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proLékaře.cz / Journals / Internal Medicine / 2019 - 3

Importance of ultrasound examination in diagnosing acute conditions

Czech version

Authors: Martin Balík
Authors‘ workplace: Klinika anesteziologie, resuscitace a intenzivní medicíny 1.
Published in: Vnitř Lék 2019; 65(3): 177-186
Category:

Overview

Availability of an ultrasound device at the critical care setting significantly enhances possible diagnostic ways and makes the management of critically ill patients more effective. Growing amount of papers confirms that qualified intensivists with background in medicine and anaesthesiology may provide accurate, safe and extensive diagnosis of the haemodynamic system with the aid of echocardiography. Examination of lungs, pleural space, quantification of pleural fluid and eventual exclusion of ventral pneumothorax should be an integral part of transtoracic echocardiographic examination. Interrogation of abdomen in sepsis of unknown origin, acute abdominal syndrome or in acute renal failure may direct further diagnostic and therapeutic steps in critically ill patient. Time factor is particularly important in shock and during admission of severe trauma where patient´s survival depends on correctly launched diagnostic algorithm. Ultrasound plays a key role here. Interrogation with ultrasound helps also before performing a percutanneous dilatational tracheostomy. The same technique may locate a vessel before cannulation in high risk patient and avoid potential complication and also unnecessary transfusion of platelets. Ultrasound has an established role in exploration of vessels in perfusion disorders and suspected deep venous thrombosis. Transcranial Doppler ultrasonography is an important aid in diagnostics of cerebral blood flow particularly in subarachnoid bleeding and intracranial hypertension. The cost of multimodal ultrasonic device is substantial however, the device may save a life of a patient and save time, complications and costs for the department in the hands of a skilled intensivist.

Keywords:

echocardiography – transcranial Doppler ultrasonography – trauma

Sources

  1. Balík M. Echokardiografie u kriticky nemocného. Anesteziologie a intenzivní medicína 2006; 17(2): 116–122.

  2. Colreavy FB, Donovan K, Lee KY et al. Transesophageal echocardiography in critically ill patients. Crit Care Med 2002; 30(5): 989–996.

  3. Poelaert J, Trouerbach J, De Buyzere M et al. Evaluation of Transesophageal Echocardiography as a Diagnostic and Therapeutic Aid in a Critical Care Setting. Chest 1995; 107(3): 774–779.

  4. Benjamin E, Griffin K, Leibowitz AB et al. Goal-directed Transesophageal echocardiography performed by intensivists to assess left ventricular function: comparison with pulmonary artery catheterization. J Cardiothorac Vasc Anesth 1998; 12(1): 10–15.

  5. Balík M, Pažout J, Fric M et al. Echokardiografie jako součást managementu hemodynamiky v intenzivní péči. Anesteziologie a neodkladná péče 2001; 12(3): 120–124.

  6. Vincent JL, Dhainaut JF, Petrret C et al. Is the pulmonary artery catheter misused? A European view. Crit Care Med 1998; 26(7): 1283–1287.

  7. Cholley B, Mayo P, Poelaert J et al. [Expert Round Table on Ultrasound in ICU]. International expert statement on training standards for critical care ultrasonography. Intensive Care Med 2011; 37(7): 1077–1083. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134–011–2246–9>.

  8. Vieillard-Baron A, Mayo PH, Vignon P et al. International consensus statement on training standards for advanced critical care echocardiography. Intensive Care Med 2014; 40(5): 654–666. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134–014–3228–5>.

  9. Lichtenstein D, Lascols N, Meziere G et al. Ultrasound diagnosis of alveolar consolidation in critically ill. Intensive Care Med 2004; 30(2): 276–281. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134–003–2075–6>.

  10. Lichtenstein D, Menu Y. A bedside ultrasound sign ruling out pneumothorax in the critically ill: lung sliding. Chest 1995; 108(5): 1345–1348.

  11. Balik M, Plasil P, Waldauf P et al. Ultrasound estimation of volume of pleural fluid in mechanically ventilated patients. Intensive Care Med 2006; 32(2): 318. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134–005–0024–2>.

  12. Sahn SA. Pleural disease in critically Ill patient. In: Irwin RS, Cerra FB, Rippe JM (eds). Intensive Care Medicine. Lippincott Raven: Philadelphia 1999: 710–727.

  13. Coppage L, Jolles H, Henry DA. Imaging of the chest in the intensive care setting. In: Shoemaker WC, Ayres SM, Grenvik A et al (eds). Textbook of critical care. Saunders: Philadelphia 1995: 332–347.

  14. Eibenberger KL, Dock WI, Ammann ME et al. Quantification of pleural effusions: sonography versus radiography. Radiology 1994; 191(3): 681–684. Dostupné z DOI: <http://dx.doi.org/10.1148/radiology.191.3.8184046>.

  15. Mayo PH, Goltz HR, Tafreshi M et al. Safety of Ultrasound-Guided Thoracentesis in Patients Receiving Mechanical Ventilation. Chest 2004; 125(3): 1059–1062.

