrome coronavirus 2, ultrasound has played a fundamental role in patients who develop the resulting disease, designated coronavirus disease 2019 (COVID-19). In this study we present ultrasound images of the lungs of neonates with a suspected or confirmed diagnosis of COVID-19, distinguishing between the changes related to COVID-19 and those unrelated to the disease. Ultrasound examinations were performed by a pediatric sonographer. A total of 27 neonates were evaluated. Among those who presented no respiratory symptoms, some tested negative for COVID-19 and others tested positive. All of those who were pulmonary symptomatic, negative for COVID-19 presented transient tachypnea of the newborn and respiratory distress syndrome. Lung ultrasound images obtained in COVID-19-negative neonates showed, in some cases, a normal pattern (with A lines, few B lines, a thin, linear pleural line, and no pleural effusion), whereas in others showed coalescent B lines and areas of opacity. In two of the COVID-19-positive neonates, lung ultrasound examination showed several coalescent B lines, pleural thickening, and areas of opacity. Lung ultrasound in the neonatal period appears to be applicable within the context of the current pandemic, allowing efficient evaluation of COVID-19-related changes in neonates, as well as of pathologies inherent to the neonatal period.

scholarly journals Effect of mandibular complete dentures relining on occlusal force distribution using T-scan system

2021 ◽  
Vol 45 (1) ◽  
Author(s):  
Eman M. Ibraheem ◽  
Hisham S. ElGabry
Keyword(s):  
Trial Registration ◽  
Force Distribution ◽  
Complete Dentures ◽  
Clinical Trial Registration ◽  
Occlusal Force ◽  
Left Posterior ◽  
Before And After ◽  
Soft Denture Liner ◽  
Edentulous Patients ◽  
Posterior Area

Abstract Background This study aimed to evaluate the effect of mandibular complete dentures relining using soft relining material on the distribution of various occlusal forces using T-Scan system. Fifty completely edentulous patients having their conventional complete dentures earlier fabricated and utilized were selected for this study. Patients were controlled diabetics, characterized by having their residual alveolar ridges moderately developed and lined with firm mucoperiosteum. Mandibular complete dentures were relined with soft denture liner and T-Scan device was used for occlusal force distribution measurement prior to denture relining and three months thereafter the relinning procedure. Results Comparison between occlusal forces percentages before and after denture relining revealed that occlusal forces percentages was significantly lower after denture relining in anterior area, significantly higher after denture relining in right posterior area, where it was insignificantly higher after relining in left posterior area. Conclusions Our findings revealed that the use of soft denture liner for mandibular complete denture relining significantly improved the occlusal load distribution. Clinical trial registration Trial registration NCT, NCT04701970. Registered 23/11/2020—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04701970

scholarly journals Comparison of the accuracy of intraoral scans between complete-arch scan and quadrant scan

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Youn-Gyeong Moon ◽  
Kyung-Min Lee
Keyword(s):  
Third Molar ◽  
Careful Consideration ◽  
Missing Teeth ◽  
Posterior Teeth ◽  
Anterior Teeth ◽  
Posterior Quadrant ◽  
Left Posterior ◽  
The Right ◽  
Best Fit ◽  
Posterior Area

Abstract Objective To compare the accuracy of complete-arch scans and quadrant scans obtained using a direct chairside intraoral scanner. Material and methods Intraoral scans were obtained from 20 adults without missing teeth except for the third molar. Maxillary and mandibular complete-arch scans were carried out, and 4 quadrant scans for each arch were performed to obtain right posterior, right anterior, left anterior, and left posterior quadrant scans. Complete-arch scans and quadrant scans were compared with corresponding model scans using best-fit surface-based registration. Shell/shell deviations were computed for complete-arch scans and quadrant scans and compared between the complete-arch scans and each quadrant scans. In addition, shell/shell deviations were calculated also for each individual tooth in complete-arch scans to evaluate factors which influence the accuracy of intraoral scans. Results Complete-arch scans showed relatively greater errors (0.09 ~ 0.10 mm) when compared to quadrant scans (0.05 ~ 0.06 mm). The errors were greater in the maxillary scans than in the mandibular scans. The evaluation of errors for each tooth showed that the errors were greater in posterior teeth than in anterior teeth. Comparing the right and left errors, the right side posterior teeth showed a more substantial variance than the left side in the mandibular scans. Conclusion The scanning accuracy has a difference between complete-arch scanning and quadrant scanning, particularly in the posterior teeth. Careful consideration is needed to avoid scanning inaccuracy for maxillary or mandibular complete-arch, particularly in the posterior area because a complete-arch scan might have potential error than a quadrant scan.

scholarly journals Lung ultrasound predicts clinical course but not outcome in COVID-19 ICU patients: a retrospective single-center analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephanie-Susanne Stecher ◽  
Sofia Anton ◽  
Alessia Fraccaroli ◽  
Jeremias Götschke ◽  
Hans Joachim Stemmler ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lung Ultrasound ◽  
Clinical Course ◽  
Point Of Care ◽  
Clinical Deterioration ◽  
Normal Lung ◽  
Icu Patients ◽  
Standardized Protocol ◽  
Ultrasound Score

