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Am J Perinatol 2022 Jun 12. Epub 2022 Jun 12.

Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California.

Objective:  In the adult and pediatric critical care population, point-of-care ultrasound (POCUS) can aid in diagnosis, patient management, and procedural accuracy. For neonatal providers, training in ultrasound and the use of ultrasound for diagnosis and management is increasing, but use in the neonatal intensive care unit (NICU) is still uncommon compared with other critical care fields. Our objective was to describe the process of implementing a POCUS program in a large academic NICU and evaluate the role of ultrasound in neonatal care during early adaption of this program. Read More

BMC Pulm Med 2022 Mar 31;22(1):118. Epub 2022 Mar 31.

Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China.

Background: Noncardiogenic pulmonary edema (NCPE) is a rare and life-threatening allergy-like reaction to the intravascular injection of a nonionic radiographic agent. We first describe a very rare case of fatal NCPE after the intravenous injection of nonionic, iso-osmolar iodine contrast media. Case presentation A 55-year-old male patient was admitted to the hospital with esophageal cancer. Read More

Clin Hemorheol Microcirc 2022 ;81(3):233-240

Emergency Medicine Unit, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy.

Objective: This study aims to evaluate the bedside use of the pocket-sized ultrasound (US) device for the detection of the intracavitary effusions.

Methods: We randomly enrolled 40 patients admitted to S. Andrea Hospital of Rome. Read More

Air Med J 2022 Jan-Feb;41(1):151-157. Epub 2021 Oct 4.

Aerospace and Sub-Aquatic Medical Faculty, Aja University of Medical Sciences, Tehran, Iran. Electronic address:

A 41-year-old male farmer was injured in a land mine explosion. After initial resuscitation, the emergency physician coordinated with the hospital and air medical crew for the patient's evacuation. The evacuation was started by a Bell 214C helicopter, and the patient's clinical condition deteriorated during flight with increased abdominal pain and distension, tachycardia, tachypnea, hypotension, and loss of consciousness. Read More

G Ital Nefrol 2022 Feb 16;39(1). Epub 2022 Feb 16.

Dipartimento di Medicina, Università di Verona; UO Nefrologia e Dialisi, Ospedale Pederzoli, Peschiera del Garda, Verona, Italia.

Ascites is a pathological accumulation of fluid in the peritoneal cavity due to various etiologies, often associated with renal failure. Paracentesis is a simple method of removing ascitic fluid by inserting a needle into the peritoneal cavity, often performed at the patient's bedside. It can be both diagnostic and therapeutic. Read More

Surgery 2022 05 31;171(5):1406-1411. Epub 2022 Jan 31.

Department of Surgery, Komaki City Hospital, Komaki, Japan.

Background: Postoperative acute kidney injury after digestive surgery can be a critical problem that causes morbidity or mortality. Although serum creatinine reflects the renal function, it takes time to measure, and only severe renal failure induces an increase in creatinine. We tried to calculate the renal artery pulsatility index as a parameter to enable the real-time monitoring of acute kidney injury, which can be measured by routine bedside ultrasonography. Read More

Medicine (Baltimore) 2021 Dec;100(48):e27971

Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

Abstract: Intussusception is common among children at the pediatric emergency department (ED) with acute abdomen. Diagnosis and treatment delay remain a challenge. This study aimed to evaluate the impact of intussusception clinical pathways (CPs) implementation, including bedside point-of-care ultrasonography, on patient management in a pediatric ED. Read More

Rofo 2022 05 28;194(5):521-531. Epub 2021 Dec 28.

Abteilung für Diagnostische und Interventionelle Radiologie, University Ulm Medical Centre, Ulm, Germany.

Sonography is the most common imaging modality in childhood and adolescence. The rapid availability, absence of X-rays, bedside applicability, e. g. Read More

Cureus 2021 Jul 28;13(7):e16699. Epub 2021 Jul 28.

Emergency Medicine, Trinity West Medical Center, Steubenville, USA.

