Articles

Mitral valve velocity time integral and passive leg raise as a measure of volume responsiveness

Fluid responsiveness is an important topic for clinicians. Aggressive hydration has been shown to lead to worse outcomes. The aim of this study was to investigate the sensitivity and specificity of mitral valv...

Authors: Ralphe Bou Chebl, Gilbert Abou Dagher, Jeffrey Wuhantu, Rana Bachir and Jennifer Carnell

Diagnostic performance of abdominal point of care ultrasound performed by an emergency physician in acute right iliac fossa pain

Right iliac fossa abdominal pain is a common reason for emergency ward admissions, its etiology is difficult to diagnose. It can be facilitated by an imaging examination, such as a Computerized Tomography scan...

Authors: Jean-Eudes Bourcier, Emeric Gallard, Jean-Philippe Redonnet, Magali Majourau, Dominique Deshaie, Jean-Marie Bourgeois, Didier Garnier and Thomas Geeraerts

Strain analysis for the identification of hypertensive cardiac end-organ damage in the emergency department

Hypertensive emergency is a life-threatening state. End-organ damage affecting the heart accounts for up to 52% of hypertensive emergencies commonly encountered in the emergency department. Recent evidence ind...

Authors: Pavitra Kotini-Shah, Susana Cuadros, Felix Huang and Joseph S. Colla

Transient systolic anterior motion with junctional rhythm after mitral valve repair in the intensive care unit

Systolic anterior motion (SAM) after mitral valve repair (MVR) can adversely affect hemodynamics due to exacerbation of left ventricular outflow tract obstruction and mitral regurgitation. Intraoperative trans...

Authors: Yusuke Seino, Nobuo Sato, Kimiya Fukui, Junya Ishikawa, Masahi Nakagawa and Takeshi Nomura

Which ultrasound transducer type is best for diagnosing pneumothorax?

An accurate physical examination is essential in the care of critically ill and injured patients. However, to diagnose or exclude a pneumothorax, chest auscultation is unreliable compared to lung ultrasonograp...

Authors: R. Ketelaars, E. Gülpinar, T. Roes, M. Kuut and G. J. van Geffen

Ultrasound-guided thoracostomy site identification in healthy volunteers

Traditional landmark thoracostomy technique has a known complication rate up to 30%. The goal of this study is to determine whether novice providers could more accurately identify the appropriate intercostal s...

Authors: Lindsay A. Taylor, Michael J. Vitto, Michael Joyce, Jordan Tozer and David P. Evans

Diagnosis of diastolic dysfunction in the emergency department: really at reach for minimally trained sonologists? A call for a wise approach to heart failure with preserved ejection fraction diagnosis in the ER

Authors: Gabriele Via and Guido Tavazzi

Is point-of-care ultrasound disruptive innovation? Formulating why POCUS is different from conventional comprehensive ultrasound

Point-of-care ultrasound (PoCUS) is spreading throughout Emergency Medicine, Critical Care and Pre-hospital Care. However, there is an underlying inherited conflict with the established specialties performing ...

Authors: Jesper Weile, Jacob Brix and Anders Broens Moellekaer

Combined lung and brain ultrasonography for an individualized “brain-protective ventilation strategy” in neurocritical care patients with challenging ventilation needs

When intracranial hypertension and severe lung damage coexist in the same clinical scenario, their management poses a difficult challenge, especially as concerns mechanical ventilation management. The needs of...

Authors: Francesco Corradi, Chiara Robba, Guido Tavazzi and Gabriele Via

Pre-hospital lung ultrasound for cardiac heart failure and COPD: is it worthwhile?

Pre-hospital ultrasound is a new challenge and lung ultrasound could be an interesting opportunity in the pre-hospital medical service. The aim of our study was to evaluate the efficacy of lung ultrasound in o...

Authors: Mirko Zanatta, Piero Benato, Sigilfredo De Battisti, Concetta Pirozzi, Renato Ippolito and Vito Cianci

Lung ultrasound training: a systematic review of published literature in clinical lung ultrasound training

Clinical lung ultrasound examinations are widely used in the primary assessment or monitoring of patients with dyspnoea or respiratory failure. Despite being increasingly implemented, there is no international...

Authors: Pia Iben Pietersen, Kristian Rørbæk Madsen, Ole Graumann, Lars Konge, Bjørn Ulrik Nielsen and Christian Borbjerg Laursen

Is it best to reFOCUS on basic echocardiography in the emergency department?

Authors: Pablo Blanco and Gabriela Bello

Today’s advanced is tomorrow’s basic

Authors: Joe Betcher, Al Majkrzak, Ross Kessler, Nik Theyyunni and Rob Huang

The implementation of a longitudinal POCUS curriculum for physicians working at rural outpatient clinics in Chiapas, Mexico

Medical care in resource limited settings is challenging, particularly with limited access to diagnostic and imaging studies. The most portable and cost effective diagnostic imaging in these areas is ultrasoun...

