Ultrasound Journal最新文献

筛选
英文 中文
Point-of-Care-ultrasound in undergraduate medical education: a scoping review of assessment methods. 本科医学教育中的护理点超声:评估方法的范围审查。
IF 3.4
Ultrasound Journal Pub Date : 2023-06-11 DOI: 10.1186/s13089-023-00325-6
Celina DeBiasio, Paul Pageau, Allan Shefrin, Michael Y Woo, Warren J Cheung
{"title":"Point-of-Care-ultrasound in undergraduate medical education: a scoping review of assessment methods.","authors":"Celina DeBiasio,&nbsp;Paul Pageau,&nbsp;Allan Shefrin,&nbsp;Michael Y Woo,&nbsp;Warren J Cheung","doi":"10.1186/s13089-023-00325-6","DOIUrl":"https://doi.org/10.1186/s13089-023-00325-6","url":null,"abstract":"<p><strong>Background: </strong>Point-of-Care-Ultrasound (POCUS) curricula have rapidly expanded in undergraduate medical education (UME). However, the assessments used in UME remain variable without national standards. This scoping review characterizes and categorizes current assessment methods using Miller's pyramid for skills, performance, and competence of POCUS in UME. A structured protocol was developed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). A literature search of MEDLINE was performed from January 1, 2010, to June 15, 2021. Two independent reviewers screened all titles and abstracts for articles that met inclusion criteria. The authors included all POCUS UME publications in which POCUS-related knowledge, skills, or competence were taught and objectively assessed. Articles were excluded if there were no assessment methods used, if they exclusively used self-assessment of learned skills, were duplicate articles, or were summaries of other literature. Full text analysis and data extraction of included articles were performed by two independent reviewers. A consensus-based approach was used to categorize data and a thematic analysis was performed.</p><p><strong>Results: </strong>A total of 643 articles were retrieved and 157 articles met inclusion criteria for full review. Most articles (n = 132; 84%) used technical skill assessments including objective structured clinical examinations (n = 27; 17%), and/or other technical skill-based formats including image acquisition (n = 107; 68%). Retention was assessed in n = 98 (62%) studies. One or more levels of Miller's pyramid were included in 72 (46%) articles. A total of four articles (2.5%) assessed for students' integration of the skill into medical decision making and daily practice.</p><p><strong>Conclusions: </strong>Our findings demonstrate a lack of clinical assessment in UME POCUS that focus on integration of skills in daily clinical practice of medical students corresponding to the highest level of Miller's Pyramid. There exists opportunities to develop and integrate assessment that evaluate higher level competencies of POCUS skills of medical students. A mixture of assessment methods that correspond to multiple levels of Miller's pyramid should be used to best assess POCUS competence in UME.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10258183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9679981","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}
引用次数: 1
Doppler flow morphology characteristics of epiaortic arteries in aortic valve pathologies: a retrospective study on a cohort of patients with ischemic stroke. 主动脉瓣病变中表主动脉的多普勒血流形态学特征:一组缺血性脑卒中患者的回顾性研究。
IF 3.4
Ultrasound Journal Pub Date : 2023-06-07 DOI: 10.1186/s13089-023-00327-4
Stefanie Meyer, Lara Wilde, Frieder Wolf, Jan Liman, Mathias Bähr, Ilko L Maier
{"title":"Doppler flow morphology characteristics of epiaortic arteries in aortic valve pathologies: a retrospective study on a cohort of patients with ischemic stroke.","authors":"Stefanie Meyer,&nbsp;Lara Wilde,&nbsp;Frieder Wolf,&nbsp;Jan Liman,&nbsp;Mathias Bähr,&nbsp;Ilko L Maier","doi":"10.1186/s13089-023-00327-4","DOIUrl":"https://doi.org/10.1186/s13089-023-00327-4","url":null,"abstract":"<p><strong>Background and aims: </strong>Neurovascular ultrasound (nvUS) of the epiaortic arteries is an integral part of the etiologic workup in patients with ischemic stroke. Aortic valve disease shares similar vascular risk profiles and therefore not only presents a common comorbidity, but also an etiologic entity. The aim of this study is to investigate the predictive value of specific Doppler curve flow characteristics in epiaortic arteries and the presence of aortic valve disease.