The Feasibility and Impact of Routine Combined Limited Transthoracic Echocardiography and Lung Ultrasound on Diagnosis and Management of Patients Admitted to ICU: A Prospective Observational Study

Haji, Kavi; Haji, Darsim; Canty, David; Royse, Alistair; Tharmaraj, Dhaksha; Azraee, Meor; Hopkins, Lynda; Royse, C.

doi:10.1053/j.jvca.2017.08.026

Cited by 16 publications

(21 citation statements)

References 25 publications

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“…Tricuspid regurgitation (moderate or greater) was noted in 19% of patients; this rate is considerably higher than that previously reported (~3%) [40]. This association probably is attributable to the higher prevalence of pulmonary hypertension and RV systolic dysfunction in our cohort [41, 42].…”

Section: Discussioncontrasting

confidence: 46%

Echocardiographic parameters of patients in the intensive care unit undergoing continuous renal replacement therapy

Kompotiatis¹,

Wiley²,

Jentzer³

et al. 2019

PLoS ONE

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Main objectivesEchocardiographic parameters have been used to predict outcomes for specific intensive care unit (ICU) populations. We sought to define echocardiographic parameters for ICU patients receiving continuous renal replacement therapy (CRRT).Design, setting, participants, and measurementsThis is a historical cohort study of consecutive ICU patients at Mayo Clinic (Rochester, Minnesota) who received CRRT from December 9, 2006, through November 13, 2015. Only patients with an echocardiographic examination within 7 days of CRRT initiation were considered.ResultsThe study included 1,276 patients. Decreased left ventricular ejection fraction (LVEF; ≤45%) was noted in 361/1,120 (32%) and increased right ventricular systolic pressure (RVSP; ≥40 mm Hg) was noted in 529/798 (66%). Right ventricular systolic dysfunction was observed in 320/820 (39%). The most common valvular abnormality was tricuspid regurgitation (244/1,276 [19%]). Stratification of these parameters by ICU type (medical, surgical, cardiothoracic, cardiac) showed that most echocardiographic abnormalities were significantly more prevalent among cardiac ICU patients: LVEF ≤45% (67/105 [64%]), RVSP ≥40 mm Hg (63/79 [80%]) and tricuspid regurgitation (50/130 [38%]). We compared patients with acute kidney injury (AKI) vs end-stage renal disease and showed that decreased LVEF (284/921 [31%] vs 78/201 [39%]), was significantly less prevalent among patients with AKI, but increased RVSP was more prevalent (445/651 [68%] vs 84/147 [57%]) with AKI.ConclusionsICU patients who required CRRT had increased prevalence of pulmonary hypertension and right and left ventricular systolic dysfunction. Prediction of adverse outcomes with echocardiographic parameters in this patient population can lead to identification of modifiable risk factors.

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Section: Discussioncontrasting

confidence: 46%

Echocardiographic parameters of patients in the intensive care unit undergoing continuous renal replacement therapy

Kompotiatis¹,

Wiley²,

Jentzer³

et al. 2019

PLoS ONE

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“…Thoracic ultrasound is already being incorporated into various algorithms for patient management in the postoperative setting. These include both serial imaging for detection of changing hemodynamic and/or lung pathology in adult populations as well as complementing point‐in‐time resuscitative efforts for identification of reversible causes of cardiac arrest including pneumothorax assessment as described in the setting of a postoperative newborn . A similar algorithm should be developed and tested in the pediatric intraoperative setting.…”

Section: Diagnostic Applicationsmentioning

confidence: 99%

Getting to know a familiar face: Current and emerging focused ultrasound applications for the perioperative setting

Conlon

Lin

Bruins

et al. 2019

Pediatric Anesthesia

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Ultrasound technology is available in many pediatric perioperative settings. There is an increasing number of ultrasound applications for anesthesiologists which may enhance clinical performance, procedural safety, and patient outcomes. This review highlights the literature and experience supporting focused ultrasound applications in the pediatric perioperative setting across varied disciplines including anesthesiology. The review also suggests strategies for building educational and infrastructural systems to translate this technology into clinical practice. K E Y W O R D S anesthesiology, echocardiography, education, nerve block, patient safety, ultrasonography | 673 CONLON et aL. How to cite this article: Conlon TW, Lin EE, Bruins BB, et al. Getting to know a familiar face: Current and emerging focused ultrasound applications for the perioperative setting. Pediatr

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“…Thoracic ultrasound can detect conditions precisely, such as pneumothorax, pulmonary edema, pulmonary embolism, pneumonia, atelectasis, pleural effusion, and diaphragmatic dysfunction. [13][14][15][16][17][18] A simple, bedside technique can offer the clinician complete evaluation of lung function and parenchyma, without the risks of x-ray exposure, and with the advantages of functional real-time evaluation. The ultrasonographic examination can be repeated numerous times on the same day without any adverse effect.…”

Section: Diaphragmatic Dysfunction Following Cardiac Surgery: Is Thermentioning

confidence: 99%

Diaphragmatic Dysfunction FollowingCardiac Surgery: Is There a Role forPulmonary Ultrasound?

Bignami

Guarnieri

Saglietti

et al. 2018

Journal of Cardiothoracic and Vascular Anesthesia

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from incisors to secondary carina on the left side to determine the depth of insertion of the left DLT. Similarly, 1 cm is added to the measured distance from incisors to the takeoff of right upper lobe bronchus to determine depth of insertion of a right DLT (tip of the right DLT is approximately 1 cm beyond the slot for right upper lobe ventilation). At our institute, we commonly use this technique to know the depth of insertion, especially when a PFOB is not available, and we find it useful in achieving optimum position of the DLT, particularly in small-sized individuals, in which we have seen significant variations in the tracheobronchial dimensions. Blind insertion to a depth estimated by height-based formulae often overestimates the depth of insertion in small-sized Asian patients, thereby increasing the risk of tracheobronchial injury associated with inserting the DLT too far. A limitation of this technique is that the distance measured from incisor to secondary carina may vary with the position of the head and neck during bronchoscopy, and therefore it is important to make the measurements with the head in a neutral position. Confirmation of position of the DLT with a PFOB remains the gold standard and should be followed whenever possible. Thus, in addition to CT scan-guided measurement, preintubation measurement of distance between incisor and secondary carina using adult bronchoscope is an effective, less resourceintensive method to know the depth of insertion of the DLT. Use of these methods improves the rate of successful placement of the DLT when a PFOB is unavailable.

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The Feasibility and Impact of Routine Combined Limited Transthoracic Echocardiography and Lung Ultrasound on Diagnosis and Management of Patients Admitted to ICU: A Prospective Observational Study

Cited by 16 publications

References 25 publications

Echocardiographic parameters of patients in the intensive care unit undergoing continuous renal replacement therapy

Echocardiographic parameters of patients in the intensive care unit undergoing continuous renal replacement therapy

Getting to know a familiar face: Current and emerging focused ultrasound applications for the perioperative setting

Diaphragmatic Dysfunction FollowingCardiac Surgery: Is There a Role forPulmonary Ultrasound?

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