Here, we report a case of hereditary hyperhomocysteinemia presenting as dilated cardiomyopathy which was successfully diagnosed using a combination of point-of-care ultrasonography (POCUS) and echocardiogram (ECHO). A 39-year-old Caucasian male with a family history of homocystinuria and early deaths in adult male members from cardiovascular disease presented with complaints of purplish discoloration and 4/10 pain in bilateral feet along with severe nausea/vomiting for the last two days. Physical examination was significant for tachycardia, low normal mean arterial pressures, dry mucous membranes, right basilar crepitations, S3 gallop with holosystolic murmur along with peripheral cyanosis, and pitting edema. Read More

Eur J Pediatr 2022 Jan 5;181(1):393-398. Epub 2021 Jul 5.

Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris Saclay University Hospitals, APHP, 157 rue de la Porte de Trivaux, 92140, Clamart, Paris, France.

Rapid diagnosis of sudden, unexpected, and potentially fatal complications in the neonatal intensive care unit (NICU) is essential for the initiation of prompt and life-saving management. Point-of-care ultrasound (POCUS) protocols are widely used in adult emergency situations to diagnose and guide treatment, but none has been specifically developed for the neonate. We propose a targeted diagnostic ultrasound protocol for the suddenly decompensating infant in the NICU for rapid screening for the most common life-threatening complications needing immediate attention. Read More

Am J Case Rep 2021 Jun 17;22:e930967. Epub 2021 Jun 17.

Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.

BACKGROUND A rectal foreign body (RFB) can be stigmatizing for patients and present a dilemma for the treating physician. Removal can be challenging owing to the variety of objects introduced. The goals of therapy are to safely remove the RFB and to minimize injury to the bowel. Read More

Indian J Gastroenterol 2021 Jun 21;40(3):326-332. Epub 2021 May 21.

Department of Surgical Gastroenterology, Post Graduate Institute of Medical Education and Research , Sector 12, Chandigarh, 160 012, India.

Background: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in acute pancreatitis (AP) are associated with development and worsening of organ failures and poor prognosis. Limited studies suggest that contrast-enhanced computed tomography (CECT) can predict the presence of IAH/ACS. We aimed to study clinical profile of patients with AP and IAH and identify predictive factors of IAH on CECT abdomen. Read More

J Clin Monit Comput 2021 08 20;35(4):923-929. Epub 2021 Apr 20.

Department of Intensive Care, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey.

This study aimed to evaluate the relationship between ultrasonographic gastric antral measurements and aspirated gastric residual volume (GRV) in mechanically ventilated critically ill patients receiving enteral nutrition (EN). This prospective observational study included 56 enterally-fed critically ill patients in one-year period. All imaging procedures were done at 30-degree head-of-bed elevation and supine position on epigastric region of abdomen with 2. Read More

Am J Case Rep 2021 Apr 17;22:e928889. Epub 2021 Apr 17.

5G Law Firm, PLLC, Woodward, OK, USA.

BACKGROUND We report the case of a patient undergoing a colonoscopy during which pressure applied on the abdomen by a nurse assisting in the procedure caused an extraluminal mesenteric tear. Mesenteric tears can be life-threating and need to be managed appropriately. This is the first case reported in the literature describing abdominal counter-pressure applied in the endoscopic procedure room as the cause of traumatic bowel injury. Read More

Pediatr Emerg Care 2021 Apr;37(4):226-229

From the Children's Emergency, KK Women's and Children's Hospital, Singapore.

Background: Tuberculosis of the abdomen is one of the most common extrapulmonary manifestations of tuberculosis. Even in areas where tuberculosis is endemic, intra-abdominal tuberculous can pose a diagnostic and management challenge because of the lack of presence of overt clinical signs and availability of expertise for point of care diagnostics. Point-of-care ultrasound (POCUS) of the abdomen performed by emergency physicians is increasingly being used for a variety of clinical presentations to facilitate accurate diagnoses in the emergency department. Read More

AJR Am J Roentgenol 2021 05 11;216(5):1392-1399. Epub 2021 Mar 11.

Instituto de Radiologia (InRad), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av Dr. Enéas Carvalho de Aguiar, 255, Sao Paulo, Brazil 05403-000.

Yellow fever is a hemorrhagic disease caused by an arbovirus endemic in South America; outbreaks have occurred in recent years. The purpose of this study was to describe abdominal ultrasound findings in patients with severe yellow fever and correlate them with clinical and laboratory data. A retrospective cohort study was performed between January and April 2018. Read More

Chest 2021 06 2;159(6):2366-2372. Epub 2021 Feb 2.