Abstract Background Point-of-care lung ultrasound (LU) is an established tool in the first assessment of patients with coronavirus disease (COVID-19). Purpose of this study was to evaluate the value of lung ultrasound in COVID-19 intensive care unit (ICU) patients in predicting clinical course and outcome. Methods We analyzed lung ultrasound score (LUS) of all COVID-19 patients admitted from March 2020 to December 2020 to the Internal Intensive Care Unit, Ludwig-Maximilians-University (LMU) of Munich. LU was performed according to a standardized protocol at ICU admission and in case of clinical deterioration with the need for intubation. A normal lung scores 0 points, the worst LUS has 24 points. Patients were stratified in a low (0–12 points) and a high (13–24 points) lung ultrasound score group. Results The study included 42 patients, 69% of them male. The most common comorbidities were hypertension (81%) and obesity (57%). The values of pH (7.42 ± 0.09 vs 7.35 ± 0.1; p = 0.047) and paO2 (107 [80–130] vs 80 [66–93] mmHg; p = 0.034) were significantly reduced in patients of the high LUS group. Furthermore, the duration of ventilation (12.5 [8.3–25] vs 36.5 [9.8–70] days; p = 0.029) was significantly prolonged in this group. Patchy subpleural thickening (n = 38; 90.5%) and subpleural consolidations (n = 23; 54.8%) were present in most patients. Pleural effusion was rare (n = 4; 9.5%). The median total LUS was 11.9 ± 3.9 points. In case of clinical deterioration with the need for intubation, LUS worsened significantly compared to baseline LU. Twelve patients died during the ICU stay (29%). There was no difference in survival in both LUS groups (75% vs 66.7%, p = 0.559). Conclusions LU can be a useful monitoring tool to predict clinical course but not outcome of COVID-19 ICU patients and can early recognize possible deteriorations.

Characterization of lung ultrasound imaging in preterm infants with bronchopulmonary dysplasia

2021 ◽  
pp. 1-13
Author(s):  
Ying-Hua Sun ◽  
Lin Yuan ◽  
Yang Du ◽  
Jian-Guo Zhou ◽  
Sam Bill Lin ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Neonatal Intensive Care ◽  
Lung Ultrasound ◽  
Imaging Method ◽  
Chronic Lung Diseases ◽  
Pleural Line ◽  
Ultrasound Features

BACKGROUND: Lung ultrasound (LUS) is a bedside technique that can be used on diagnosis and follow-up of neonatal respiratory diseases. However, there are rare reports on the ultrasound features of bronchopulmonary dysplasia (BPD) which is one of the most common chronic lung diseases in preterm infants. OBJECTIVE: To describe the ultrasound features of different BPD levels, and to investigate the value of ultrasound in evaluating moderate-to-severe BPD. METHODS: In this prospective cohort study, newborns of less than 37 weeks’ gestational age in neonatal intensive care unit (NICU) were included. The LUS characteristics including pleural line, alveolar-interstitial syndrome (AIS), retrodiaphragmatic hyperechogenicity and diaphragmatic morphology were observed and recorded. The reliability of LUS in evaluating moderate and severe BPD were compared and calculated. RESULTS: A total of 108 infants were enrolled in our study: 39, 24, 29, 16 infants had non, mild, moderate and severe BPD. The median(IQR) pleura thickness in the moderate-to-severe BPD group was 1.7(1.6–1.85) mm, which was thicker than that in the none-to-mild BPD infants (P <  0.001), meanwhile the proportions of rough pleural lines, diffuse AIS, retrodiaphragmatic hyperechogenicity, small cysts above the diaphragm and rough diaphragm in the moderate-to-severe BPD group were also higher than those in none-to-mild BPD group (86.7% vs 36.5, 57.8% vs 7.9%, 37.8% vs 0, 33.3% vs 0, P <  0.001). In evaluating moderate-to-severe BPD, rough pleura had 91.1% (95% confidence interval [CI]: 0.793–0.965) in sensitivity, 91.3% (95% CI: 0.797–0.966) in negative predictive value (NPV), and 66.7% (95% CI: 0.544–0.771) in specificity. Small cysts had 100% (95% CI: 0.941-1) in specificity, 100% (95% CI: 0.816-1) in PPV, and 37.8% in sensitivity (95% CI: 0.251–0.524). Rough diaphragm had 100% (95% CI: 0.943-1) in sensitivity, 100% (95% CI: 0.796-1) in PPV and 33.3% (95% CI: 0.211–0.478) in specificity. CONCLUSIONS: Depending on its unique advantages such as convenient, no radiation and repeatable, LUS is a valuable imaging method in assessing the severity of BPD, especially in moderate and severe BPD.