  16. Jones PW, Moyers JP, Rogers JT et al. Ultrasound-Guided Thoracentesis 2003. Is It a Safer Method? Chest 2003; 123(2): 418–423.

  17. Fartoukh M, Azoulay E, Galliot R et al. Clinically Documented Pleural Effusions in Medical ICU Patients. How Useful Is Routine Thoracentesis? Chest 2002; 121(1): 178–184.

  18. Barterr T. The Evaluation of Pleural Effusion. Chest 1994; 106(4): 1209–1214. Erratum in Chest 1995; 107(2): 592.

  19. Lichtenstein D, Hulot JS, Rabiller A et al. Feasibility and safety of ultrasound-aided thoracentesis in mechanically ventilated patients. Intensive Care Med 1999; 25(9): 955–958.

  20. Gattinoni L, Vagginelli F, Chiumello D et al. Physiologic rationale for ventilator setting in acute lung injury/acute respiratory distress syndrome patients. Crit Care Med 2003; 31(4 Suppl): S300-S304. Dostupné z DOI: <http://dx.doi.org/10.1097/01.CCM.0000057907.46502.7B>.

  21. Ahmed SH, Ouzounian SP, Dirusso S et al. Hemodynamic and Pulmonary Changes after Drainage of Significant Pleural Effusions in Critically Ill, Mechanically Ventilated Surgical Patients. J Trauma 2004; 57(6): 1184–1188.

  22. Talmor M, Hydo L, Gershenwald JG et al. Beneficial effects of chest tube drainage of pleural effusion in acute respiratory failure refractory to PEEP ventilation. Surgery 1998; 123(2): 137–143.

  23. Vignon P, Chastagner C, Berkane V et al. Quantitative assessment of pleural effusion in critically ill patients by means of ultrasonography. Crit Care Med 2005; 33(8): 1757–1763.

  24. Roch A, Bojan M, Michelet P et al. Usefulness of Ultrasonography in Predicting Pleural Effusions > 500 ml in Patients Receiving Mechanical Ventilation. Chest 2005; 127(1): 224–232. Dostupné z DOI: <http://dx.doi.org/10.1378/chest.127.1.224>.

  25. Peris A, Tutino L, Balik M et al. The use of point-of-care bedside lung ultrasound significantly reduces the number of radiographs and computed tomography scans in critically ill patients. Anesth Analg 2010; 111(3): 687–692. Dostupné z DOI: <http://dx.doi.org/10.1213/ANE.0b013e3181e7cc42>.

  26. Tocino IM, Miller MH, Fairfax WR. Distribution of pneumothorax in the supine and semirecumbent critically ill adult. Am J Roentgenol 1985; 144(5): 901–905. Dostupné z DOI: <http://dx.doi.org/10.2214/ajr.144.5.901>.

  27. McGonigal MD, Schwab CW, Kauder DR et al. Supplemented emergent chest CT in the management of blunt torso trauma. J Trauma 1990; 30(12): 1431–1435.

  28. Lichtenstein D, Meziere G, Biderman R et al. The „lung point“: an ultrasound sign specific to pneumothorax. Intensive Care Med 2000; 26(10): 1434–1440.

  29. Volpicelli G, Elbarbary M, Blaivas M et al. International Liaison Committee on Lung Ultrasound for International Consensus Conference on Lung Ultrasound (2012) International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 2012; 38(4): 577–591. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134–012–2513–4>.

  30. Tsubo T, Yatsu Y, Suzuki A et al. Daily changes of the area of density in the dependent lung region – evaluation using transesophageal echocardiography. Intensive Care Med 2001; 27(12): 1881–1886. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134–001–1115–3>.

  31. Lichtenstein D, Meziere G, Biderman R et al. The comet-tail artifact: an ultrasound sign of alveolar-intersticial syndrome. Am J Respir Crit Care Med 1997; 156(5): 1640–1646. Dostupné z DOI: <http://dx.doi.org/10.1164/ajrccm.156.5.96–07096>.

  32. Lichtenstein D, Meziere G. Ultrasound diagnosis of an acute dyspnea. Crit Care 2003; 7(Suppl 2): P189. Dostupné z DOI: <http://dx.doi.org/10.1186/cc2078>.

  33. Bouhemad B, Brisson H, Le-Guen M et al. Bedside ultrasound assessment of positive end-expiratory pressure-induced lung recruitment. Am J Respir Crit Care Med 2011; 183(3): 341–347. Dostupné z DOI: <http://dx.doi.org/10.1164/rccm.201003–0369OC>.

  34. Matamis D, Soilemezi E, Tsagourias M et al. Sonographic evaluation of the diaphragm in critically ill patients. Technique and clinical applications. Intensive Care Med 2013; 39(5): 801–810. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134–013–2823–1>.

  35. Chen SC, Yen ZS, Wang HP et al. Ultrasonography is superior to plain radiography in the diagnosis of pneumoperitoneum. Br J Surg 2002; 89(3): 351–354. Dostupné z DOI: <http://dx.doi.org/10.1046/j.0007–1323.2001.02013.x>.

