scholarly journals Perioperative ultrasound; Fashion, luxury or necessity!

2019 ◽  
pp. 115-118
Author(s):  
Fazal Hameed Khan
Keyword(s):  
Intensive Care ◽  
Ultrasound Guidance ◽  
Lung Ultrasound ◽  
Perioperative Period ◽  
Critical Conditions ◽  
Nerve Blocks ◽  
Airway Assessment ◽  
Special Request ◽  
Plan Modification ◽  
Successful Extubation

The technique of ultrasound is not new in medicine. Advancement of the technique, portability of the equipment and the desire of the anesthesiologist to reach to a quick diagnosis has made this an essential tool for today’s anesthesiologist. There are many areas during the perioperative period where ultrasound can play an important role in guiding otherwise blind and invasive interventions, diagnosing critical conditions, and assessing for possible anatomic variations that may lead to plan modification. The irrefutable outcome of perioperative use of ultrasound performed by anesthesiologists is increasingly being acknowledged .It has been playing a role in central venous cannulation, epidural space identification, performing peripheral nerve and chronic pain nerve blocks. Transesophageal echocardiography, airway assessment, gastric ultrasound, lung ultrasound and neuro monitoring are some of the newly introduced uses of this modality. As the ultrasound guidance is becoming standard practice of care, anesthesiologists need to develop a thorough understanding of this technology and practical skills by training themselves.Editor’s Note: This editorial was written by the respected Prof. Fazal H. Khan on our special request to complement a research paper being published in this issue [Soliman AM, Samy MA, Heikal AM, El Ramely MA, Kotb TA. Ultrasound-guided assessment of diaphragmatic thickness as an indicator of successful extubation. Anaesth pain & intensive care 2019;23(2):178-185]Citation: Khan FM. Perioperative ultrasound Fashion, luxury or necessity! Anaesth. pain & intensive care 2019;23(2):115-118

scholarly journals The lung ultrasound in differential diagnostic of acute respiratory failure reason

2020 ◽  
pp. 12-22
Author(s):  
D.A. Kuzhel ◽  
Keyword(s):  
Computed Tomography ◽  
Acute Respiratory Distress Syndrome ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Soft Tissues ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Critical Conditions ◽  
Portable Ultrasound ◽  
Acoustic Resistance

Ultrasound lungs examination has been considered uninformative for decades due to the high acoustic resistance between soft tissues and airy lungs. Recently, the work in emergency conditions has proved the usefulness of ultrasound technologies, especially while diagnosing acute respiratory failures. Introduction of ultrasound technologies into the practice of intensive care units made it possible to change the ‘philosophy’ of diagnosing critical conditions, promoting ultrasound as primary technique, even in the era of widespread use of computed tomography. Portable ultrasound diagnostic devices, along with general clinical examination, made it possible to differentiate rapidly such acute conditions as cardiogenic shock, acute respiratory distress syndrome, pneumothorax, atelectasis, and other lung lesions

scholarly journals Correction to: Lung ultrasound to predict pediatric intensive care admission in infants with bronchiolitis (LUSBRO study)

2021 ◽  
Author(s):  
Sara Bobillo-Perez ◽  
Clara Sorribes ◽  
Paula Gebellí ◽  
Nuria Lledó ◽  
Marta Castilla ◽  
...  
Keyword(s):  
Intensive Care ◽  
Lung Ultrasound ◽  
Pediatric Intensive Care ◽  
Intensive Care Admission

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.

scholarly journals Lung ultrasound presentation of COVID-19 patients: phenotypes and correlations

2021 ◽  
Author(s):  
Gianmarco Secco ◽  
◽  
Marzia Delorenzo ◽  
Francesco Salinaro ◽  
Caterina Zattera ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lung Ultrasound ◽  
Structure And Function ◽  
General Ward ◽  
Prognostic Role ◽  
Interstitial Syndrome ◽  
Lung Structure ◽  
And Function ◽  
The Relationship

AbstractBedside lung ultrasound (LUS) can play a role in the setting of the SarsCoV2 pneumonia pandemic. To evaluate the clinical and LUS features of COVID-19 in the ED and their potential prognostic role, a cohort of laboratory-confirmed COVID-19 patients underwent LUS upon admission in the ED. LUS score was derived from 12 fields. A prevalent LUS pattern was assigned depending on the presence of interstitial syndrome only (Interstitial Pattern), or evidence of subpleural consolidations in at least two fields (Consolidation Pattern). The endpoint was 30-day mortality. The relationship between hemogasanalysis parameters and LUS score was also evaluated. Out of 312 patients, only 36 (11.5%) did not present lung involvment, as defined by LUS score < 1. The majority of patients were admitted either in a general ward (53.8%) or in intensive care unit (9.6%), whereas 106 patients (33.9%) were discharged from the ED. In-hospital mortality was 25.3%, and 30-day survival was 67.6%. A LUS score > 13 had a 77.2% sensitivity and a 71.5% specificity (AUC 0.814; p < 0.001) in predicting mortality. LUS alterations were more frequent (64%) in the posterior lower fields. LUS score was related with P/F (R2 0.68; p < 0.0001) and P/F at FiO2 = 21% (R2 0.59; p < 0.0001). The correlation between LUS score and P/F was not influenced by the prevalent ultrasound pattern. LUS represents an effective tool in both defining diagnosis and stratifying prognosis of COVID-19 pneumonia. The correlation between LUS and hemogasanalysis parameters underscores its role in evaluating lung structure and function.

scholarly journals Subparaneural injection in popliteal sciatic nerve blocks evaluated by MRI

