Critical Ultrasound Journal最新文献

{"title":"Ultrasonography in trauma: a nation-wide cross-sectional investigation.","authors":"Jesper Weile,&nbsp;Klaus Nielsen,&nbsp;Stine C Primdahl,&nbsp;Christian A Frederiksen,&nbsp;Christian B Laursen,&nbsp;Erik Sloth,&nbsp;Hans Kirkegaard","doi":"10.1186/s13089-017-0071-2","DOIUrl":"https://doi.org/10.1186/s13089-017-0071-2","url":null,"abstract":"<p><strong>Background: </strong>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 Trauma Life Support (ATLS) protocol. No guidelines exist as to the use of ultrasonography in trauma in Denmark. We aimed to determine the current use of ultrasonography for assessing trauma patients in Denmark.</p><p><strong>Methods: </strong>We conducted a nation-wide cross-sectional investigation of ultrasonography usage in trauma care. The first phase consisted of an Internet-based investigation of existing guidelines, and the second phase was a series of structured interviews of orthopedic surgeons, anesthesiologists, and radiologists on call in all hospitals receiving traumatized patients in Denmark.</p><p><strong>Results: </strong>Guidelines were obtained from all 22 hospitals receiving traumatized patients in Denmark. Twenty-one (95.5%) of the guidelines included and recommended FAST as part of trauma assessment. The recommended person to perform the examination was the radiologist in n = 11 (50.0%), the surgeon in n = 6 (27.3%), the anesthesiologist in n = 1 (4.5%), and unspecified in n = 3 (13.6%) facilities. FAST indications varied between circulatory instability n = 8 (36.4%), team leader's discretion n = 6 (27.3%), abdominal trauma n = 3 (13.6%), and not specified n = 6 (27.3%). Telephone interviews revealed that exams were always n = 8 (36.4%) or often n = 4 (18.2%) registered in the patients' charts. The remaining n = 10 (45.5%) facilities either never registered n = 2 (9.1%), it was not possible to register n = 1 (4.5%), or unknown by the trauma leaders n = 7 (31.8%). Images were often stored in n = 1 (4.5%), never stored in n = 10 (45.5%), not possible to store in n = 2 (9.1%), and unknown in n = 9 (40.9%) facilities.</p><p><strong>Conclusion: </strong>Ultrasonography was used in a non-uniform fashion by multiple specialties in Danish trauma facilities. Very few images from FAST examinations were stored and documentation was scanty. National guidelines on application and documentation of ultrasonography in trauma are called for.</p>","PeriodicalId":46598,"journal":{"name":"Critical Ultrasound Journal","volume":"9 1","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13089-017-0071-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35109237","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":"Systematic review and meta-analysis for the use of ultrasound versus radiology in diagnosing of pneumonia.","authors":"Saeed Ali Alzahrani,&nbsp;Majid Abdulatief Al-Salamah,&nbsp;Wedad Hussain Al-Madani,&nbsp;Mahmoud A Elbarbary","doi":"10.1186/s13089-017-0059-y","DOIUrl":"https://doi.org/10.1186/s13089-017-0059-y","url":null,"abstract":"<p><strong>Background: </strong>Physicians are increasingly using point of care lung ultrasound (LUS) for diagnosing pneumonia, especially in critical situations as it represents relatively easy and immediately available tool. They also used it in many associated pathological conditions such as consolidation, pleural effusion, and interstitial syndrome with some reports of more accuracy than chest X-ray. This systematic review and meta-analysis are aimed to estimate the pooled diagnostic accuracy of ultrasound for the diagnosis of pneumonia versus the standard chest radiological imaging.</p><p><strong>Methods and main results: </strong>A systematic literature search was conducted for all published studies comparing the diagnostic accuracy of LUS against a reference Chest radiological exam (C X-ray or Chest computed Tomography CT scan), combined with clinical criteria for pneumonia in all age groups. Eligible studies were required to have a Chest X-ray and/or CT scan at the time of clinical evaluation. The authors extracted qualitative and quantitative information from eligible studies, and calculated pooled sensitivity and specificity and pooled positive/negative likelihood ratios (LR). Twenty studies containing 2513 subjects were included in this meta-analysis. The pooled estimates for lung ultrasound in the diagnosis of pneumonia were, respectively, as follows: Overall pooled sensitivity and specificity for diagnosis of pneumonia by lung ultrasound were 0.85 (0.84-0.87) and 0.93 (0.92-0.95), respectively. Overall pooled positive and negative LRs were 11.05 (3.76-32.50) and 0.08 (0.04-0.15), pooled diagnostic Odds ratio was 173.64 (38.79-777.35), and area under the pooled ROC (AUC for SROC) was 0.978.</p><p><strong>Conclusion: </strong>Point of care lung ultrasound is an accurate tool for the diagnosis of pneumonia. Considering being easy, readily availability, low cost, and free from radiological hazards, it can be considered as important diagnostic strategy in this condition.