Bedside lung ultrasound in the care of the critically ill.

Bedside lung ultrasound in the care of the critically ill. Crit Care Resusc. 2017 Dec;19(4):327-336 Authors: Rudas M, Orde S, Nalos M Abstract OBJECTIVE: To describe the technique and review the utility of bedside lung ultrasound in acute care. SUMMARY: Lung ultrasound is a useful point-of-care investigation in acute care, especially in patients with dyspnoea or haemodynamic instability. Although normal lung parenchyma is not accessible to ultrasound, distinctive artefacts arising from parietal and visceral pleura indirectly imply the presence of normal lung. As aeration of lung tissue reduces with disease process, visual assessment of several pathologic entities by ultrasound becomes possible. Ultrasound can be used for qualitative and quantitative assessment as well as to guide intervention. Compared with supine anteroposterior chest x-rays, lung ultrasound is faster and superior at ruling out pneumothorax and diagnosing lung consolidation, pleural effusions or pulmonary oedema. It is a logical and highly valuable extension of echocardiography and can be incorporated into diagnostic algorithms for assessment of dyspnoea, hypotension, chest pain or trauma. It provides rapid information about potentially reversible pathology in cardiac arrest scenarios. Other advantages include bedside availability, repeatability, provision of dynamic diagnostic information, ease of use and the absence of radiation exposure. PMID: 29202259 [PubMed - in process]
Source: Critical Care and Resuscitation - Category: Intensive Care Tags: Crit Care Resusc Source Type: research

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The objective of this study was to examine the usefulness of these less invasive small-bore aspiration catheters for drainage of pneumothorax.MethodsBaseline characteristics and laboratory test data at admission of 70 patients who were admitted to and underwent drainage treatment for pneumothorax at our hospital between April 2011 and February 2017 were retrospectively reviewed based on their medical records. The primary endpoints were factors associated with drainage treatment failure, and baseline characteristics and laboratory test data were compared between those treated with a small-bore aspiration catheter and those ...
Source: Respiratory Investigation - Category: Respiratory Medicine Source Type: research
In conclusion, the double-level RLB could delay the time to initial administration of analgesics, but this technique may be insufficient to reduce the analgesic requirement within the 12-hour postoperative period following breast cancer surgery. PMID: 30012909 [PubMed - in process]
Source: The Tohoku Journal of Experimental Medicine - Category: Research Authors: Tags: Tohoku J Exp Med Source Type: research
ConclusionThe diaphragm fenestrations were possibly the result of tissue necrosis caused by thermocoagulation after excision of deep endometriotic lesions during the first surgery. Using a CO2 laser for the vaporization of superficial lesions is favorable because of the smaller depth of penetration compared with electrocautery and better access to hard to reach areas 9, 10. Endometriotic lesions involving the entire thickness of the diaphragm should be completely excised and the defect repaired with either sutures or staples 11, 12, 13.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
ConclusionIntravenous methamphetamine use increases a wide number of inflammatory markers that can increase the risk of spontaneous pneumothoraces and pneumomediastinum. In patients with known risk factors, methamphetamine use can promote an increased incidence of spontaneous pneumothorax and pneumomediastinum.
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
Publication date: Available online 20 April 2018Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): G. Thery, J. Rosman, G. Julien, F. Chaix, P. Mateu
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
ConclusionIntravenous methamphetamine use increases a wide number of inflammatory markers that can increase the risk of spontaneous pneumothoraces and pneumomediastinum. In patients with known risk factors, methamphetamine use can promote an increased incidence of spontaneous pneumothorax and pneumomediastinum.
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
ConclusionThe diaphragm fenestrations were possibly the result of tissue necrosis caused by thermocoagulation after excision of deep endometriotic lesions during the first surgery. Using a CO2 laser for the vaporization of superficial lesions is favorable because of the smaller depth of penetration compared with electrocautery and better access to hard to reach areas 9, 10. Endometriotic lesions involving the entire thickness of the diaphragm should be completely excised and the defect repaired with either sutures or staples 11, 12, 13.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Publication date: Available online 20 April 2018Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): G. Thery, J. Rosman, G. Julien, F. Chaix, P. Mateu
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
FDA has approved a new device intended to treat breathing difficulty associated with severe emphysema. The approval comes just two weeks after an FDA advisory panel shot down a competing technology targeting the same patient population. The agency approved Pulmonx Inc.'s Zephyr endobronchial valve through the breakthrough device designation, a pathway reserved for devices that provide for more effective treatment or diagnosis of a life-threatening or irreversibly debilitating disease or condition. Devices also must meet one of the following criteria: the device must represent a breakthrough technology; there must be no app...
Source: MDDI - Category: Medical Devices Authors: Tags: Regulatory and Compliance Source Type: news
ConclusionsThe successful treatment of a large spontaneous hemopneumothorax depends on early recognition, proactive intervention, and early consideration by a cardiothoracic surgeon. Once the diagnosis is confirmed, early thoracotomy should be considered. Such an aggressive surgery not only leads to shorter hospitalization but also confers better long-term outcomes.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
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