Authors: Annie Heffernan Rominger, Gerardo Antonio Aguilar Gomez and Patrick Elliott

ABCDE of prehospital ultrasonography: a narrative review

Prehospital point-of-care ultrasound used by nonradiologists in emergency medicine is gaining ground. It is feasible on-scene and during aeromedical transport and allows health-care professionals to detect or ...

Authors: Rein Ketelaars, Gabby Reijnders, Geert-Jan van Geffen, Gert Jan Scheffer and Nico Hoogerwerf

An easier and safe affair, pleural drainage with ultrasound in critical patient: a technical note

Thoracic ultrasound is a powerful diagnostic imaging technique for pleural space disorders. In addition to visualising pleural effusion, thoracic ultrasound also helps clinicians to identify the best puncture ...

Authors: Luigi Vetrugno, Giovanni Maria Guadagnin, Daniele Orso, Enrico Boero, Elena Bignami and Tiziana Bove

Application of robotic transcranial Doppler for extended duration recording in moderate/severe traumatic brain injury: first experiences

Authors: F. A. Zeiler and P. Smielewski

Icterus and abdominal pain: an unexpected, rare sonographic finding in a Peruvian Emergency Department

The use of point-of-care ultrasound (POCUS) has become increasingly important in resource-limited settings. It can rapidly diagnose both tropical infectious diseases and more common pathology at the bedside. I...

Authors: Stephanie J. Doniger and Alexander Wang

The impact of heart, lung and diaphragmatic ultrasound on prediction of failed extubation from mechanical ventilation in critically ill patients: a prospective observational pilot study

Failed extubation from mechanical ventilation in critically ill patients is multifactorial, complex and not well understood. We aimed to identify whether combined transthoracic echocardiography, lung and diaph...

Authors: Kavi Haji, Darsim Haji, David J. Canty, Alistair G. Royse, Cameron Green and Colin F. Royse

The Area method: a new method for ultrasound assessment of diaphragmatic movement

Ultrasound can be used to assess diaphragm movement. Existing methods focus on movement at a single point at the hemidiaphragm and may not consider the anatomic and functional complexity. We aimed to develop a...

Authors: Søren Helbo Skaarup, Anders Løkke and Christian B. Laursen

Lung and diaphragm ultrasound as predictors of success in weaning from mechanical ventilation

Lung and diaphragm ultrasound methods have recently been introduced to predict the outcome of weaning from mechanical ventilation (MV). The aim of this study is to assess the reliability and accuracy of these ...

Authors: Eva Tenza-Lozano, Ana Llamas-Alvarez, Enrique Jaimez-Navarro and Javier Fernández-Sánchez

Problems with interpretation of transient hyperemic response ratio (THRR)

Authors: Achyut Sharma and Diptesh Aryal

Feasibility study of advanced focused cardiac measurements within the emergency department

This study aims to compare the increased time needed to perform advanced focused cardiac measurements in the emergency department, including diastolic heart failure evaluation via E/E′, and cardiac output with...

Authors: Joe Betcher, Al Majkrzak, Jim Cranford, Ross Kessler, Nik Theyyunni and Rob Huang

Prospective evaluation of cardiac ultrasound performance by general internal medicine physicians during a 6-month faculty development curriculum

Point-of-care (POCUS) education is rapidly expanding within medical schools and internal medicine residency programs, but lack of trained faculty is a major barrier. While POCUS training can improve short-term...

Authors: Christopher J. Smith, Abdulrahman Morad, Christopher Balwanz, Elizabeth Lyden and Tabatha Matthias

Point-of-care lung ultrasound for diagnosis of Pneumocystis jirovecii pneumonia: notes from the field

Thoracic ultrasound is helpful to evaluate lung pathology in patients with acute dyspnea. Several studies have demonstrated the efficacy of point-of-care ultrasound in patients with extrapulmonary TB and HIV c...

Authors: Maria Teresa Giordani, Francesca Tamarozzi, Daniel Kaminstein, Enrico Brunetti and Tom Heller

eFAST for the diagnosis of a perioperative complication during percutaneous nephrolithotomy

A 29-year-old patient with normal preanesthetic evaluation was planned for percutaneous nephrolithotomy (PCNL) for right nephrolithiasis with right pyelolithiasis. Surgery was performed under general anesthesi...

Authors: Achyut Sharma, Prajjwal Bhattarai and Apurb Sharma

Ultrasound assessment of visual loss during severe preeclampsia: a case report

Bilateral retinal detachments and cortical blindness are rare complications of preeclampsia and the association of the two pathologies is exceptional. We report the case of a preeclamptic patient who presented...

