Australasian Journal of Ultrasound in Medicine最新文献

{"title":"The impact of ultrasound imaging on patient management – Let's practice the evidence","authors":"Gillian Whalley","doi":"10.1002/ajum.12412","DOIUrl":"https://doi.org/10.1002/ajum.12412","url":null,"abstract":"<p>As a novice researcher, I worked with a cardiology professor who was driven by clinical evidence. Clinical trials were his bread and butter, and leading guideline writing groups became his passion. The most memorable take-home message for me was this: Before you do any test, a clinician should ask themselves, ‘Will this change management? And if so, how?’ A clinician should know what they will do if the test is positive or negative and be able to articulate that. Sadly, this is not always the case. And whilst it might be ‘nice to know’, the cost of confirmatory tests is certainly not insignificant.</p><p>When I trained in ultrasound, we still called it ‘diagnostic ultrasound’ to differentiate it from therapeutic ultrasound, but this also highlighted the immense and unique diagnostic properties of ultrasound. Increasingly, ultrasound is used to not only diagnose, but also to monitor and screen for conditions, as well as to aid in management and prognosis. While all of these are laudable uses, I still think it is helpful when we can link our imaging directly to change in management.</p><p>In this issue of AJUM, Smith and Mistry<span><sup>1</sup></span> present research documenting the impact of formal echocardiography (echo) on patient management in a small clinical audit of formal echos in their intensive care unit (ICU). Although half of the patients had critical findings found on formal echo, only 25% resulted in management change. Perhaps, the remainder of the critical findings were either already suspected, and therefore being treated; or had been anticipated. Indeed, it is possible that a point of care ultrasound (POCUS) had already given them some clinical cues, and thus, the formal echo was simply confirmatory. In a reasonable number of patients, the formal echo helped make the decision to proceed with palliation and this seems an entirely reasonable reason to do an extra imaging test.</p><p>Also, in the ICU setting, Xin <i>et al</i>.<span><sup>2</sup></span> report on the use of Tissue Doppler Imaging (TDI) of the diaphragm to optimise the timing of weaning from mechanical ventilation in ICU patients. Using TDI to measure the low velocity motion of heart muscle is fundamental to echocardiography, so the extension to the diaphragm seems a logical extension of practice. But a good idea still needs to be tested and shown to aid patient management. Innovation needs to be effective.</p><p>Innovation is a key part of medicine, and finding new applications for imaging is part of that. Lau <i>et al</i>.<span><sup>3</sup></span> applied shear wave elastography to patients in a case–control study comparing patients with COVID-19 with controls and found that patients with recent (<6 months) COVID-19 had increased liver stiffness. They were prompted to do the study after observing elevated liver enzymes in these patients. But as the authors point out, these may be transient changes, and data are needed to see whether these abnormalities are asso","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12412","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142320923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS‐guided tissue acquisition from gastric subepithelial lesions—The optimal technique still remains undecided","authors":"S. Giri, Sridhar Sundaram","doi":"10.1002/ajum.12398","DOIUrl":"https://doi.org/10.1002/ajum.12398","url":null,"abstract":"","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141821757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound‐assisted and landmark‐based nusinersen delivery in spinal muscular atrophy adults: A retrospective analysis","authors":"B. Zanfini, Agata Katia Patanella, Francesco Vassalli, S. Catarci, Marika Pane, L. Frassanito, M. Biancone, Mariangela Di Muro, Chiara Bravetti, Eugenio Maria Mercuri, Mario Sabatelli, G. Draisci","doi":"10.1002/ajum.12401","DOIUrl":"https://doi.org/10.1002/ajum.12401","url":null,"abstract":"Nusinersen, the first treatment approved for all spinal muscular atrophy (SMA) types, is administered intrathecally through lumbar puncture. We used ultrasound assistance or a landmark‐based technique to access the lumbar intrathecal space in adult SMA patients. This study aimed to evaluate the technical success and adverse events (AEs) in such patients using either technique over a long observation period.Fifty‐one adult patients received 507 consecutive interlaminar nusinersen administrations. Patients presented with both ‘uncomplicated spines’ or ‘complicated spines’; two patients had previous back surgery. Technical success and AEs were recorded using either technique. A generalised linear mixed model was applied to evaluate predictors of technical success and complications.An overall success rate of 99.6%, with only two procedures failing to reach the intrathecal space, and an overall optimal procedure rate of 90.3% have been reported. A total of 455 procedures (89.7%) were uneventfully performed. One (0.2%) case of severe AE (puncture of a bulky abdominal annexal