BLUE-Protocol and FALLS-Protocol: Two Applications of Lung Ultrasound in the Critically Ill.

BLUE-Protocol and FALLS-Protocol: Two Applications of Lung Ultrasound in the Critically Ill. Chest. 2015 Jun 1;147(6):1659-70 Authors: Lichtenstein DA Abstract This review article describes two protocols adapted from lung ultrasound: the bedside lung ultrasound in emergency (BLUE)-protocol for the immediate diagnosis of acute respiratory failure and the fluid administration limited by lung sonography (FALLS)-protocol for the management of acute circulatory failure. These applications require the mastery of 10 signs indicating normal lung surface (bat sign, lung sliding, A-lines), pleural effusions (quad and sinusoid sign), lung consolidations (fractal and tissue-like sign), interstitial syndrome (lung rockets), and pneumothorax (stratosphere sign and the lung point). These signs have been assessed in adults, with diagnostic accuracies ranging from 90% to 100%, allowing consideration of ultrasound as a reasonable bedside gold standard. In the BLUE-protocol, profiles have been designed for the main diseases (pneumonia, congestive heart failure, COPD, asthma, pulmonary embolism, pneumothorax), with an accuracy > 90%. In the FALLS-protocol, the change from A-lines to lung rockets appears at a threshold of 18 mm Hg of pulmonary artery occlusion pressure, providing a direct biomarker of clinical volemia. The FALLS-protocol sequentially rules out obstructive, then cardiogenic, then hypovolemic shock for expediting the diagnosis of distributive (usually septi...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research

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Publication date: Available online 14 September 2019Source: Journal of Cardiology CasesAuthor(s): Toshio Kimura, Yoshiharu Nishibori, Kojiro Miki, Katsunao Tanaka, Koichi Fujita, Masanori Takada, Takao Maruyama, Masaharu IshiharaAbstractEndovascular therapy (EVT) has been accepted as a minimally invasive treatment for peripheral artery disease, and its applicability has been widened with the development of techniques and devices. A long, totally occluded lesion in the superficial femoral artery (SFA) is one of the most challenging lesions for EVT due to technical difficulties in wire-crossing. Recently, intentional subinti...
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research
Conclusions: Women with deep invasive endometriosis who underwent IVF do not seem to be exposed to a substantially increased risk of recurrence/disease progression. Larger evidence from independent groups is however required for a definitive conclusion. PMID: 31517304 [PubMed]
Source: Reproductive Biology - Category: Reproduction Medicine Authors: Tags: Eur J Obstet Gynecol Reprod Biol X Source Type: research
michowski P Abstract A simple, rapid and efficient methodology was developed for the extraction and determination of heterocyclic aromatic amines (HAAs) in cigarette and forest fire ash samples based on a novel Ultrasound-Assisted Dispersive Solid-liquid Microextraction (UA-DSLME) coupled to polyurethane foam (PUF) mini-column as a clean-up strategy and on-line determination by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The optimal working conditions were found by (i) application of two-level full factorial designs and (ii) implementation of a response surface methodology based on the second-order ...
Source: Talanta - Category: Chemistry Authors: Tags: Talanta Source Type: research
Authors: Rodriguez AE, Restrepo MI Abstract INTRODUCTION: Aspiration pneumonia is a subclass of community-acquired pneumonia that is expected to have an increasing contribution in mortality and morbidity, particularly in the elderly population over the next coming decades. While studies have revealed significant progress in identifying risk factors for aspiration pneumonia, the clinical presentation and diagnosis remains challenging to healthcare providers. Areas Covered: We conducted a broad literature review using the MeSH heading in PubMed/MEDLINE of "aspiration pneumonia" from January 1970 to July 201...
Source: Expert Review of Clinical Pharmacology - Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research
THE HIGH COST OF LOW VALUE CARE. Trans Am Clin Climatol Assoc. 2019;130:60-70 Authors: McGinn T, Cohen S, Khan S, Richardson S, Oppenheim M, Wang J Abstract The main focus of this study is bridging the "evidence gap" between frontline decision-making in health care and the actual evidence, with the hope of reducing unnecessary diagnostic testing and treatments. From our work in pulmonary embolism (PE) and over ordering of computed tomography pulmonary angiography, we integrated the highly validated Wells' criteria into the electronic health record at two of our major academic tertiary hospita...
Source: Transactions of the American Clinical and Climatological Association - Category: General Medicine Tags: Trans Am Clin Climatol Assoc Source Type: research
Conclusions: Multiple mechanisms may contribute to WRF in acute decompensated heart failure, and prognosis will differ according to etiology, patient features, and treatment strategies. During hospitalization, treatment should focus on the patient's clinical status, resolution of symptoms and signs of congestion rather than temporary changes in renal function. PMID: 31516163 [PubMed - in process]
Source: Transactions of the American Clinical and Climatological Association - Category: General Medicine Tags: Trans Am Clin Climatol Assoc Source Type: research
This study considers a mathematical framework for analyzing the behavior of ultrasonic waves’ nonlinearities due to load-induced cracks with loaded interfaces in concrete materials. The proposed framework uses phase-space domain that is essential in chaos analysis, which is the main contribution of the following article. To verify chaotic behavior, three mathematical tools are exploited. First, Poincaré map is used to verify aperiodic behavior of ultrasonic waves in phase-space domain. Next, Recurrence plot as well as recurrence quantification analysis are performed to verify deterministic behavior of ultrasou...
Source: Journal of Sound and Vibration - Category: Physics Source Type: research
In this study, ultrasound-assisted extraction of flavonoid from Crinum asiaticum was studied through response surface methodology (RSM) to gain the best extraction process of flavonoid and enhance the extraction rate of flavonoid. In the following RSM experiment, we selected the corresponding data of every factor as the center point through the single-factor experiments, then the experimental data was subjected to multiple regression analysis. According to the statistical analysis results, the results were consistent with the polynomial regression model, the determination coefficient (R2) was 0.9769. The best conditions fo...
Source: Saudi Journal of Biological Sciences - Category: Biology Source Type: research
CONCLUSIONS Testing at maximum dorsiflexion provided improved reliability when using UTC in healthy individuals. The ICC at 100% dorsiflexion was increased, and the MDC was reduced for all echotypes. Therefore, standardizing test positions when using UTC is advisable for reliable comparison of results between studies. PMID: 31516131 [PubMed - in process]
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
Authors: Chu C, Yi X, Sun J, Zhang X, Liu S, Zhang N, Wang J Abstract Anesthetic effects and safety of dexmedetomidine and tramadol, respectively, combined with propofol in ultrasound-guided percutaneous microwave coagulation therapy (PMCT) for hepatocellular carcinoma (HCC) were compared. One hundred and seventy-six patients with HCC, treated by ultrasound-guided PMCT in The Affiliated Hospital of Qingdao University from January 2014 to December 2016, were retrospectively analyzed and divided into two groups: dexmedetomidine group (anesthetized with dexmedetomidine combined with propofol, n=91) and tramadol group ...
Source: Oncology Letters - Category: Cancer & Oncology Tags: Oncol Lett Source Type: research
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