</p><p><strong>Methods: </strong>Retrospective, single-center analysis of ischemic stroke patients, both receiving full nvUS of the extracranial common- (CCA), internal- (ICA) and external carotid artery (ECA) and echocardiography (TTE/TEE) during their inpatient stay. A rater blinded for the TTE/TEE results investigated Doppler flow curves for the following characteristics: 'pulsus tardus et parvus' for aortic valve stenosis (AS) and 'bisferious pulse', 'diastolic reversal', 'zero diastole' and 'no dicrotic notch' for aortic valve regurgitation (AR). Predictive value of these Doppler flow characteristics was investigated using multivariate logistic regression models.</p><p><strong>Results: </strong>Of 1320 patients with complete examination of Doppler flow curves and TTE/TEE, 75 (5.7%) showed an AS and 482 (36.5%) showed an AR. Sixty-one (4.6%) patients at least showed a moderate-to-severe AS and 100 (7.6%) at least showed a moderate-to-severe AR. After adjustment for age, coronary artery disease, arterial hypertension, diabetes mellitus, smoking, peripheral arterial disease, renal failure and atrial fibrillation, the following flow pattern predicted aortic valve disease: 'pulsus tardus et parvus' in the CCA and ICA was highly predictive for a moderate-to-severe AS (OR 1158.5, 95% CI 364.2-3684.8, p < 0.001). 'No dicrotic notch' (OR 102.1, 95% CI 12.4-839.4, p < 0.001), a 'bisferious pulse' (OR 10.8, 95% CI 3.2-33.9, p < 0.001) and a 'diastolic reversal' (OR 15.4, 95% CI 3.2-74.6, p < 0.001) in the CCA and ICA predicted a moderate-to-severe AR. The inclusion of Doppler flow characteristics of the ECA did not increase predictive value.</p><p><strong>Conclusions: </strong>Well defined, qualitative Doppler flow characteristics detectable in the CCA and ICA are highly predictive for aortic valve disease. The consideration of these flow characteristics can be useful to streamline diagnostic and therapeutic measures, especially in the outpatient setting.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10247641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9954508","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}
引用次数: 0
Real-time Remote Expert-guided Echocardiography by Medical Students. 医学生实时远程专家引导超声心动图。
IF 3.4
Ultrasound Journal Pub Date : 2023-06-02 DOI: 10.1186/s13089-023-00328-3
Håvard Solvin, Matthias Lippert, Henrik Holmstrøm, Ole Jakob Elle, Henrik Brun
{"title":"Real-time Remote Expert-guided Echocardiography by Medical Students.","authors":"Håvard Solvin,&nbsp;Matthias Lippert,&nbsp;Henrik Holmstrøm,&nbsp;Ole Jakob Elle,&nbsp;Henrik Brun","doi":"10.1186/s13089-023-00328-3","DOIUrl":"https://doi.org/10.1186/s13089-023-00328-3","url":null,"abstract":"<p><strong>Background: </strong>Echocardiography is a highly specialised examination performed by experienced healthcare professionals. These experienced healthcare professionals may not be available to patients during all hours in rural healthcare facilities. Remote-guided echocardiography could improve the availability of specialised care for patients living in rural areas. This study examined the feasibility of real-time remote guidance for medical students to perform an echocardiographic assessment of the left side of the heart. Thirteen healthy volunteers were recruited for remote-guided echocardiography, which was performed by 13 medical students. Student examinations/images were compared to reference echocardiography. Measurements of left ventricular fractional shortening and mitral valve blood flow velocity were also compared. Furthermore, guidance through a smartphone videoconference was compared to designated remote guidance software.</p><p><strong>Results: </strong>Two-thirds of the images acquired by students were rated as medium or good quality and usable to evaluate two thirds of the cardiac structures. No significant bias was found for left ventricular fractional shortening. The measurements from the students' exams had a variation coefficient of 14.8% compared to the reference. The calculated deviation of the insonation angle was above 25° for both E and A-wave mitral valve blood flow velocity measurements. Images acquired by guidance through smartphone videoconference were of lower quality than those obtained using the designated remote guidance software.</p><p><strong>Conclusion: </strong>Real-time remote-guided echocardiography performed by medical students has limited value for clinical screening but could be useful for educational purposes.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10235836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9928992","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}
引用次数: 1