</p>","PeriodicalId":46598,"journal":{"name":"Critical Ultrasound Journal","volume":"9 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13089-017-0059-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34770427","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":"Transesophageal echocardiography in orthotopic liver transplantation: a comprehensive intraoperative monitoring tool.","authors":"Luigi Vetrugno, Federico Barbariol, Umberto Baccarani, Francesco Forfori, Giovanni Volpicelli, Giorgio Della Rocca","doi":"10.1186/s13089-017-0067-y","DOIUrl":"10.1186/s13089-017-0067-y","url":null,"abstract":"<p><p>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 undergoing liver transplantation. The American Association for the Study of Liver Diseases states that transesophageal echocardiography should be used in all liver transplant candidates in order to assess chamber sizes, hypertrophy, systolic and diastolic function, valvular function, and left ventricle outflow tract obstruction. However, intraoperative transesophageal echocardiography can be used to \"visualize\" other organs too; thanks to its proximity and access to multiple acoustic windows: liver, lung, spleen, and kidney. Although only limited scientific evidence exists promoting this comprehensive use, we describe the feasibility of TEE in the setting of liver transplantation: it is a highly valuable tool, not only as a cardiovascular monitoring, but also as a tool to evaluate lungs and pleural spaces, to assess hepatic vein blood flow and inferior vena cava anastomosis and patency, i.e., in cases of modified surgical techniques. The aim of this case series is to add our own experience of TEE as a comprehensive intraoperative monitoring tool in the field of orthotopic liver transplantation (and major liver resection) to the literature.</p>","PeriodicalId":46598,"journal":{"name":"Critical Ultrasound Journal","volume":"9 1","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35104506","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":"Correlation of carotid blood flow and corrected carotid flow time with invasive cardiac output measurements.","authors":"Irene W Y Ma,&nbsp;Joshua D Caplin,&nbsp;Aftab Azad,&nbsp;Christina Wilson,&nbsp;Michael A Fifer,&nbsp;Aranya Bagchi,&nbsp;Andrew S Liteplo,&nbsp;Vicki E Noble","doi":"10.1186/s13089-017-0065-0","DOIUrl":"https://doi.org/10.1186/s13089-017-0065-0","url":null,"abstract":"<p><strong>Background: </strong>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 blood flow) and their correlations with invasive reference measurements of cardiac output. Consenting adult patients (n = 51) at Massachusetts General Hospital cardiac catheterization laboratory undergoing right heart catheterization between February and April 2016 were included. Carotid ultrasound images were obtained concurrently with cardiac output measurements, obtained by the thermodilution method in the absence of severe tricuspid regurgitation and by the Fick oxygen method otherwise. Corrected carotid flow time was calculated as systole time/√cycle time. Carotid blood flow was calculated as π × (carotid diameter)²/4 × velocity time integral × heart rate. Measurements were obtained using a single carotid waveform and an average of three carotid waveforms for both measures.</p><p><strong>Results: </strong>Single waveform measurements of corrected flow time did not correlate with cardiac output (ρ = 0.25, 95% CI -0.03 to 0.49, p = 0.08), but an average of three waveforms correlated significantly, although weakly (ρ = 0.29, 95% CI 0.02-0.53, p = 0.046). Carotid blood flow measurements correlated moderately with cardiac output regardless of if single waveform or an average of three waveforms were used: ρ = 0.44, 95% CI 0.18-0.63, p = 0.004, and ρ = 0.41, 95% CI 0.16-0.62, p = 0.004, respectively.</p><p><strong>Conclusions: </strong>Carotid blood flow may be a better marker of cardiac output and less subject to measurements issues than corrected carotid flow time.</p>","PeriodicalId":46598,"journal":{"name":"Critical Ultrasound Journal","volume":"9 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13089-017-0065-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34930907","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":"Applicability of a modified EFAST protocol (r-EFAST) to evaluate hemodynamically unstable patients after percutaneous cardiac intervention.","authors":"José Luis Vázquez Martínez,&nbsp;Kary Leonisa Quiñones Coneo,&nbsp;Tomas Villen Villegas,&nbsp;María Sánchez Porras,&nbsp;Cesar Pérez-Caballero Macarrón,&nbsp;Ana Coca Pérez,&nbsp;Luis Fernandez Pineda","doi":"10.1186/s13089-017-0070-3","DOIUrl":"https://doi.org/10.1186/s13089-017-0070-3","url":null,"abstract":"<p><p>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 will attempt to explore a modified approach involving a focused examination on the retroperitoneal (r-EFAST). We have provided examples of 3 cases where r-EFAST was used to detect retroperitoneal bleeding in critical situations.