POCUS journal最新文献_第8页

Evaluation Of Congestion Levels in Septic Patients Admitted to Critical Care Units with a Combined Venous Excess-Lung Ultrasound Score (VExLUS) - a Research Protocol. 用静脉过度-肺超声联合评分(VExLUS)评估重症监护病房脓毒症患者的充血水平——一项研究方案。

POCUS journal Pub Date : 2023-01-01 DOI: 10.24908/pocus.v8i1.16188

Miguel Romano, Eduardo Viana, José Diogo Martins, Rogério Corga Da Silva

{"title":"Evaluation Of Congestion Levels in Septic Patients Admitted to Critical Care Units with a Combined Venous Excess-Lung Ultrasound Score (VExLUS) - a Research Protocol.","authors":"Miguel Romano, Eduardo Viana, José Diogo Martins, Rogério Corga Da Silva","doi":"10.24908/pocus.v8i1.16188","DOIUrl":"https://doi.org/10.24908/pocus.v8i1.16188","url":null,"abstract":"Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection with a high mortality rate. Septic shock is a subset of sepsis with manifest circulatory dysfunction (use of vasopressors and persistent elevation of lactic acid) . As stated in literature, in addition to the use of empiric antibiotics and control of the infectious focus, intravenous fluid therapy is an essential intervention to promote hemodynamic stabilization. However, the literature also describes harmful outcomes related to fluid overload. Hemodynamic management in critically ill patients has traditionally focused on maintaining adequate cardiac output and arterial blood pressure by relying on fluid administration and/or vasopressor/inotropic support. However, organ perfusion is affected by other important factors, such as venous pressure, which can be overlooked. The evaluation of lung congestion with point of care ultrasound (POCUS), as a signal of extravascular fluid, and, more recently, a venous excess Doppler ultrasound (VExUS) grading system, are parameters for the assessment of the fluid status of the patient and organ congestion. Our main hypothesis is that adding a modified lung ultrasound score to the VExUS protocol could provide higher sensitivity and earlier identification of fluid overload, guiding the clinician in the decision of fluid administration in patients with sepsis.","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9783527","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

Book Review 书评

POCUS journal Pub Date : 2022-11-21 DOI: 10.24908/pocus.v7i2.15765

D. Restrepo

引用次数: 0

Ultrasound-Guided Nerve Blocks: Suggested Procedural Guidelines for Emergency Physicians. 超声引导下的神经阻滞：急诊医生建议程序指南》。

POCUS journal Pub Date : 2022-11-21 eCollection Date: 2022-01-01 DOI: 10.24908/pocus.v7i2.15233

Joseph R Brown, Andrew J Goldsmith, Alexis Lapietra, Jose L Zeballos, Kamen V Vlassakov, Alexander B Stone, R Starr Knight, Jennifer Carnell, Arun Nagdev

引用次数: 0

Incidentalomas Among Healthy Nephrology Fellow Volunteers at POCUS Workshops: A Case Series. POCUS研讨会上健康肾脏学志愿者中的偶发瘤:一个病例系列。

POCUS journal Pub Date : 2022-01-01 DOI: 10.24908/pocus.v7iKidney.14997

Ira Blau, Behdad Besharatian, Nathaniel Reisinger

引用次数: 0

A Point-of-Care Ultrasound Rotation for Medical Education Fellows in Emergency Medicine. 急诊医学医学教育研究员的护理点超声轮转。

POCUS journal Pub Date : 2022-01-01 DOI: 10.24908/pocus.v7i1.14745

Alanna O'Connell, Al'ai Alvarez, Peter Tomaselli, Arthur Au, Dimitrios Papanagnou, Resa E Lewiss

引用次数: 0

Impact of Point-of-Care Ultrasound in Medical Decision Making: Informing the Development of an Internal Medicine Global Health POCUS Curriculum. 护理点超声在医疗决策中的影响:告知内科全球健康POCUS课程的发展。

POCUS journal Pub Date : 2022-01-01 DOI: 10.24908/pocus.v7i1.15620

Michelle Fleshner, Steve Fox, Thomas Robertson, Ayako Wendy Fujita, Divya Bhamidipati, Thuy Bui