Ultrasound findings in Kaposi sarcoma patients: overlapping sonographic features with disseminated tuberculosis. 卡波西肉瘤患者的超声表现:弥散性结核的重叠声像图特征。
IF 3.4
Ultrasound Journal Pub Date : 2023-06-01 DOI: 10.1186/s13089-023-00323-8
Michaela Aurelia Maria Huson, Tapiwa Kumwenda, Joe Gumulira, Ethel Rambiki, Claudia Wallrauch, Tom Heller
{"title":"Ultrasound findings in Kaposi sarcoma patients: overlapping sonographic features with disseminated tuberculosis.","authors":"Michaela Aurelia Maria Huson,&nbsp;Tapiwa Kumwenda,&nbsp;Joe Gumulira,&nbsp;Ethel Rambiki,&nbsp;Claudia Wallrauch,&nbsp;Tom Heller","doi":"10.1186/s13089-023-00323-8","DOIUrl":"https://doi.org/10.1186/s13089-023-00323-8","url":null,"abstract":"<p><strong>Background: </strong>Focused Assessment with Sonography for HIV-associated TB (FASH) is a diagnostic tool for extra-pulmonary tuberculosis (TB) in symptomatic patients with advanced HIV. As Kaposi's sarcoma (KS) is also prevalent in this patient population, changes due to KS may mimic TB findings and clinical interpretation of target FASH findings can be challenging. We aimed to describe sonographic findings in patients with KS.</p><p><strong>Methods: </strong>We performed a prospective observational study at Lighthouse clinic at Kamuzu Central Hospital, Lilongwe, Malawi, in consecutive patients with newly diagnosed KS, without known diagnosis of TB, referred for paclitaxel treatment. All patients underwent FASH and abdominal ultrasound to assess for effusions and changes in liver and spleen, as well as systematic sonographic assessment for lymphadenopathy.</p><p><strong>Results: </strong>We included 30 patients. We found inguinal lymph nodes using ultrasound in 20 patients; in 3 (10%) additionally abdominal lymph nodes were found. Pathological effusions were seen in eight patients (27%): pericardial effusion in one (3%), pleural effusion in six (20%) and ascites in four (13%) patients. We found focal spleen lesions in three (10%) patients. Most of these lesions were echogenic, but in one patient, we saw hypoechoic lesions with an echogenic center. In three (10%) patients an unusual \"sponge-like pattern\" of the splenic vasculature was found. Six (20%) patients had echogenic focal lesions in the liver resembling hemangiomas, individual lesions showing a hypoechoic center. In two patients echogenic portal fields were seen.</p><p><strong>Conclusions: </strong>The majority of patients with newly diagnosed KS demonstrate sonographic features of disease, predominantly lymphadenopathy. Effusions were observed in a significant minority, as well as focal lesions in liver or spleen, which commonly resemble hemangiomas, but hypoechoic lesions were also observed and can easily be mistaken for extra-pulmonary TB. A 'sponge-like pattern' of the spleen should not be confused with micro-abscesses. In conclusion, this case series illustrates the diverse nature of ultrasound features in patients with KS, which can be difficult to distinguish from other opportunistic diseases, including TB.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10232376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9568749","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}
引用次数: 2
Ultrasound detected increase in optic disk height to identify elevated intracranial pressure: a systematic review. 超声检测视盘高度增加以识别颅内压升高:一项系统综述。
IF 3.4
Ultrasound Journal Pub Date : 2023-05-25 DOI: 10.1186/s13089-023-00324-7
Ghadi Ghanem, David Haase, Agatha Brzezinski, Rikke Ogawa, Parsa Asachi, Alan Chiem
{"title":"Ultrasound detected increase in optic disk height to identify elevated intracranial pressure: a systematic review.","authors":"Ghadi Ghanem, David Haase, Agatha Brzezinski, Rikke Ogawa, Parsa Asachi, Alan Chiem","doi":"10.1186/s13089-023-00324-7","DOIUrl":"10.1186/s13089-023-00324-7","url":null,"abstract":"<p><strong>Background: </strong>Elevated intracranial pressure (eICP) is a serious medical emergency that requires prompt identification and monitoring. The current gold standards of eICP detection require patient transportation, radiation, and can be invasive. Ocular ultrasound has emerged as a rapid, non-invasive, bedside tool to measure correlates of eICP. This systematic review seeks to explore the utility of ultrasound detected optic disc elevation (ODE) as an ultrasonographic finding of eICP and to study its sensitivity and specificity as a marker of eICP.