Department of Clinical and Experimental Medicine, Insubria University, Varese, Italy.

Background: Chest radiography is universally accepted as the method of choice to confirm correct positioning of a nasogastric tube (NGT). Considering also that radiation exposure could increase with multiple insertions in a single patient, bedside abdominal ultrasound (BAU) may be a potentially useful alternative to chest radiography in the management of NGTs.

Research Question: What is the accuracy of BAU in confirming the correct positioning of an NGT?

Study Design And Methods: After a specific course consisting of 10 h of training, the authors studied, in a prospective multicenter cohort, the validity of BAU to confirm correct NGT placement. Read More

Can J Anaesth 2021 Mar 24;68(3):376-386. Epub 2020 Nov 24.

Department of Anesthesia, University of Western Ontario, London, ON, Canada.

Point-of-care ultrasound (POCUS) uses ultrasound at the bedside to aid decision-making in acute clinical scenarios. The increased use of ultrasound for regional anesthesia and vascular cannulation, together with more anesthesiologists trained in transesophageal echocardiography have contributed to the widespread use of POCUS in perioperative care. Despite the support of international experts, the practice of POCUS in perioperative care is variable as Canadian guidelines for anesthesiologists do not currently exist. Read More

J Korean Med Sci 2020 Oct 12;35(39):e327. Epub 2020 Oct 12.

Department of Anesthesiology and Pain Medicine, Ewha Womans University, School of Medicine, Seoul, Korea.

Background: Protective mechanical ventilation using low tidal volume has been introduced to surgical patients to reduce the incidence of postoperative pulmonary complications. We investigated the effects of protective ventilation (PV) techniques on anesthesia-induced atelectasis identified via lung ultrasonography in patients undergoing abdominal surgery.

Methods: A total of 42 adult patients who were scheduled for open abdominal surgery with an expected duration > 2 hours were included in the study. Read More

Ultraschall Med 2020 Aug 4;41(4):362-386. Epub 2020 Aug 4.

Internal Medicine, Luigi Sacco University Hospital, Milano, Italy.

As the availability of portable echocardiographic equipment is becoming more and more widespread, physicians can add a powerful tool to their bedside examination skills, thus helping them to more effectively face the growing complexity of patients admitted to internal medicine departments or the emergency room. Focused cardiac ultrasound (FoCUS) can be defined as a goal-directed, simplified, qualitative examination performed at the bedside using portable echocardiographic devices. FoCUS is not meant to be a substitute for a standard 2D color Doppler echocardiographic examination. Read More

Rev Recent Clin Trials 2020;15(4):269-277

Department of Anesthesiology and Emergency Sciences-Emergency Medicine Division, Policlinico Gemelli/IRCCSUniversity of Catholic of Sacred Heart, Rome, Italy.

Background: In the last years, ultrasound technology has entered clinical practice as a tank and today, it has also allowed no-cardiologists to extend their medical examination without needing to call the consultant and having a good profile of diagnostic accuracy. The ultrasound bedside does not replace the consultant, but it allows not to perform inappropriate consultations with more savings for hospitals.

Objective: The aim was to review the recently published literature to inform the clinician about the most up to date management of use bedside echography in the emergency setting. Read More

Mil Med 2020 12;185(11-12):2171-2172

Department of Family Medicine, Mike O'Callaghan Military Medical Center, Nellis Air Force Base, 4700 N Las Vegas Blvd, Las Vegas, NV 89191.

We report a case of acute urinary retention in an adolescent female secondary to hematocolpos. A 13-year-old female presented to the emergency department with acute urinary retention and suprapubic abdominal pain for 24 hours. She denied menstruation or sexual history. Read More

Cureus 2020 Jun 8;12(6):e8503. Epub 2020 Jun 8.

Emergency Medicine, Hospital Corporation of America West Florida Graduate Medical Education Consortium/Brandon Regional Hospital, University of South Florida Morsani College of Medicine, Brandon, USA.

Prompt and accurate diagnostic evaluation of the nontraumatic acute abdomen in the emergency department (ED) is crucial to lessen mortality burden. In patients with perforated viscus and pneumoperitoneum, point-of-care ultrasound (POCUS) can assist the emergency physician (EP) in the rapid bedside diagnosis. This report describes a case in which EP-performed POCUS led to the early detection and timely management of an atypical presentation of pneumoperitoneum. Read More

J Bras Nefrol 2021 Jul-Sep;43(3):445-449

Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil.

