The Rapid Assessment of Dyspnea with Ultrasound: RADiUS

Manson, William C.; Hafez, Nadim

doi:10.1016/j.cult.2011.03.010

Cited by 31 publications

(23 citation statements)

References 55 publications

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“…POCUS is of great importance as a bedside tool for immediately identifying types of acute respiratory failure and shock with guided hemodynamic management. Many protocols have been adopted and validated (10,11). Some protocols have adopted only LUS for uid management and diagnosis of respiratory failure (12).…”

Section: Discussionmentioning

confidence: 99%

Point-of-care ultrasound for COVID-19 pneumonia patients in the ICU

Bitar

Shamsah

Bamasood

et al. 2020

Preprint

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BackgroundPoint-of-care ultrasound (POCUS) has a major role in the management of patients with acute hypoxic respiratory and circulatory failure and guides hemodynamic management. There is scarce literature on POCUS assessment characteristics in COVID-19 pneumonia with hypoxic respiratory failure.MethodsThe study is an observational, prospective, single‐center study conducted in the intensive care unit of Adan General Hospital from May 1st, 2020, to June 25, 2020. The study included adults suspected to have COVID-19 transferred to the intensive care unit (ICU) with fever or suspected respiratory infection. Patients were transferred to the ICU directly from the ED or general medical wards after reverse transcriptase-polymerase chain reaction (RT-PCR) testing. A certified intensivist in critical care ultrasound who was blinded to the RT-PCR results, if available at the time of examination, performed the lung ultrasound and echocardiology within 12 hours of the patient’s admission to the ICU. We calculated the E/e’, E/A ratio, left ventricular ejection fraction EF, IVC diameter, RV size and systolic function. We performed ultrasound in 12 chest areas.ResultsOf 92 patients with suspected COVID-19 pneumonia, 77 (84%) cases were confirmed. The median age of the patients was 53 (82-36) years, and 71 (77%) were men.In the group of patients with confirmed COVID-19 pneumonia, echocardiographic findings showed normal E/e’, deceleration time (DT), and transmittal E/A ratio in comparison to the non-COVID19 patients (P .001 for both). The IVC diameter was <2 cm with > 50% collapsibility in 62 (81%) patients with COVID-19 pneumonia; a diameter of > 2 cm and < 50% collapsibility in all patients, with a P value of 0.001, was detected among those with non-COVID-19 pneumonia. There were 3 cases of myocarditis with poor EF (5.5%), severe RV dysfunction was seen in 9 cases (11.6%), and 3 cases showed RV thrombus.Chest US revealed four signs suggestive of COVID-19 pneumonia in 77 patients (98.6%) (sensitivity 96.9%, CI 85%‐99.5%) when compared with RT-PCR results.ConclusionPOCUS plays an important role in bedside diagnosis, hemodynamic assessment and management of patients with acute hypoxic respiratory and circulatory failure in patients with COVID-19 pneumonia.

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Section: Discussionmentioning

confidence: 99%

Point-of-care ultrasound for COVID-19 pneumonia patients in the ICU

Bitar

Shamsah

Bamasood

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…POCUS helps not only in the early identification of the source of infection but also in early interventions such as drainage or removal of the infectious source. However, because of the hemodynamic instability of septic shock patients [1], it is reasonable to carry out diagnostic and interventional ultrasound-guided procedures bedside.…”

Section: Discussionmentioning

confidence: 99%

“…He was admitted to the critical care unit upon diagnosis of acute pulmonary edema and suspicion of sepsis. The Rapid Assessment of Dyspnea with Ultrasound protocol [1] was immediately started and showed depressed systolic function of the left ventricle, with cardiac index 2 mL/min/m 2 , and ultrasound of the chest showed severe bilateral ultrasonic B lines suggestive of acute pulmonary edema. Clinically, there was still no obvious source of infection: he had a bilateral pulmonary crepitation and there was no abdominal or costovertebral angle tenderness.…”

Section: Case Filementioning

confidence: 99%

It Is Always Early with Point-of-Care Ultrasound

Bitar

Zaalouk

Maadarani

et al. 2020

Case Reports in Critical Care

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A 56-year-old male was admitted to the emergency department for acute pulmonary edema and septic shock, yet no clear source of infection was noted upon physical examination. Due to his unstable condition, bedside ultrasound was performed. A heterogeneous mass in the liver was noted; hence, a tentative diagnosis of liver abscess was made. The abscess was confirmed by abdominal magnetic resonance imaging. Drainage of the abscess was attempted and guided by early ultrasound. This case highlights that point-of-care ultrasound, when performed by an ultrasound-capable critical care physician, can significantly decrease the time to diagnosis for septic patients.