Authors: Fehmi Ferhi, Abdeljalil Khlifi, Feten Hachani, Khalil Tarmiz and Khaled Benjazia

Acute fissuration of a giant splenic artery aneurysm detected by point-of-care ultrasound: case report

Epigastric pain is frequent in Emergency Medicine and remains a challenging situation. Besides benign etiologies such as gastritis or uncomplicated cholelithiasis, it could reveal myocardial infarction or vasc...

Authors: Philippe Le Conte, David Trewick, Philippe Pes, Eric Frampas and Eric Batard

Emergency physician use of tissue Doppler bedside echocardiography in detecting diastolic dysfunction: an exploratory study

This study evaluates the agreement between emergency physician (EP) assessment of diastolic dysfunction (DD) by a simplified approach using average peak mitral excursion velocity (eʹ_A) and an independent cardiolo...

Authors: Marina Del Rios, Joseph Colla, Pavitra Kotini-Shah, Joan Briller, Ben Gerber and Heather Prendergast

Ultrasound evaluation of the airway in the ED: a feasibility study

Recognition of the difficult airway is a critical element of emergency practice. Mallampati score and body mass index (BMI) are not always predictive and they may be unavailable in critically ill patients. Ult...

Authors: Elizabeth A. Hall, Ibrahim Showaihi, Frances S. Shofer, Nova L. Panebianco and Anthony J. Dean

Transcranial Doppler ultrasound in the ICU: it is not all sunshine and rainbows

Authors: Pablo Blanco and Anselmo Abdo-Cuza

Early abnormal transient hyperemic response test can predict delayed ischemic neurologic deficit in subarachnoid hemorrhage

Early detection of vasospasm is crucial to prevent significant delayed ischemic neurological deficit post subarachnoid hemorrhage. The standard methods of detection, including cerebral angiogram and computed t...

Authors: Hosam Al-Jehani, Mark Angle, Judith Marcoux and Jeanne Teitelbaum

Abstracts from the 13th WINFOCUS World Congress on Ultrasound in Emergency & Critical Care

Authors: Stephen Alerhand, Adam Nevel, Bret Nelson, Michael Halperin, Felipe Serrano, Gregor Prosen, Tjaša Banović, Stephanie J. Doniger, Mirjana Brvar, Barbara Furman, P. Gallego Rodríguez, Tomas Villén Villegas, A. Trueba Vicente, L. W. Alba Muñoz, C. Guillén Astete, N. Díaz García…

The Assessment of Competency in Thoracic Sonography (ACTS) scale: validation of a tool for point-of-care ultrasound

The rapid adoption of point-of-care ultrasound (POCUS) has created a need to develop assessment tools to ensure that learners can competently use these technologies. In this study, the authors developed and te...

Authors: Scott J. Millington, Robert T. Arntfield, Robert Jie Guo, Seth Koenig, Pierre Kory, Vicki Noble, Haney Mallemat and Jordan R. Schoenherr

Management of cardiopulmonary assist devices in critically ill patients using point-of-care transthoracic echocardiography: a case series

Point-of-care transthoracic echocardiography is increasingly being utilized by the intensive care physicians in the management of hemodynamically unstable patients. However, its use in the management of critic...

Authors: Babar Fiza, Michael Tang and Michael Maile

Evaluation of a short formation on the performance of point-of-care renal ultrasound performed by physicians without previous ultrasound skills: prospective observational study

Point-of-Care Ultrasound (PoCUS) is recommended by emergency medicine societies for the detection of hydronephrosis. Training of certified Emergency Physicians (EP) without prior ultrasound experience remains ...

Authors: François Javaudin, François Mounier, Philippe Pes, Idriss Arnaudet, Frédéric Vignaud, Eric Frampas and Philippe Le Conte

Postural lung recruitment assessed by lung ultrasound in mechanically ventilated children

Atelectasis is a common finding in mechanically ventilated children with healthy lungs. This lung collapse cannot be overcome using standard levels of positive end-expiratory pressure (PEEP) and thus for only ...

Authors: Gerardo Tusman, Cecilia M. Acosta, Stephan H. Böhm, Andreas D. Waldmann, Carlos Ferrando, Manuel Perez Marquez and Fernando Suarez Sipmann

Point-of-care transcranial Doppler by intensivists

In the unconscious patient, there is a diagnostic void between the neurologic physical exam, and more invasive, costly and potentially harmful investigations. Transcranial color-coded sonography and two-dimens...