</p><p><strong>Methods: </strong>This systematic review followed the preferred reporting items for systematic reviews and meta-analyses guidelines. We systematically searched PubMed, EMBASE, and Cochrane Central for English articles published before April 2023; yielding 1,919 total citations. After eliminating duplicates, and screening the records, we identified 29 articles that addressed ultrasonographically detected ODE.</p><p><strong>Results: </strong>The 29 articles included a total of 1249 adult and pediatric participants. In patients with papilledema, the mean ODE ranged between 0.6 mm and 1.2 mm. Proposed cutoff values for ODE ranged between 0.3 mm and 1 mm. The majority of studies reported a sensitivity between 70 and 90%, and specificity ranged from 69 to 100%, with a majority of studies reporting a specificity of 100%.</p><p><strong>Conclusions: </strong>ODE and ultrasonographic characteristics of the optic disc may aid in differentiating papilledema from other conditions. Further research on ODE elevation and its correlation with other ultrasonographic signs is warranted as a means to increase the diagnostic accuracy of ultrasound in the setting of eICP.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10212868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9901373","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}
引用次数: 0
Determinants of point-of-care ultrasound lung sliding amplitude in mechanically ventilated patients. 机械通气患者点护理超声肺滑动振幅的决定因素。
IF 3.4
Ultrasound Journal Pub Date : 2023-05-23 DOI: 10.1186/s13089-023-00326-5
David N Briganti, Christine E Choi, Julien Nguyen, Charles W Lanks
{"title":"Determinants of point-of-care ultrasound lung sliding amplitude in mechanically ventilated patients.","authors":"David N Briganti,&nbsp;Christine E Choi,&nbsp;Julien Nguyen,&nbsp;Charles W Lanks","doi":"10.1186/s13089-023-00326-5","DOIUrl":"https://doi.org/10.1186/s13089-023-00326-5","url":null,"abstract":"<p><strong>Background: </strong>Although lung sliding seen by point-of-care ultrasound (POCUS) is known to be affected to varying degrees by different physiologic and pathologic processes, it is typically only reported qualitatively in the critical care setting. Lung sliding amplitude quantitatively expresses the amount of pleural movement seen by POCUS but its determinants in mechanically ventilated patients are largely unknown.</p><p><strong>Methods: </strong>This was a single-center, prospective, observational pilot study examining 40 hemithoraces in 20 adult patients receiving mechanical ventilation. Each subject had lung sliding amplitude measured in both B-mode and by pulsed wave Doppler at their bilateral lung apices and bases. Differences in lung sliding amplitude were correlated with anatomical location (apex vs base) as well as physiologic parameters including positive end expiratory pressure (PEEP), driving pressure, tidal volume and the ratio of arterial partial pressure of oxygen (PaO<sub>2</sub>) to fraction of inspired oxygen (FiO<sub>2</sub>).</p><p><strong>Results: </strong>POCUS lung sliding amplitude was significantly lower at the lung apex compared to the lung base in both B-mode (3.6 ± 2.0 mm vs 8.6 ± 4.3 mm; p < 0.001) and the pulsed wave Doppler mode (10.3 ± 4.6 cm/s vs 13.9 ± 5.5 cm/s; p < 0.001) corresponding to expected distribution of ventilation to the lung bases. Inter-rater reliability of B-mode measurements was excellent (ICC = 0.91) and distance traversed in B-mode had a significant positive correlation with pleural line velocity (r<sup>2</sup> = 0.32; p < 0.001). There was a non-statistically significant trend towards lower lung sliding amplitude for PEEP ≥ 10 cmH<sub>2</sub>O, as well as for driving pressure ≥ 15 cmH<sub>2</sub>O in both ultrasound modes.</p><p><strong>Conclusion: </strong>POCUS lung sliding amplitude was significantly lower at the lung apex than the lung base in mechanically ventilated patients. This was true when using both B-mode and pulsed wave Doppler. Lung sliding amplitude did not correlate with PEEP, driving pressure, tidal volume or PaO<sub>2</sub>:FiO<sub>2</sub> ratio. Our findings suggest that lung sliding amplitude can be quantified in mechanically ventilated patients in a physiologically predictable way and with high inter-rater reliability. A better understanding of POCUS derived lung sliding amplitude and its determinants may aid in the more accurate diagnosis of lung pathologies, including pneumothorax, and could serve as a means of further reducing radiation exposure and improving outcomes in critically ill patients.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10203658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9526162","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}