</p>","PeriodicalId":46598,"journal":{"name":"Critical Ultrasound Journal","volume":"9 1","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13089-017-0070-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35083337","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":"Minimal training sufficient to diagnose pediatric wrist fractures with ultrasound.","authors":"Henrik Hedelin,&nbsp;Christian Tingström,&nbsp;Hanna Hebelka,&nbsp;Jon Karlsson","doi":"10.1186/s13089-017-0066-z","DOIUrl":"https://doi.org/10.1186/s13089-017-0066-z","url":null,"abstract":"<p><strong>Background: </strong>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 if radiographs are needed could improve patient flow and decrease unnecessary radiographs. The aim of this study was to evaluate the role of ultrasound (US) as a point-of-care triage tool for pediatric wrist injuries with limited training.</p><p><strong>Methods: </strong>Physicians with no previous US experience attended a 1.5 h course in the use of US to diagnose distal radius fractures at the Emergency Department (ED). The physicians firstly used US to diagnose a potential fracture and, if the patient had a fracture, grouped the patient according to how they wanted him/her to be treated based on US. The physician then interpreted the subsequent radiographs and decided on a treatment based on this information. Consultant traumatologists and a senior radiologist established a gold standard for correct treatment and radiological diagnosis, respectively.</p><p><strong>Results: </strong>One hundred and sixteen injuries in 115 patients were included. The ED physician identified 75 fractures on radiographs. With the exception of a minimal buckle fracture, all were identified on US. US had a tendency to interpret complete fractures on radiographs as incomplete (n = 7) leading to incorrect treatment decisions.</p><p><strong>Conclusions: </strong>In the hands of an US novice, US examination is comparable with radiographs as a point-of-care tool to distinguish a fractured wrist from a non-fractured one. US is not, however, as good as radiographs for placing fractured wrists into the correct treatment group.</p><p><strong>Level of evidence: </strong>Level III. Diagnostic study of non-consecutive patients.</p>","PeriodicalId":46598,"journal":{"name":"Critical Ultrasound Journal","volume":"9 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13089-017-0066-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34978314","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":"The Assessment of Competency in Thoracic Sonography (ACTS) scale: validation of a tool for point-of-care ultrasound.","authors":"Scott J Millington,&nbsp;Robert T Arntfield,&nbsp;Robert Jie Guo,&nbsp;Seth Koenig,&nbsp;Pierre Kory,&nbsp;Vicki Noble,&nbsp;Haney Mallemat,&nbsp;Jordan R Schoenherr","doi":"10.1186/s13089-017-0081-0","DOIUrl":"https://doi.org/10.1186/s13089-017-0081-0","url":null,"abstract":"<p><strong>Background: </strong>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 tested a rating scale to assess the quality of point-of-care thoracic ultrasound studies performed by novices. In Phase 1, the Assessment of Competency in Thoracic Sonography (ACTS) scale was developed based on structured interviews with subject matter experts. The tool was then piloted on a small series of ultrasound studies in Phase 2. In Phase 3 the tool was applied to a sample of 150 POCUS studies performed by ten learners; performance was then assessed by two independent raters.</p><p><strong>Results: </strong>Evidence for the content validity of the ACTS scale was provided by a consensus exercise wherein experts agreed on the general principles and specific items that make up the scale. The tool demonstrated reasonable inter-rater reliability despite minimal requirements for evaluator training and displayed evidence of good internal structure, with related scale items correlating well with each other. Analysis of the aggregate learning curves suggested a rapid early improvement in learner performance with slower improvement after approximately 25-30 studies.</p><p><strong>Conclusions: </strong>The ACTS scale provides a straightforward means to assess learner performance. Our results support the conclusion that the tool is an effective means of making valid judgments regarding competency in point-of-care thoracic ultrasound, and that the majority of learner improvement occurs during their first 25-30 practice studies.</p>","PeriodicalId":46598,"journal":{"name":"Critical Ultrasound Journal","volume":"9 1","pages":"25"},"PeriodicalIF":0.0,"publicationDate":"2017-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13089-017-0081-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35579090","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":"Management of cardiopulmonary assist devices in critically ill patients using point-of-care transthoracic echocardiography: a case series.","authors":"Babar Fiza,&nbsp;Michael Tang,&nbsp;Michael Maile","doi":"10.1186/s13089-017-0080-1","DOIUrl":"https://doi.org/10.1186/s13089-017-0080-1","url":null,"abstract":"<p><p>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 critically ill patients requiring cardiopulmonary mechanical device support remains to be well described. In this case series, we present two case reports where point-of-care echocardiography was successfully used by the intensive care team in diagnosing and managing problems related to cardiopulmonary assist device malposition.