Echocardiography and Ultrasound in the Intensive Care Unit

2015 ◽  
pp. 890-907
Author(s):  
Pranav R. Shah ◽  
Chad Wagner ◽  
Andrew Shaw
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Venous Thrombosis ◽  
Diagnostic Tool ◽  
Point Of Care ◽  
Venous Access ◽  
Lung Pathology ◽  
Cardiac Evaluation ◽  
And Training

Sonography in the intensive care unit is a rapidly emerging point-of-care diagnostic tool. Literature supports the use of sonography for the evaluation of lung pathology, protocol based focused cardiac evaluation, and abdominal pathology, as well as identifying deep venous thrombosis. There is also evidence that ultrasound guided procedures such as venous access, thoracentesis, and paracentesis may decrease complications compared to a landmark based technique. However, there is ambiguity in the literature regarding definition, scope, and training in this modality as used by intensivists. The purpose of this chapter is to provide a broad overview of the role of ultrasound in the ICU and data supporting the use of point-of-care protocols. This chapter does not provide instruction on how to perform a complete transthoracic or transesophageal exam, nor does it provide a library of images of various pathologies since a reader seeking such depth would be better served by a full textbook on echocardiography.

scholarly journals Utility of point-of-care ultrasound in the pediatric intensive care unit

2019 ◽  
Author(s):  
Reagan Lyman ◽  
Yoshikazu Yamaguchi ◽  
Alok Moharir ◽  
Alok Moharir ◽  
Joseph D. Tobias
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Point Of Care ◽  
Pediatric Intensive Care ◽  
Therapeutic Interventions ◽  
Point Of Care Ultrasound ◽  
Critical Care Units ◽  
Clinical Scenarios

For critically ill patients, point-of-care ultrasound (POCUS) has been rapidly adopted for use in emergency departments and critical care units for diagnostic purposes and to guide decision making. We present two unique clinical scenarios in the Pediatric Intensive Care Unit (PICU), one in which ultrasound was used as a diagnostic tool to identify pulmonary edema, and the other in which ultrasound was used to facilitate placement of a naso-duodenal tube for enteral feeding. The potential role of POCUS in the PICU is presented and its utility in these two unique clinical scenarios discussed. Although, many cases will still require further radiological tests, The success of POCUS lies in immediate diagnosis allowing at the spot therapeutic interventions without wasting precious time.Citation: Lyman R, Yamaguchi Y, Moharir A, Tobias JD. Utility of point-of-care ultrasound in the pediatric intensive care unit. Anaesth pain & intensive care 2019;23(3):314-317

scholarly journals Incorporating point-of-care ultrasound into daily intensive care unit rounds: Another source of interruptions?

2018 ◽  
Vol 21 (1) ◽  
pp. 18-21
Author(s):  
O Olusanya ◽  
AVK Wong ◽  
J Kirk-Bayley ◽  
P Parulekar
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Online Survey ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Clinical Decisions ◽  
Bedside Ultrasonography ◽  
Ward Rounds ◽  
And Training

Point-of-care ultrasound (POCUS) is the use of bedside ultrasonography by the treating clinician, incorporating those images into direct clinical decisions. While there are a number of different techniques and training pathways in this relatively new modality, there has been little discussion around the logistics of integrating POCUS into the standard critical care “business day” of ward rounds, procedures and meetings. This article explores some of these aspects and presents data from an online survey of POCUS practitioners.

scholarly journals Nurses' adherence to the Kangaroo Care Method: support for nursing care management

2015 ◽  
Vol 23 (3) ◽  
pp. 483-490 ◽  
Author(s):  
Laura Johanson da Silva ◽  
Josete Luzia Leite ◽  
Carmen Gracinda Silvan Scochi ◽  
Leila Rangel da Silva ◽  
Thiago Privado da Silva
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Management Strategies ◽  
Kangaroo Care ◽  
Reference Framework ◽  
The City ◽  
And Training