引用次数: 0
Femoral vein pulsatility: a simple tool for venous congestion assessment. 股静脉搏动:静脉充血评估的简单工具。
IF 3.4
Ultrasound Journal Pub Date : 2023-05-10 DOI: 10.1186/s13089-023-00321-w
V Bhardwaj, P Rola, A Denault, G Vikneswaran, R Spiegel
{"title":"Femoral vein pulsatility: a simple tool for venous congestion assessment.","authors":"V Bhardwaj,&nbsp;P Rola,&nbsp;A Denault,&nbsp;G Vikneswaran,&nbsp;R Spiegel","doi":"10.1186/s13089-023-00321-w","DOIUrl":"https://doi.org/10.1186/s13089-023-00321-w","url":null,"abstract":"<p><strong>Background: </strong>Femoral vein Doppler (FVD) is simpler than the VExUS score which is a multimodal scoring system based on combination of IVC diameter, hepatic venous Doppler, portal vein pulsatility and renal vein Doppler, may be useful in assessing right ventricular overload and signs of venous congestion. There is limited data on the relationship between FVD and VExUS score.</p><p><strong>Results: </strong>Adult post-cardiac surgery patients were assessed for venous congestion using the VExUS score and FVD. Agreement between VExUS and FVD was studied using Kappa test, sensitivity, specificity, PPV and NPV for VExUS and FVD was calculated keeping CVP as gold standard. In total, 107 patients were enrolled, with a mean age of 55.67 ± 12.76. The accuracy of VExUS and FVD for detecting venous congestion was 80.37 (95% CI of 71.5 to 87.4) and 74.7 (95% CI of 65.4 to 82.6), respectively. The level of agreement between FVD and VExUS was moderate (Kappa value of 0.62, P < 0.001) while the agreement between FVD and CVP was weak (Kappa value of 0.49, P < 0.001).</p><p><strong>Conclusion: </strong>FVD has good accuracy for detecting venous congestion and shows moderate agreement with VExUS grading. With potentially easier physical accessibility and a shorter learning curve for novices, it may be a simple and valuable tool for assessing venous congestion.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9821338","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}
引用次数: 4
Airway ultrasound to detect subglottic secretion above endotracheal tube cuff. 气道超声检测气管内管袖口上方声门下分泌物。
IF 3.4
Ultrasound Journal Pub Date : 2023-05-06 DOI: 10.1186/s13089-023-00318-5
Osman Adi, Chan Pei Fong, Roslanuddin Mohd Sallehuddin, Azma Haryaty Ahmad, Kok Meng Sum, Zulrushdi Md Yusof, Gabriele Via, Guido Tavazzi
{"title":"Airway ultrasound to detect subglottic secretion above endotracheal tube cuff.","authors":"Osman Adi,&nbsp;Chan Pei Fong,&nbsp;Roslanuddin Mohd Sallehuddin,&nbsp;Azma Haryaty Ahmad,&nbsp;Kok Meng Sum,&nbsp;Zulrushdi Md Yusof,&nbsp;Gabriele Via,&nbsp;Guido Tavazzi","doi":"10.1186/s13089-023-00318-5","DOIUrl":"https://doi.org/10.1186/s13089-023-00318-5","url":null,"abstract":"<p><strong>Background: </strong>Subglottic secretion had been proven as one of the causes of microaspiration and increased risk of ventilator-associated pneumonia (VAP). The role of ultrasound to detect subglottic secretion has not yet been established.</p><p><strong>Purpose: </strong>The purpose of this study is to determine the sensitivity and specificity of upper airway ultrasound (US) in the detection of subglottic secretions as compared to computed tomography (CT) scanning.</p><p><strong>Material and methods: </strong>A prospective observational study was carried out in adult trauma patients requiring mechanical ventilation and cervical CT scan. All patients had an endotracheal tube cuff-pressure maintained between 20 and 30 cm H<sub>2</sub>O. Airway US was performed at the bedside immediately before the patient was transferred to the CT scan suite. The sensitivity, specificity, and positive/negative predictive values (PPV, NPV) of the upper airway US detection of subglottic secretions were then calculated and compared with CT findings.</p><p><strong>Results: </strong>Fifty participants were consecutively included. Subglottic secretions were detected in 31 patients using upper airway US. The sensitivity and specificity of upper airway US in detecting subglottic secretion were 96.7% and 90%, respectively (PPV 93.5%, NPV 94.7%). 18 (58%) patients with subglottic secretions developed VAP during their ICU stay (p = 0.01). The area under the receiver operating curve (AUROC) was 0.977 (95% CI 0.936-1.00).</p><p><strong>Conclusions: </strong>Upper airway US is a useful tool for detecting subglottic secretions with high sensitivity and specificity.</p><p><strong>Clinical implications: </strong>This study shows: 1. Upper airway US may aid in detecting subglottic secretions, which are linked to VAP. 2. Detecting subglottic secretions at the bedside aids in determining the best frequency of subglottic aspiration to clean the subglottic trachea. 3. Upper airway US may also aid in detecting the correct ETT position. Trial registration Clinicaltrials.gov.</p><p><strong>Clinicaltrials: </strong>gov identifier NCT04739878 Date of registration 2nd May 2021 URL of trial registry record https://clinicaltrials.gov/ct2/show/NCT04739878 .</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10164205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9782414","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}