Lung Ultrasound in Bronchopulmonary Dysplasia: Patterns and Predictors in Very Preterm Infants

Neonatology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Victoria Aldecoa-Bilbao ◽  
Mar Velilla ◽  
Marta Teresa-Palacio ◽  
Carla Balcells Esponera ◽  
Ana Herranz Barbero ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Lung Ultrasound ◽  
Respiratory Support ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Pleural Line ◽  
Respiratory Management ◽  
Postmenstrual Age ◽  
Severity Of The Disease

<b><i>Introduction:</i></b> Lung ultrasound (LUS) is useful for respiratory management in very preterm infants (VPI), but little is known about the echographic patterns in bronchopulmonary dysplasia (BPD), the relation between the image findings, and the severity of the disease and its long-term outcomes. We aimed to describe LUS patterns in BPD and analyze the accuracy of LUS to predict the need for respiratory support at 36 weeks postmenstrual age (PMA) in VPI. <b><i>Methods:</i></b> Preterm infants ≤30.6 weeks of gestational age were recruited. LUS was performed at admission, at 7th, and 28th day of life (DOL) with a standardized protocol (6 zones: anterior, lateral, and posterior fields). Clinical data, respiratory outcomes, and image findings were recorded. <b><i>Results:</i></b> Eighty-nine patients were studied. Infants with BPD had significantly higher LUS score at admission, at 7th, and 28th DOL. Patients with BPD exhibited more consolidations and pleural line abnormalities at 7th and 28th DOL than those without BPD (<i>p</i> &#x3c; 0.001), regardless of the definition used for BPD. LUS at 7th DOL predicted <i>NICHD 2001-BPD</i> with <i>R</i><sup>2</sup> = 0.522; AUC = 0.87 (0.79–0.94), <i>p</i> &#x3c; 0.001, and <i>Jensen 2019-BPD</i> with <i>R</i><sup>2</sup> = 0.315 (AUC = 0.80 [0.70–0.90], <i>p</i> &#x3c; 0.001). A model including mechanical ventilation &#x3e;5 days, oxygen therapy for 7 days and LUS score at 7th DOL accurately predicted the need for respiratory support at 36 weeks PMA (<i>R</i><sup>2</sup> = 0.655, <i>p</i> &#x3c; 0.001) with an AUC = 0.90 (0.84–0.97), <i>p</i> &#x3c; 0.001. <b><i>Conclusion:</i></b> LUS score, pleural line abnormalities, and consolidations can be useful to diagnose BPD in VPI and to predict its severity after the first week of life.

scholarly journals May awake video-assisted thoracoscopic surgery with thoracic epidural anesthesia use routinely for minimaly invasive thoracic surgery procedures in the future?

2018 ◽  
Vol 5 (5) ◽  
pp. 1602
Author(s):  
Gonul Sagiroglu ◽  
Fazli Yanik ◽  
Yekta A. Karamusfaoglu ◽  
Elif Copuroglu
Keyword(s):  
Thoracic Surgery ◽  
General Anesthesia ◽  
Epidural Anesthesia ◽  
Thoracoscopic Surgery ◽  
Lung Ventilation ◽  
Thoracic Epidural Anesthesia ◽  
One Lung Ventilation ◽  
Thoracic Epidural ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Background: In the last years thoracic surgery developed in greater extent with equipments and techniques in one lung ventilation. Still general anesthesia in one lung ventilation approved as gold standard. In thoracic surgery most performed surgeries are plerural decortication and lung biopsy. Avoidance of intubation in Video Assisted Thoracoscopic Surgery (VATS) procedures gains us some advantages in postoperative period; a better respiratory parameters, survival and morbidity mortality rates, reduced hospitalization time and costs, reduced early stress hormone and immune response.  Methods: In this study, we reported our experience of 24 consecutive patients undergoing VATS with Thoracic Epidural Anesthesia (TEA) between December 2015 through July 2016 to evaluate the feasibility, safety and indication of this innovative technique whether it will be a gold standart in thoracic surgeries or not in the future.Results: Operation procedures included wedge resection in 11 (46%) patients (eight of them for pneumothorax, three of them for diagnosis), in 10 (42%) patients pleural biopsy (eight of them used talc pleurodesis), in two (8%) patients air leak control with fibrin glue and in one (4%) patient bilateral thoracal sympathectomy for hyperhidrosis.  We used T4-5 TEA space for 17 (72%) of patients, while we used T4-6 TEA space for 7 (28%) of patients. TEA block reached the desired level after the mean 26.4±4.3 minutes (range 21-34 min). There was no occurrence of hypotension and bradycardia during and after TEA. One (4%) patient required conversion to general anesthesia and tracheal intubation because of significant diaphragmatic contractions and hyperpne. Conversion to thoracotomy was not needed in any patient.Conclusions: We conclude that nVATS procedure with aid of TEA is feasibile and safety with minimal adverse events. The procedure can have such advantages as early mobilization, opening of early oral intake, early discharge, patient satisfaction, low pain level. Nevertheless, there is a need for randomized controlled trials involving wider case series on the subject.

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