Open Medicine ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. 346-353
Author(s):  
Benedikt Büttner ◽  
Alexander Schwarz ◽  
Caspar Mewes ◽  
Katalin Kristof ◽  
José Hinz ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Local Anesthetic ◽  
Ultrasound Guidance ◽  
Resonance Imaging ◽  
Nerve Blocks ◽  
Cross Sectional ◽  
Neurological Sequelae ◽  
Patient Reported ◽  
Study Population ◽  
Intraneural Injection

AbstractIntraneural injection of a local anesthetic can damage the nerve, yet it occurs frequently during distal sciatic block with no neurological sequelae. This has led to a controversy about the optimal needle tip placement that results from the particular anatomy of the sciatic nerve with its paraneural sheath.The study population included patients undergoing lower extremity surgery under popliteal sciatic nerve block. Ultrasound-guidance was used to position the needle tip subparaneurally and to monitor the injection of the local anesthetic. Sonography and magnetic resonance imaging were used to assess the extent of the subparaneural injection.Twenty-two patients participated. The median sciatic cross-sectional area increased from 57.8 mm2 pre-block to 110.8 mm2 immediately post-block. An intraneural injection according to the current definition was seen in 21 patients. Two patients had sonographic evidence of an intrafascicular injection, which was confirmed by MRI in one patient (the other patient refused further examinations). No patient reported any neurological symptoms.A subparaneural injection in the popliteal segment of the distal sciatic nerve is actually rarely intraneural, i.e. intrafascicular. This may explain the discrepancy between the conventional sonographic evidence of an intraneural injection and the lack of neurological sequelae.

scholarly journals Lung ultrasound in the intensive care unit: let’s move forward

2014 ◽  
Vol 40 (10) ◽  
pp. 1592-1594 ◽  
Author(s):  
Dimitris Georgopoulos ◽  
Nectaria Xirouchaki ◽  
Giovanni Volpicelli
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lung Ultrasound ◽  
Let's Move

scholarly journals Patients in intensive care unit for COVID-19 pneumonia: the lung ultrasound patterns at admission and discharge. An observational pilot study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Persona Paolo ◽  
Valeri Ilaria ◽  
Zarantonello Francesco ◽  
Forin Edoardo ◽  
Sella Nicolò ◽  
...  
Keyword(s):  
Intensive Care ◽  
Lung Ultrasound ◽  
Low Cost ◽  
Low Frequency ◽  
Specific Pattern ◽  
University Hospital ◽  
Left Hemithorax ◽  
Significant Difference ◽  
The Right ◽  
B Lines

Abstract Background During COVID-19 pandemic, optimization of the diagnostic resources is essential. Lung Ultrasound (LUS) is a rapid, easy-to-perform, low cost tool which allows bedside investigation of patients with COVID-19 pneumonia. We aimed to investigate the typical ultrasound patterns of COVID-19 pneumonia and their evolution at different stages of the disease. Methods We performed LUS in twenty-eight consecutive COVID-19 patients at both admission to and discharge from one of the Padua University Hospital Intensive Care Units (ICU). LUS was performed using a low frequency probe on six different areas per each hemithorax. A specific pattern for each area was assigned, depending on the prevalence of A-lines (A), non-coalescent B-lines (B1), coalescent B-lines (B2), consolidations (C). A LUS score (LUSS) was calculated after assigning to each area a defined pattern. Results Out of 28 patients, 18 survived, were stabilized and then referred to other units. The prevalence of C pattern was 58.9% on admission and 61.3% at discharge. Type B2 (19.3%) and B1 (6.5%) patterns were found in 25.8% of the videos recorded on admission and 27.1% (17.3% B2; 9.8% B1) on discharge. The A pattern was prevalent in the anterosuperior regions and was present in 15.2% of videos on admission and 11.6% at discharge. The median LUSS on admission was 27.5 [21–32.25], while on discharge was 31 [17.5–32.75] and 30.5 [27–32.75] in respectively survived and non-survived patients. On admission the median LUSS was equally distributed on the right hemithorax (13; 10.75–16) and the left hemithorax (15; 10.75–17). Conclusions LUS collected in COVID-19 patients with acute respiratory failure at ICU admission and discharge appears to be characterized by predominantly lateral and posterior non-translobar C pattern and B2 pattern. The calculated LUSS remained elevated at discharge without significant difference from admission in both groups of survived and non-survived patients.

scholarly journals Invasive, minimally invasive and non-invasive hemodynamic monitoring in perioperative medicine

2020 ◽  
Vol 12 (1) ◽  
pp. 7-19
Author(s):  
Guerrero Gutiérrez Manuel Alberto ◽  
Pérez Nieto Orlando Rubén ◽  
Eder Iván Zamarrón López ◽  
Jesús Salvador Sánchez Díaz ◽  
Escarramán Martínez Diego ◽  
...  
Keyword(s):  
Intensive Care ◽  
Pulmonary Artery ◽  
Minimally Invasive ◽  
Hemodynamic Monitoring ◽  
Perioperative Period ◽  
Invasive Monitoring ◽  
Less Invasive ◽  
Non Invasive ◽  
Fundamental Part ◽  
Invasive Hemodynamic Monitoring

The hemodynamic monitoring is a fundamental part of the patient in the perioperative period, during the last decade the monitoring at the patient's bedside has grown at giant steps, from the emergency area, operating room, to the Intensive Care area. One of its most important advances is the decrease in the use of pulmonary artery catheter, which is being replaced by ultrasound and less invasive monitoring techniques, in this article we will review from the beginning of the monitoring to the most used less invasive monitors currently.

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