引用次数: 1
Intra-and inter-observer variability of point of care ultrasound measurements to evaluate hemodynamic parameters in healthy volunteers. 观察点超声测量评估健康志愿者血液动力学参数的内部和内部变异性。
IF 3.4
Ultrasound Journal Pub Date : 2023-05-05 DOI: 10.1186/s13089-023-00322-9
Deborah Blanca, Esther C Schwarz, Tycho Joan Olgers, Ewoud Ter Avest, Nasim Azizi, Hjalmar R Bouma, Jan Cornelis Ter Maaten
{"title":"Intra-and inter-observer variability of point of care ultrasound measurements to evaluate hemodynamic parameters in healthy volunteers.","authors":"Deborah Blanca,&nbsp;Esther C Schwarz,&nbsp;Tycho Joan Olgers,&nbsp;Ewoud Ter Avest,&nbsp;Nasim Azizi,&nbsp;Hjalmar R Bouma,&nbsp;Jan Cornelis Ter Maaten","doi":"10.1186/s13089-023-00322-9","DOIUrl":"https://doi.org/10.1186/s13089-023-00322-9","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care ultrasound (POCUS) is a valuable tool for assessing the hemodynamic status of acute patients. Even though POCUS often uses a qualitative approach, quantitative measurements have potential advantages in evaluating hemodynamic status. Several quantitative ultrasound parameters can be used to assess the hemodynamic status and cardiac function. However, only limited data on the feasibility and reliability of the quantitative hemodynamic measurements in the point-of-care setting are available. This study investigated the intra- and inter-observer variability of PoCUS measurements of quantitative hemodynamic parameters in healthy volunteers.</p><p><strong>Methods: </strong>In this prospective observational study, three sonographers performed three repeated measurements of eight different hemodynamic parameters in healthy subjects. An expert panel of two experienced sonographers evaluated the images' quality. The repeatability (intra-observer variability) was determined by calculating the coefficient of variation (CV) between the separate measurements for each observer. The reproducibility (inter-observer variability) was assessed by determining the intra-class correlation coefficient (ICC).</p><p><strong>Results: </strong>32 subjects were included in this study, on whom, in total, 1502 images were obtained for analysis. All parameters were in a normal physiological range. Stroke volume (SV), cardiac output (CO), and inferior vena cava diameter (IVC-D) showed high repeatability (CV under 10%) and substantial reproducibility (ICC 0.61-0.80). The other parameters had only moderate repeatability and reproducibility.</p><p><strong>Conclusions: </strong>We demonstrated good inter-observer reproducibility and good intra-observer repeatability for CO, SV and IVC-D taken in healthy subjects by emergency care physicians.</p>","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10163179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9417668","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}
引用次数: 1
Correction: Empowering the willing: the feasibility of tele-mentored self-performed pleural ultrasound assessment for the surveillance of lung health. 纠正:赋予意愿:远程指导自我胸膜超声评估监测肺部健康的可行性。
IF 3.4
Ultrasound Journal Pub Date : 2023-05-04 DOI: 10.1186/s13089-023-00316-7
Andrew W Kirkpatrick, Jessica L McKee, Chad G Ball, Irene W Y Ma, Lawrence A Melniker
{"title":"Correction: Empowering the willing: the feasibility of tele-mentored self-performed pleural ultrasound assessment for the surveillance of lung health.","authors":"Andrew W Kirkpatrick,&nbsp;Jessica L McKee,&nbsp;Chad G Ball,&nbsp;Irene W Y Ma,&nbsp;Lawrence A Melniker","doi":"10.1186/s13089-023-00316-7","DOIUrl":"https://doi.org/10.1186/s13089-023-00316-7","url":null,"abstract":"","PeriodicalId":36911,"journal":{"name":"Ultrasound Journal","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10160331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9407175","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}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信