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“…A kritikus ellátásban hangsúlyozandó a komplex, klinikai szemléletet igénylő tünetorientált (symptome-based vagy problem-based) modulok ismerete. Ilyen például a sokkos állapotra kifejlesztett protokollok közül a RUSH (Rapid Ultrasound in Shock) [10,11], de léteznek a légzési elégtelenség gyors differenciál-diagnosztikáját célzó alkalmazások is [12,13]. A robbanásszerű terjedésben kulcsszerepe volt a hordozható, jó minőségű és költséghatékony UH-készülékek megjelenésének.…”

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Az ágy melletti ultrahangvizsgálat diagnosztikus lehetőségeinek vizsgálata a sürgősségi betegellátásban

2016

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Bevezetés: Az ismeretlen etiológiájú kritikus állapotok közül a keringési elégtelenség (sokk) gyors differenciáldiag-nosztikája mindennapi kihívás a sürgősségi betegellátásban. A "Rapid Ultrasound in Shock" (RUSH) protokoll 2010 óta ismert, amelynek segítségével a négy sokkforma (kardiogén, disztributív, obstruktív, hypovolaemiás) elkülöníthe-tő. A módszerrel percek alatt megállapítható, hogy a háttérben milyen kórfolyamat (pericardialis tamponád, szívelég-telenség, tüdőembólia, hypovolaemia, vérzés, feszülő légmell, aortadissectio, illetve aortaaneurysma-ruptura vagy disztributív sokk) áll. Célkitűzés: A szerzők a RUSH protokoll alkalmasságát vizsgálták a sokk differenciáldiagnoszti-kájában. Módszer: A retrospektív vizsgálatban 123 kritikus állapotú beteg vizsgálatának eredményeit elemezték. A betegeket a Markusovszky Kórház Sürgősségi Osztályán egy klinikai, tünetorientált ultrahangmodul segítségével vizsgálták. A betegekről részletes feljegyzéseket és képanyagot rögzítettek. Eredmények: A vizsgált betegek közül 64 beteg szenvedett sokkban, a többi kritikus állapotú beteg akut, súlyos mellkasi vagy hasi fájdalomban, illetve fulladás-ban szenvedett. Következtetések: Az eredmények megerősítik a célzott ágy melletti ultrahangvizsgálat előnyeit. Az első hazai vizsgálat eredményei alapján a szerzők véleménye szerint a módszer a hazai sürgősségi oktatásba és ellátásba integrálható. Orv. Hetil., 2016, 157(15), 569-574.Kulcsszavak: sürgősségi betegellátás, ágy melletti ultrahang, point of care ultrahang, keringési elégtelenség, RUSHprotokoll Evaluation of the diagnostic value of bedside ultrasonography in the critical careIntroduction: Rapid differential diagnosis of circulatory failure (shock) with unknown etiology is a daily challenge in the field of emergency medicine. The Rapid Ultrasound in Shock (RUSH) protocol is well known since 2010. With the use of targeted steps, the 4 forms of shock (cardiogen, distributive, obstructive, hypovolemic) can be separated in a few minutes. Aim: The aim of the authors was to evaluate the usefulness of the Rapid Ultrasound in Shock protocol for the diagnosis of different forms of shock. Method: The retrospective study included 123 critically ill patients admitted to the Emergency Department of Markusovszky Hospital, Szombathely, Hungary. Detailed records were obtained from all patients. Results: From the 123 crirically ill patients, 64 patients suffered from circulatory failure, while the remaining patients had acute severe chest or abdominal pain, or respiratory failure. Conclusions: Based on the results of the first evaluation of the Rapid Ultrasound in Shock protocol in Hungarian patients, the authors conclude that, the bedside ultrasonography has a great value in emergency medicine, and this the protocol is suitable for its integration into patient care and education of emergency medicine.

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The Rapid Assessment of Dyspnea with Ultrasound: RADiUS

Cited by 31 publications

References 55 publications

Point-of-care ultrasound for COVID-19 pneumonia patients in the ICU

Point-of-care ultrasound for COVID-19 pneumonia patients in the ICU

It Is Always Early with Point-of-Care Ultrasound

Az ágy melletti ultrahangvizsgálat diagnosztikus lehetőségeinek vizsgálata a sürgősségi betegellátásban

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