cyst) was recorded. Twenty‐seven episodes (5.3%) of post‐dural puncture headache (PDPH) and 24 episodes (4.7%) of radicular or back pain, both successfully treated with medical therapy, have also been reported. Technical success was significantly associated with ‘complicated spines’ (P = 0.022) and the use of ultrasound assistance (P = 0.01), and the use of ultrasound was the only independent predictor of uncomplicated procedures (P = 0.007).In adult patients with SMA both landmark‐based and ultrasound‐assisted techniques are safe and effective even in the long term. The use of assistance is associated with technical success and can predict uncomplicated procedures.Our results support the use of ultrasonography in order to improve the success and reduce the burden of nusinersen intrathecal administration.","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141646794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous ultrasound in the diagnosis and assessment of inflammatory activity in tinea capitis","authors":"F. J. Rodríguez‐Cuadrado, G. Roustan-Gullón, F. Alfageme‐Roldán","doi":"10.1002/ajum.12402","DOIUrl":"https://doi.org/10.1002/ajum.12402","url":null,"abstract":"Although the diagnosis of tinea capitis is mainly microbiological, the risk of evolution towards cicatricial alopecia in the most severe cases requires empirical treatment based on physical examination and complementary examinations.Two patients were evaluated by physical examination, cutaneous ultrasound and microbiological examination.Ultrasound showed follicular widening and increased vascularization in Doppler mode. In one of them, the finding of severe inflammatory activity led to the indication of oral corticotherapy.Cutaneous ultrasound could play a role not only in supporting the clinical diagnosis but that it may even guide the indication of treatment in the presence of severe inflammation that sometimes may not manifest itself clinically.Cutaneous ultrasound may constitute an additional test of considerable usefulness in the diagnosis and evaluation of inflammatory activity in cases such as the ones presented, fast, non‐invasive and of high accessibility.","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141661393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management change following transthoracic echocardiogram in the intensive care unit","authors":"Jeremy A Smith,&nbsp;Ravi Mistry","doi":"10.1002/ajum.12397","DOIUrl":"https://doi.org/10.1002/ajum.12397","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction/Purpose</h3>\u0000 \u0000 <p>The optimal utilisation of echocardiography in intensive care units (ICU) is not yet known; however, its use is becoming more frequent. Management change from transthoracic echocardiography (TTE) in ICU is quoted to be from 3% to 50%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of clinical practice was performed over a 2-month period in a tertiary adult ICU, to explore the utilisation of formal TTEs and the findings of these. The rate of management change and critical findings were investigated, along with the indication for TTE and the patient cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-three TTEs were performed in 54 patients. A change in management occurred in 25.4% (16/63) of TTEs, with critical findings being found in 47.6% (30/63) of all TTEs. The most common indications for formal TTEs were incompletely differentiated or further evaluation of shock, and post arrest cardiac function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Almost half of the TTEs performed had critical findings, with common critical findings being severe LV dysfunction, severe RV dysfunction and regional wall motion abnormalities. Despite critical findings being seen frequently, there was only management change in 25%, suggesting that several of the critical findings were already suspected, clinically confirmed or had anticipatory management prior to TTE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Critical findings are common in critically ill patients. However, not all critical findings will lead to a change in management. Formal TTEs in the ICU should be focussed to the clinical question being asked and a screening intensivist performed bedside TTE may be appropriate in certain situations to decrease workload of cardiology department.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142320796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Placental cord insertion migration: Implications for ultrasound documentation and follow‐up of abnormal placental cord insertion site","authors":"Samantha Ward, Zhonghua Sun, Sharon Maresse","doi":"10.1002/ajum.12399","DOIUrl":"https://doi.org/10.1002/ajum.12399","url":null,"abstract":"It is well‐documented in the literature that the placenta migrates during pregnancy; however, studies regarding placental cord insertion (PCI) migration are scarce. This longitudinal, prospective study aimed to determine whether PCI migration is a true phenomenon, to assess whether the PCI can change classification during pregnancy and to determine the validity of PCI site documentation including follow‐up of abnormal PCI.Eighty‐three participants who had first, second and third trimester ultrasound examinations at a Western Australian private