  36. Chen SC, Wang HP, Chen WJ et al. Selective use of ultrasonography for the detection of pneumoperitoneum. Acad Emerg Med 2002; 9(6): 643–645.

  37. Ralls PW, Colletti PM, Lapin SA et al. Realtime sonography in suspected acute cholecystitis: Prospective evaluation of primary and secondary signs. Radiology 1985; 155(3): 767–771. Dostupné z DOI: <http://dx.doi.org/10.1148/radiology.155.3.3890007>.

  38. Kadir S. Teaching Atlas of Interventional Radiology: Non-Vascular Interventional Procedures. Thieme: New York 2006. ISBN 978–1588900562.

  39. Malecka-Panas E, Juszynski A, Chrzastek J et al. Pancreatic fluid collections: Diagnostic and therapeutic implications of percutaneous drainage guided by ultrasound. Hepatogastroenterology 1998; 45(21): 873–878.

  40. Platt JF. Doppler ultrasound of the kidney. Semin Ultrasound CT MR 1997; 18(1): 22–26.

  41. Sugrue M, Jones F, Deane SA et al. Intraabdominal hypertension is an independent cause of postoperative renal impairment. Arch Surg 1999; 134(10): 1082–1085.

  42. Kirkpatrick AW, Colistro R, Fox DL et al. Renal arterial resistive index response to intra-abdominal hypertension in a porcine model. Crit Care Med 2007; 35(1): 207–2013.

  43. Maio RF, Burney RE, Gregor MA et al. A study of preventable trauma mortality in rural Michigan. J Trauma 1996; 41(1): 83–90.

  44. Papadopoulous IN, Bukis D, Karalas E et al. Preventable prehospital trauma deaths in a Hellenic urban health region: An audit of prehospital trauma care. J Trauma 1996; 41(5): 864–869.

  45. Esposito TJ, Sanddal ND, Hansen JD et al. Analysis of preventable trauma deaths and inappropriate trauma care in a rural state. J Trauma 1995; 39(5): 955–962.

  46. Scalea TM, Rodriguez A, Chiu WC et al. Focused assessment with sonography for trauma (FAST): Results from an international consensus conference. J Trauma 1999; 46(3): 466–472.

  47. Wherrett LJ, Boulanger BR, McLellan BA et al. Hypotension after blunt abdominal trauma: The role of emergent abdominal sonography in surgical triage. J Trauma 1996; 41(5): 815–820.

  48. Sustic A, Zupan Z, Esskinja N et al. Ultrasonography guided percutaneous tracheostomy with dilatation forceps after anterior cervical spine fixation. Acta Anaesthesiol Scand 1999; 43(10): 1078–1080.

  49. Bleck TP. Rebleeding and vasospasm after SAH: New strategies for improving outcome. J Crit Illn 1997; 12: 572–582.

  50. Seiler R, Grolimund P, Huber P. Transcranial Doppler sonography: An alternative to angiography in the evaluation of vasospasm after subarachnoid hemorrhage. Acta Radiol Suppl 1986; 369: 99–102.

  51. Lindegaard KF, Nornes H, Bakke SJ et al. Cerebral vasospasm diagnosis by means of angiography and blood velocity measurements. Acta Neurochir (Wien) 1989; 100(1–2): 12–24.

  52. Aaslid R, Markwalder TM, Nornes H. Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. J Neurosurg 1982; 57(6): 769–774. Dostupné z DOI: <http://dx.doi.org/10.3171/jns.1982.57.6.0769>.

  53. Steiner LA, Balestreri M, Johnston AJ et al. Sustained moderate reductions in arterial CO2 after brain trauma time-course of cerebral blood flow velocity and intracranial pressure. Intensive Care Med 2004; 30(12): 2180–2187. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134–004–2463–6>.

  54. Lee JH, Kelly DF, Oertel M et al. Carbon dioxide reactivity, pressure autoregulation, and metabolic suppression reactivity after head injury: A transcranial Doppler study. J Neurosurg 2001; 95(2): 222–232. Dostupné z DOI: <http://dx.doi.org/10.3171/jns.2001.95.2.0222>.

  55. Dosemeci L, Dora B, Yilmaz M et al. Utility of transcranial Doppler ultrasonography for confirmatory diagnosis of brain death: Two sides of the coin. Transplantation 2004; 77(1): 71–75. Dostupné z DOI: <http://dx.doi.org/10.1097/01.TP.0000092305.00155.72>.

  56. Blaivas M. Ultrasound in the detection of venous thromboembolism. Crit Care Med 2007; 35(5 Suppl): S224–S234.

  57. Maecken T, Grau T. Ultrasound imaging in vascular access. Crit Care Med 2007; 35(5 Suppl): S178-S185.

  58. Randolph A, Cook D, Gonzales C et al. Ultrasound guidance for placement of central venous catheters: A meta-analysis of the literature. Crit Care Med 1996; 24(12): 2053–2058.

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