</p>","PeriodicalId":46598,"journal":{"name":"Critical Ultrasound Journal","volume":"9 1","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2017-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13089-017-0080-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35571563","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":"Evaluation of a short formation on the performance of point-of-care renal ultrasound performed by physicians without previous ultrasound skills: prospective observational study.","authors":"François Javaudin,&nbsp;François Mounier,&nbsp;Philippe Pes,&nbsp;Idriss Arnaudet,&nbsp;Frédéric Vignaud,&nbsp;Eric Frampas,&nbsp;Philippe Le Conte","doi":"10.1186/s13089-017-0078-8","DOIUrl":"https://doi.org/10.1186/s13089-017-0078-8","url":null,"abstract":"<p><strong>Background: </strong>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 debated. We investigate performance of a brief training session for the detection of hydronephrosis with PoCUS performed by EP without previous ultrasound experience.</p><p><strong>Patients and methods: </strong>This was a prospective observational study of a convenience sample of patients older than 18 years with presumed renal colic, acute pyelonephritis or documented acute renal failure. Exclusion criteria were pregnancy and documented end of life.After inclusion and informed consent, a PoCUS was performed. A radiologist's renal ultrasound (RRUS) was then conducted, the radiologist being blind to PoCUS result.The objective was to determine the diagnostic performance of PoCUS performed by EP for the detection of hydronephrosis using RRUS as gold standard.</p><p><strong>Results: </strong>Six EP participated in this study. 55 patients were included, five secondary excluded for lack of RRUS. Age was 47 ± 22 years, sex ratio 1. Hydronephrosis prevalence was 38% (CI 95% [26-52%]). Sensitivity of PoCUS was 100% (CI 95% [82-100%]) while its specificity was 71% (CI 95% [52-86%]) with a NPV of 100% (CI 95% [85-100%]) and a 68% (CI 95% [48-84%]) PPV. Kappa coefficient was 0.65 (CI 95% [0.45-0.85]).</p><p><strong>Discussion: </strong>We demonstrated that a short training program enables EP without previous ultrasound skills to rule out hydronephrosis with satisfactory performances. The main limitation was the absence of collection of the number of PoCUS by EP. After this didactic course, an experiential phase must be carried out.</p>","PeriodicalId":46598,"journal":{"name":"Critical Ultrasound Journal","volume":"9 1","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"2017-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13089-017-0078-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35541106","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":"Postural lung recruitment assessed by lung ultrasound in mechanically ventilated children.","authors":"Gerardo Tusman,&nbsp;Cecilia M Acosta,&nbsp;Stephan H Böhm,&nbsp;Andreas D Waldmann,&nbsp;Carlos Ferrando,&nbsp;Manuel Perez Marquez,&nbsp;Fernando Suarez Sipmann","doi":"10.1186/s13089-017-0073-0","DOIUrl":"https://doi.org/10.1186/s13089-017-0073-0","url":null,"abstract":"<p><strong>Background: </strong>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 individualized lung recruitment maneuvers lead to satisfactory therapeutic results. In this short communication, we demonstrate by lung ultrasound images (LUS) the effect of a postural recruitment maneuver (P-RM, i.e., a ventilatory strategy aimed at reaerating atelectasis by changing body position under constant ventilation).</p><p><strong>Results: </strong>Data was collected in the operating room of the Hospital Privado de Comunidad, Mar del Plata, Argentina. Three anesthetized children undergoing mechanical ventilation at constant settings were sequentially subjected to the following two maneuvers: (1) PEEP trial in the supine position PEEP was increased to 10 cmH₂O for 3 min and then decreased to back to baseline. (2) P-RM patient position was changed from supine to the left and then to the right lateral position for 90 s each before returning to supine. The total P-RM procedure took approximately 3 min. LUS in the supine position showed similar atelectasis before and after the PEEP trial. Contrarily, atelectasis disappeared in the non-dependent lung when patients were placed in the lateral positions. Both lungs remained atelectasis free even after returning to the supine position.</p><p><strong>Conclusions: </strong>We provide LUS images that illustrate the concept and effects of postural recruitment in children. This maneuver has the advantage of achieving recruitment effects without the need to elevate airways pressures.</p>","PeriodicalId":46598,"journal":{"name":"Critical Ultrasound Journal","volume":"9 1","pages":"22"},"PeriodicalIF":0.0,"publicationDate":"2017-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13089-017-0073-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35512255","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}