OBJECTIVE: construct an explanatory theoretical model about nurses' adherence to the Kangaroo Care Method at the Neonatal Intensive Care Unit, based on the meanings and interactions for care management.METHOD: qualitative research, based on the reference framework of the Grounded Theory. Eight nurses were interviewed at a Neonatal Intensive Care Unit in the city of Rio de Janeiro. The comparative analysis of the data comprised the phases of open, axial and selective coding. A theoretical conditional-causal model was constructed.RESULTS: four main categories emerged that composed the analytic paradigm: Giving one's best to the Kangaroo Method; Working with the complexity of the Kangaroo Method; Finding (de)motivation to apply the Kangaroo Method; and Facing the challenges for the adherence to and application of the Kangaroo Method.CONCLUSIONS: the central phenomenon revealed that each nurse and team professional has a role of multiplying values and practices that may or may not be constructive, potentially influencing the (dis)continuity of the Kangaroo Method at the Neonatal Intensive Care Unit. The findings can be used to outline management strategies that go beyond the courses and training and guarantee the strengthening of the care model.

Role of Sildenafil in the Treatment of Persistent Pulmonary Hypertension of Newborn (PPHN) - Should it Be Withdrawn from Market of Bangladesh due to Threat of being Misuses

2020 ◽  
Vol 35 (2) ◽  
pp. 100-104
Author(s):  
Maksudur Rahman ◽  
Mohammad Abdullah Al Mamun ◽  
MAK Azad Chowdhury ◽  
Abu Sayeed Munsi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cardiac Intensive Care Unit ◽  
Cross Sectional ◽  
Cardiac Intensive Care ◽  
Hospital Protocol

Background: Recently it has been apprehended that sildenafil, a drug which has been successfully using in the treatment of PPHN and erectile dysfunction in adult, is going to be withdrawn from the market of Bangladesh due to threat of its misuses. Objective: The aim of this study was to see the extent of uses of sildenafil in the treatment of PPHN and importance of availability of this drugs in the market inspite of its probable misuses. Methods: This cross sectional study was conducted in neonatal intensive care unit (NICU), special baby care unit (SCABU) and cardiac intensive care unit (CICU) of Dhaka Shishu (Children) Hospital from June, 2017 to May 2018. Neonates with PPHN were enrolled in the study. All cases were treated with oral sildenefil for PPHN along with others management according to hospital protocol. Data along with other parameters were collected and analyzed. Results: Total 320 patients with suspected PPHN were admitted during the study period. Among them 92 (29%) cases had PPHN. Male were 49(53 %) cases and female were 43(47%) cases. Mean age at hospital admission was 29.7±13.4 hours. Based on echocardiography,13(14%) cases had mild, 38 (41%) cases moderate and 41(45%) cases severe PPHN. Mean duration of sildenafil therapy was 11.9±7.1 days. Improved from PPHN were 83 (90%) cases. Mortality was 10% (9). Conclusion: In this study it was found that the incidence of PPHN is 29% among the suspected newborns. Sildenafil is successfull in improving the oxygenation of PPHN and to decrease the mortality of neonates. DS (Child) H J 2019; 35(2) : 100-104

scholarly journals How reliable is procalcitonin as an inflammatory marker?1)

2012 ◽  
Vol 35 (6) ◽  
pp. ---
Author(s):  
Katharina Biller ◽  
Peter Fae ◽  
Reinhard Germann ◽  
Autar K. Walli ◽  
Peter Fraunberger
Keyword(s):  
Intensive Care ◽  
Diagnostic Tool ◽  
Plasma Levels ◽  
Bacterial Infections ◽  
Respiratory Tract Infections ◽  
Inflammatory Marker ◽  
Antibiotic Use ◽  
Intensive Care Patients ◽  
Tract Infections

Abstract The role of procalcitonin (PCT) plasma levels as a diagnostic tool for intensive care patients has been intensively investigated during the past years. In particular for recognition of bacterial infections, PCT levels have been shown to be superior to other clinical and biochemical markers. Furthermore, some very recent studies show that in patients with lower respiratory tract infections PCT guided antibiotic therapy reduces antibiotic use and thereby may also reduce duration of stay of patients in hospital and thus cut hospitalisation costs. However, various studies indicate that the value of PCT as a prognostic marker is limited because of false positive or negative values. Despite these limitations PCT plasma levels are currently measured in intensive care units. The present study summarises the possible clinical uses of this laboratory marker as a diagnostic tool for the assessment of critically ill patients.

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.

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