Authors: Vincent Issac Lau and Robert Thomas Arntfield

The relationship between single and two-dimensional indices of left ventricular size using hemodynamic transesophageal echocardiography in trauma and burn patients

Conventional echocardiographic technique for assessment of volume status and cardiac contractility utilizes left ventricular end-diastolic area (LVEDA) and fractional area of change (FAC), respectively. Our go...

Authors: Duraid Younan, T. Mark Beasley, David C. Pigott, C. Blayke Gibson, John P. Gullett, Jeffrey Richey, Jean-Francois Pittet and Ahmed Zaky

POCUS in perioperative medicine: a North American perspective

Ultrasound (US) performed at the point of care has found fertile ground in perioperative medicine. In the hands of anesthesiologists, transesophageal echocardiography (TEE) has become established as a powerful...

Authors: Lorenzo De Marchi and Massimiliano Meineri

Time to correct the flow of corrected flow time

Recently published study of Ma et al. evaluates two relatively novel measures of fluid responsiveness, carotid blood flow and corrected carotid flow time (ccFT). Both measures have been recently quoted as poss...

Authors: Igor Barjaktarevic, Alan Chiem and Maxime Cannesson

Bedside transcranial sonography monitoring in a patient with hydrocephalus post subarachnoid hemorrhage

Development of hydrocephalus can occur after subarachnoid hemorrhage (SAH). Typically, it is diagnosed with computed tomography, CT, scan. However, transcranial sonography (TCS) can be used particularly in pat...

Authors: Ahmed Najjar, André Y. Denault and Michel W. Bojanowski

Ultrasonography in trauma: a nation-wide cross-sectional investigation

The Focused Assessment with Sonography in Trauma (FAST) protocol is considered beneficial in emergent evaluation of trauma patients with blunt or penetrating injury and has become integrated into the Advanced ...

Authors: Jesper Weile, Klaus Nielsen, Stine C. Primdahl, Christian A. Frederiksen, Christian B. Laursen, Erik Sloth and Hans Kirkegaard

Transesophageal echocardiography in orthotopic liver transplantation: a comprehensive intraoperative monitoring tool

Intraoperative transesophageal echocardiography is a minimally invasive monitoring tool that can provide real-time visual information on ventricular function and hemodynamic volume status in patients undergoin...

Authors: Luigi Vetrugno, Federico Barbariol, Umberto Baccarani, Francesco Forfori, Giovanni Volpicelli and Giorgio Della Rocca

Right heart thrombus in transit: a series of two cases

Right heart thrombus in transit is an increasingly recognized medical emergency with very high mortality rate. Echocardiography helps to establish the diagnosis and can differentiate between right heart thromb...

Authors: Eva Otoupalova, Bhavinkumar Dalal and Brian Renard

A simplified lung ultrasound approach to detect increased extravascular lung water in critically ill patients

The quantification of B-lines at lung ultrasonography is a valid tool to estimate the extravascular lung water (EVLW) in patients after major cardiac surgery. However, there is still uncertainty about the corr...

Authors: Antonio Anile, Jole Russo, Giacomo Castiglione and Giovanni Volpicelli

Applicability of a modified EFAST protocol (r-EFAST) to evaluate hemodynamically unstable patients after percutaneous cardiac intervention

Percutaneous cardiac intervention is an invasive diagnostic and therapeutic technique which carries a significant complication rate. Although the usefulness of EFAST protocol is widely recognised, this paper w...

Authors: José Luis Vázquez Martínez, Kary Leonisa Quiñones Coneo, Tomas Villen Villegas, María Sánchez Porras, Cesar Pérez-Caballero Macarrón, Ana Coca Pérez and Luis Fernandez Pineda

Minimal training sufficient to diagnose pediatric wrist fractures with ultrasound

In children, non-fractured wrists generally need no treatment and those that are fractured may only require a 3-week cast without any clinical follow-up. The ability to perform a point-of-care triage decision ...

Authors: Henrik Hedelin, Christian Tingström, Hanna Hebelka and Jon Karlsson

Correlation of carotid blood flow and corrected carotid flow time with invasive cardiac output measurements

Non-invasive measures that can accurately estimate cardiac output may help identify volume-responsive patients. This study seeks to compare two non-invasive measures (corrected carotid flow time and carotid bl...

Authors: Irene W. Y. Ma, Joshua D. Caplin, Aftab Azad, Christina Wilson, Michael A. Fifer, Aranya Bagchi, Andrew S. Liteplo and Vicki E. Noble

A randomised crossover study to compare the cross-sectional and longitudinal approaches to ultrasound-guided peripheral venepuncture in a model

Ultrasound-guided peripheral intravenous access may present an alternative to central or intraosseous access in patients with difficult peripheral veins. Using venepuncture of a phantom model as a proxy, we in...

Authors: James Griffiths, Amadeus Carnegie, Richard Kendall and Rajeev Madan