{"title":"Impact of Point-of-Care Ultrasound in Medical Decision Making: Informing the Development of an Internal Medicine Global Health POCUS Curriculum.","authors":"Michelle Fleshner, Steve Fox, Thomas Robertson, Ayako Wendy Fujita, Divya Bhamidipati, Thuy Bui","doi":"10.24908/pocus.v7i1.15620","DOIUrl":"https://doi.org/10.24908/pocus.v7i1.15620","url":null,"abstract":"Abstract Background: Point-of-care Ultrasound (POCUS) is particularly useful in low-middle income countries (LMICs) where advanced imaging modalities and diagnostics are often unavailable. However, its use among Internal Medicine (IM) practitioners is limited and without standard curricula. This study describes POCUS scans performed by U.S. IM residents rotating in LMICs to provide recommendations for curriculum development. Methods: IM residents within a global health track performed clinically-indicated POCUS scans at two sites. They logged their interpretations and whether or not the scan changed diagnosis or management. Scans were quality-assured by POCUS experts in the US to validate results. Using the criteria of prevalence, ease of learning, and impact, a framework was developed for a POCUS curriculum for IM practitioners within LMICs. Results: A total of 256 studies were included in analysis. 237 (92.5%) answered the clinical question, 107 (41.8%) changed the diagnosis, and 106 (41.4%) changed management. The most frequently used applications were the Focused Assessment for Sonography for HIV associated TB (FASH) exam, finding fluid (pericardial effusion, pleural effusion, ascites), qualitative assessment of left ventricular function, and assessment for A-lines/B-lines/consolidation. The following scans met ease of learning criteria: FASH-basic, assessment of LV function, A-lines vs. B-lines, and finding fluid. Finding fluid and assessment of LV function changed diagnosis and management most frequently, greater than 50% of the time for each category. Discussion/Conclusion: We recommend the following applications as highest yield for inclusion in a POCUS curriculum for IM practitioners within LMICs: finding fluid (pericardial effusion, pleural effusion, ascites) and assessment of gross LV function.","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9979946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9180352","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

Point-of-Care Ultrasound for the Diagnosis of Colon Cancer. 即时超声诊断结肠癌。

POCUS journal Pub Date : 2022-01-01 DOI: 10.24908/pocus.v7i2.15657

Weihao Chen, Readon Teh, Absar Qurishi

引用次数: 0

The Role of Point-of-Care Ultrasound in Pilonidal Sinus Disease. 即时超声在毛窦疾病中的作用。

POCUS journal Pub Date : 2022-01-01 DOI: 10.24908/pocus.v7i2.15543

Hadiel Kaiyasah, Lamis Abufool, Labib Al Ozaibi

引用次数: 0

Point of Care Ultrasound in Monitoring of Post-Renal Biopsy Bleeding. 超声在肾活检后出血监测中的应用。

POCUS journal Pub Date : 2022-01-01 DOI: 10.24908/pocus.v7iKidney.14988

Natalie N McCall, Anna Burgner

引用次数: 0

Recovery of Severe Acute Kidney Injury in a Patient with COVID-19: Role of Lung Ultrasonography. 1例COVID-19重症急性肾损伤患者的康复:肺部超声检查的作用。

POCUS journal Pub Date : 2022-01-01 DOI: 10.24908/pocus.v7iKidney.15343

Varun Madireddy, Daniel W Ross, Deepa A Malieckal, Shamir Hasan, Azzour Hazzan, Hitesh H Shah

{"title":"Recovery of Severe Acute Kidney Injury in a Patient with COVID-19: Role of Lung Ultrasonography.","authors":"Varun Madireddy, Daniel W Ross, Deepa A Malieckal, Shamir Hasan, Azzour Hazzan, Hitesh H Shah","doi":"10.24908/pocus.v7iKidney.15343","DOIUrl":"https://doi.org/10.24908/pocus.v7iKidney.15343","url":null,"abstract":"Acute kidney injury (AKI) is recognized as a complication of COVID-19 among hospitalized patients. Lung ultrasonography (LUS) can be a useful tool in the management of COVID-19 pneumonia when interpreted correctly. However, the role of LUS in management of severe AKI in the setting of COVID-19 remains to be defined. We report a 61-year-old male who was hospitalized with acute respiratory failure from COVID-19 pneumonia. In addition to requiring invasive mechanical ventilation, our patient developed AKI and severe hyperkalemia requiring urgent dialytic therapy during his hospital stay. Our patient remained dialysis dependent despite subsequent recovery of lung function. Three days following discontinuation of mechanical ventilation, our patient developed a hypotensive episode during his maintenance hemodialysis treatment. A point of care LUS performed soon after the intradialytic hypotensive episode found no extravascular lung water. Hemodialysis was discontinued and the patient was initiated on intravenous fluids for one week. AKI subsequently resolved. We consider LUS an important tool in identifying COVID-19 patients that would benefit from intravenous fluids following recovery of lung function.","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9994289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9088028","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