Point-of-Care Ultrasound (POCUS) has been gaining momentum as an extension to physical examination in several specialties. In nephrology, POCUS has generally been used in a restricted way in urinary tract evaluation. We report the case of a patient with nephrotic syndrome secondary to amyloidosis, previously diagnosed by renal biopsy, who was oligosymptomatic when seen the an outpatient clinic, where the POCUS, focused on the heart, lung and abdomen, revealed anasarca, pulmonary congestion and cardiac changes suggestive of cardiac amyloidosis. Read More

Clin Hemorheol Microcirc 2020 ;75(1):19-26

Institute of Biotechnology, Brandenburg University of Technology, Senftenberg, Germany.

Aim: Use of contrast enhanced ultrasound (CEUS) in severe cases of COVID-19 infection to assess pulmonary changes near the pleura.

Material And Methods: Bedside examinations by an experienced intensive care unit examiner using a multi-frequency probe (C1-6 MHz) with B-mode and CEUS to assess pleural-near changes in severe cases of COVID-19 infection with respiratory failure. CEUS with bolus delivery via a central venous catheter of 2. Read More

J Ultrasound 2020 Jun 2;23(2):175-181. Epub 2020 May 2.

Interventional Ultrasound Unit, Pineta Grande Hospital, SS Domitiana, KM 30,00, 81030, Castel Volturno, CE, Italy.

Purpose: To assess the role of intracavitary contrast-enhanced ultrasound (IC-CEUS) as a focused ultrasound (US) examination aimed at supporting a single physician in the management of interventional procedures for abdominal fluid collections/abscesses.

Methods: In 43 patients (27 M/16 F, median age 68 years, range 35-91), a single physician performed catheter drainage (42) or needle aspiration (3) for the following: 14 infected abdominal fluid collections, 11 non-infected abdominal fluid collections, 9 pyogenic liver abscesses, 8 gallbladder empyema, and 3 infected pancreatic fluid collections. IC-CEUS (0. Read More

Intern Emerg Med 2021 Jan 1;16(1):171-181. Epub 2020 May 1.

Department of Emergency Medicine, Careggi University Hospital, Largo Brambilla, 3, 50134, Firenze, Italy.

Acute aortic syndromes (AASs) are deadly cardiovascular emergencies involving the thoracic aorta. AASs are relatively rare conditions, have unspecific signs and symptoms (including truncal pain, syncope, neurologic deficit and limb ischemia) and require contrast-enhanced tomography angiography (CTA) of the chest and abdomen for conclusive diagnosis and subsequent therapeutic planning. In the Emergency Department (ED), most patients with potential signs/symptoms of AASs are finally found affected by other alternative diagnoses. Read More

Clin Hemorheol Microcirc 2020 ;74(4):353-361

Institute of Biotechnology, Brandenburg University of Technology, Senftenberg, Germany.

In the hands of experienced examiners, the contrast enhanced sonography (CEUS) offers the possibility to analyze dynamic microcirculatory disturbances in real time dynamically without any risk for kidneys and thyroid gland even in severe progressing disease bedside. Based on severe COVID-19 infections, first experiences with abdominal CEUS examinations are presented. In the stage of an imminent organ failure with significantly reduced kidney and liver function, CEUS can be used to show a narrowing of the organ-supplying arteries, as well as a delayed capillary filling of vessels near the capsule, a regional reduced parenchymal perfusion or an inflammatory hyperemia with capillary hypercirculation. Read More

JPEN J Parenter Enteral Nutr 2021 01 15;45(1):136-145. Epub 2020 Apr 15.

Nutrition Department, Alfred Health, Melbourne, Australia.

Introduction: The development of bedside methods to assess muscularity is an essential critical care nutrition research priority. We aimed to compare ultrasound-derived muscle thickness at 5 landmarks with computed tomography (CT) muscle area at intensive care unit (ICU) admission. Secondary aims were to (1) combine muscle thicknesses and baseline covariates to evaluate correlation with CT muscle area and (2) assess the ability of the best-performing ultrasound model to identify patients with low CT muscle area. Read More