imaging practice over a 12‐month period between November 2021 and November 2022 were recruited. The measured distance of the lower margin of the placenta to the cervix, the distance of the PCI to the closest placental edge and the PCI classification were documented in each trimester. Data analysis was conducted to determine PCI migration rates during pregnancy and to test for association between PCI migration and maternal and placental factors.The PCI migrated during pregnancy and the PCI classification has the potential to evolve. All identifiable PCIs that were normal in first trimester remained so throughout the pregnancy. The majority (67.6%) of cord insertions that were marginal in first trimester progressed to a normal insertion site by third trimester; 23.5% remained marginal and 8.8% evolved to a velamentous insertion. Three velamentous cord insertions were recorded in first trimester, none of which normalised—two remained velamentous during the pregnancy and one evolved to marginal in second trimester. Marginal cord insertions (MCIs) ≤10 mm from the placental edge in second trimester remained marginal in third trimester; MCIs that were >15 mm from the placental edge in second trimester normalised in third trimester.Placental cord insertion migration is a phenomenon that occurs during pregnancy with the potential for PCI classification to evolve. Due to the association between abnormal PCI and perinatal complications, coupled with the potential for marginal cord insertion to evolve, documentation of PCI and follow‐up of abnormal PCI is beneficial, particularly in cases of velamentous insertion and marginal insertion at the placental edge or in the lower uterus.","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141339337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal large tubular oesophageal duplication cyst: A case report","authors":"Călina Maier,&nbsp;Radu Vlădăreanu,&nbsp;Raluca Tocariu,&nbsp;Marcela Șerban,&nbsp;Maria Olincă,&nbsp;Elvira Brătilă","doi":"10.1002/ajum.12387","DOIUrl":"https://doi.org/10.1002/ajum.12387","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Oesophageal duplication cyst (EDC) is a rare congenital anomaly representing, after neuronal tumours, the second most common cause of posterior mass in children, with a prevalence of approximately 1/22,500 live births. Cervical cysts are very rare, and their antenatal detection is fairly uncommon.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We report the case of an isolated large mediastinal and cervical tubular EDC diagnosed prenatally in the third trimester.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After birth, the baby became symptomatic developing respiratory distress due to the enlargement of the cyst and she underwent excision of the mass. The post-operative evolution was very good.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our purpose was to raise awareness of the ultrasonographic features of this condition, thus improving the rate of prenatal diagnosis and offering the parents a proper counselling regarding the prognosis and the need for a further multidisciplinary approach after birth.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12387","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142320627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A stab in the dark","authors":"Gillian Whalley","doi":"10.1002/ajum.12391","DOIUrl":"https://doi.org/10.1002/ajum.12391","url":null,"abstract":"<p>Procedural guidance with ultrasound is challenging traditional medicine. And for good reason – precision is an ally whenever you are inserting a needle into a human body. With some imagination, I am able to conjure up a gruesome Hollywood-esque image of someone gripping a syringe in a gloved fist and thrusting it towards a body with the intention of hitting a target under the skin. In my mind, there is an element of chance as to whether the needle hits the intended anatomical target. It's a stab in the dark. In a more nuanced and stable clinical scenario, the insertion point is carefully considered and the odds of missing may be relatively low. But no matter how low, it seems intuitively sensible to use any imaging guidance available. And increasingly, that guidance is provided by ultrasound. Ultrasound has been established as a helpful addition to inserting intravenous lines, taking biopsies and draining free fluid, to name but a few.</p><p>If one assumes that the person inserting a needle has absolutely no knowledge of underlying anatomy and is simply taking a stab whilst hoping it will hit its spot then it is easy to perceive the massive benefit of ultrasound-guided procedures. But that simply isn't true. Medical students spend many hours learning about surface anatomy and how it relates to the underlying layers of tissue, muscle and bone below the skin. Doctors have a great understanding of anatomy and use their hands to palpate for certain underlying structures such as bony processes, tendons and veins, in order to piece together an image in their mind about the underlying anatomy. Anyone who has had blood taken knows that those technicians who do this are adept at feeling the anatomy on the inside of the elbow to find a vein to puncture and drain blood from no matter how deep it is. It is a well-honed skill.