Utility of ultrasound in resuscitation

Abstract

a b s t r a c tUltrasound has become a diagnostic and therapeutic tool for critical situations. This article reviews the development of ultrasound with respect to critical events and its impact on reducing morbidity and mortality from abdominal and chest trauma, on the recognition of reversible causes of pulseless electrical activity, on decision-making in acute respiratory failure, and on predicting survival and reducing complications associated with invasive procedures. We revised how ultrasounds performed by non-experts with a minimum of training and focused on recognizing specific situations have a good degree of correlation with expert conducted ultrasounds. Some protocols of ultrasound in resuscitation described in the literature are reviewed and a description is made of the most relevant variables in critical situations, including left ventricular function, volume responsiveness, cardiac tamponade, right ventricular dilatation, and pulmonary evaluation. Palabras clave: Ultrasonido Resucitación cardiopulmonar Taponamiento Cardíaco Volumen Sistólico Disfunción ventricular Derecha r e s u m e nEl ultrasonido se ha convertido en una herramienta diagnóstica y terapéutica en situaciones críticas. Este artículo revisa la evolución del ultrasonido en eventos críticos y su impacto a través de la disminución de morbimortalidad en trauma abdominal y torácico, en el reconocimiento de causas reversibles en actividad eléctrica sin pulso, en la toma de decisiones en falla ventilatoria aguda, en predicción de supervivencia y en la disminución de complicaciones en procedimientos invasivos. Se revisa cómo el ultrasonido realizado por no expertos con mínimo entrenamiento enfocado al reconocimiento de situaciones específicas tiene una adecuada correlación con el experto. Se revisan algunos protocolos de ultrasonido en reanimación descritos en la literatura y se hace una descripción de las variables más ଝ Please cite this article as: Coronado JDP, Franco GA. Utilidad del Ultrasonido en Reanimación. Rev Colomb Anestesiol. 2015.http://dx.

Utilidad del ultrasonido en el paro cardiorrespiratorio: a propósito de un caso

“…La supervivencia para la AEP y la asistolia es mucho menor que para otros ritmos de paro cardiaco, probablemente debido al hecho de que dependen de la identificación correcta y del tratamiento rápido de las causas subyacentes. De estas causas no desfibrilables, solo se diagnostican fácilmente la hipoxemia, la hipotermia y la hipo/hiperpotasemia (1). La ecografía desempeña un papel importante en estas situaciones de paro cardiaco, ya que permite a los médicos excluir rápidamente las causas potencialmente reversibles.…”

“…En las últimas dos décadas, el ultrasonido ha desempeñado un papel importante en diferentes tipos de áreas médicas y ello ha permitido enfoques prácticos, rápidos, efectivos y sin necesidad de irradiación (1). El tromboembolismo pulmonar (TEP) es una de las principales causas de morbilidad y mortalidad.…”

The Value of Focused Echocardiography During Cardiac Arrest

“…17 The true impact that echocardiography has on improving patient survival is optimistic, but more research is needed. 2,5,7,17 The benefits of using echocardiography during cardiac arrest continue to grow, and its potential use is not fully known. The indisputable evidence of the benefits discussed has given rise to echocardiography becoming a standard part of the cardiac arrest protocol in other parts of the world.…”

“…Performing a focused echocardiogram, in the cardiac arrest setting, is challenging, and the universal recommendation is that only providers with significant training fulfill that role. 2,3,5,6,15,[16][17][18][19] Cardiac sonographer training recommendations are well established for performing routine, comprehensive echocardiograms. 16 A consensus statement from the ASE stated that echocardiography is a very specialized field requiring specific training to become competent.…”

“…However, there are no specific training requirements indicated to perform in this role. 16,17 The ASE consensus statement on focused cardiac sonography states the following: “Although there are no specific training requirements offered, this document provides a framework from which the medical community can establish the criteria necessary to optimize the use of this exciting new technology.” 16 Experienced users could provide an additional benefit during a cardiac arrest, with multiple sonographic views being obtained during manual compressions. 2 This highlights the importance of a user who is exclusively trained in performing and interpreting echocardiograms.…”