</p><p>But taking blood is one thing, injecting substances is quite another. Intra-articular injections for the treatment of joint osteoarthritis have been popular for some time and are safely performed using anatomical landmarks only. But increasingly, practitioners are using ultrasound to guide needle placement. In this issue of AJUM, Oo <i>et al</i>.<span>¹</span> have performed a systematic review of ultrasound-guided injections and concluded that clinical outcomes are superior compared with landmark-guided injections. As a potential patient, I can see how this may build confidence in the procedure, but the added benefit of improved clinical outcomes makes ultrasound guidance even more compelling.</p><p>All new approaches come with a learning curve however and potentially some questions about who should do these procedures. Those with extensive landmark-guided experience may find the ultrasound hinders the process at first. And conversely, those with ultrasound experience may not have the confidence with landmark-guided procedures. Having two professionals (one an ultrasound expert) working side by side may seem attract","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12391","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141078980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel technique for the measurement of cervical length in non-pregnant women","authors":"Yana Vinnikov,&nbsp;Eran Barzilay,&nbsp;Oshri Barel,&nbsp;Gil Levy","doi":"10.1002/ajum.12383","DOIUrl":"10.1002/ajum.12383","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Cervical elongation is considered a risk factor for pelvic organ prolapse treatment failure in uterine preservation surgery. Consensus has not been reached regarding what is considered a normal cervical length, or how to measure it. Our primary aim was to test a new technique for measuring cervical length.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We enrolled women undergoing hysterectomy, with or without pelvic organ prolapse (for all indications except cervical tumours/history of cervical operations). Their cervical lengths were measured both by ultrasound and anatomical measurement. The external length of the cervix was measured using Doppler location of the uterine artery near the cervical-uterine junction as the proximal point and compared to the ultrasound measurement of the cervical canal. The uterine specimen was used to record anatomical cervical measurements as well as uterine corpus length. Baseline characteristics such as age, body mass index and pelvic organ prolapse quantification were also collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty women were eligible for evaluation. We found the average anatomical cervical canal length was (ccAN) 33.95 mm (range ±  9.23) and by external measurement (ceAN) 36.80 mm (range ± 7.54). We found a significant, high-powered correlation between our ultrasound and anatomical measurements in both techniques, as well as between the two ultrasound techniques. We also found a negative correlation between cervical length and women's age (r_p = −0.443, P = 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Transvaginal ultrasound measurement of cervical length using the location of the uterine artery was found to have a strong correlation to the anatomical cervical length and can be used for the measurement of normal cervical length.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141111260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising flow without congestion using the venous-arterial Doppler enhanced resuscitation framework","authors":"Jon-Emile S Kenny,&nbsp;Philippe Rola","doi":"10.1002/ajum.12388","DOIUrl":"10.1002/ajum.12388","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Ultrasonography as a guide for intravenous (IV) fluid therapy is increasingly accepted within the spheres of acute care. Initial investigations and protocols often focused on measures of arterial flow as an objective approach for personalising organ ‘perfusion.’ More recently, and with literature associating excessive IV fluid with adverse outcomes, venous ultrasound as a measure of organ ‘congestion’ is taking hold. Yet, arterial (i.e., ‘perfusion’) and venous (i.e., ‘congestion’) Doppler ultrasound measures are often performed separately and can be time-consuming, especially for novices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We report a case, wherein venous and arterial Doppler were simultaneously measured using a wireless, wearable ultrasound as a means to optimise flow without congestion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Before IV volume expansion, the patient had Doppler measures consistent with low central venous pressure (CVP) and stroke volume (SV). Following IV volume expansion, venous Doppler remained the same; however, carotid corrected flow time (ccFT) increased significantly.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A framework for venous-arterial Doppler enhanced resuscitation (VADER) can be used to guide IV volume in patients at risk for venous congestion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12388","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141129224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}