Integrated Cardiac and Lung Ultrasound (ICLUS) in the Cardiac Intensive Care Unit

AbstractPurpose of ReviewThis review highlights the use of basic lung ultrasound and introduces the concept of integrated cardiac and lung ultrasound (ICLUS) in the care of patients in the cardiac intensive care unit (ICU).Recent FindingsCardiac ultrasound is a fundamental imaging modality that is the gold standard for the diagnosis of cardiac pathology at the bedside. However, the demographics of the modern cardiac ICU are evolving to encompass patients with complex multi-organ system dysfunction in addition to acute cardiovascular disease. Therefore, a more comprehensive diagnostic approach is needed to allow the cardiologist to unravel the potential interplay of multiple pathologic processes. Literature on lung ultrasound has expanded dramatically in recent years as it has proven to be a feasible and accurate exam that provides rapid diagnosis of pulmonary pathology including pneumothorax, pleural effusion, pneumonia, and pulmonary edema. Furthermore, combined cardiac and lung sonography exposes the interaction of circulatory and pulmonary physiology that is central to the diagnosis and management of acute cardiovascular disease. ICLUS provides valuable information for the diagnosis and management of conditions such as respiratory failure, shock, and heart failure.SummaryNumerous studies in recent years have illustrated the utility of lung ultrasound in various clinical settings. Integration of lung and cardiac ultrasound provides the cardiologist with a more holistic exam...
Source: Current Cardiovascular Imaging Reports - Category: Radiology Source Type: research

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Conclusions: Subcutaneous emphysema and pneumothorax may occur in patients with SARS-CoV-2 pneumonia and chronic pulmonary disease. Chronic cardiac disease might be aggravated by SARS-CoV-2 infection, and develop heart failure.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Discussion Pulmonary embolism (PE) is potentially life-threatening but fortunately rare event especially in the pediatric population. It was first described in children in 1861. PE is likely underreported because of minimal or non-specific clinical symptoms. The incidence is estimated at 0.05-4.2% with the 4.2% based on autopsy reports. It is probably also increasing as more central venous catheters (CVC) are used, and more children are surviving previously poor prognostic diseases. There is a bimodal distribution with cases
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
Authors: Carlucci P, Trigiani M, Mori PA, Mondoni M, Pinelli V, Casalini AG, Conte EG, Buggio G, Villari L, Marchetti G Abstract Diseases of the pleura and pleural space are common and present a significant contribution to the workload of respiratory physicians, accounting for an annual incidence of more than 1.5 million cases in the US with the majority of cases resulting from congestive heart failure, pneumonia, and cancer 1. Although the radiographic and ultrasonographic detection of pleural abnormalities may be obvious, the determination of a specific diagnosis can often represent a challenge. Since pleural eff...
Source: Panminerva Medica - Category: General Medicine Tags: Panminerva Med Source Type: research
Last week on twitter I wrote a series of tweets about necessary qualifiers.  Here are the tweets which represent an incomplete sample of the problem: 1st tweet on  importance of qualifiers w/ “diagnoses” Do not label the patient as COPD exacerbation without saying why: Differential includes acute bronchitis, pneumonia, pneumothorax, left side heart failure, anemia, opiates, PE etc. 2nd qualifier tweet – Never tell me the patient has CKD without giving me the stage and the cause.  Corollary – do not give me the eGFR for patients with AKI – the estimates do not work with increasi...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs
ConclusionsThis study validates previous research suggesting a low clinical yield for CXR in the setting of non‐traumatic chest pain in the ED. This refined clinical decision rule has a favorable sensitivity and negative predictive value in a patient population with low incidence of disease. Further validation is needed prior to use in practice.This article is protected by copyright. All rights reserved.
Source: Academic Emergency Medicine - Category: Emergency Medicine Authors: Tags: Original Contribution Source Type: research
CONCLUSIONS: This study validates previous research suggesting a low clinical yield for CXR in the setting of non-traumatic chest pain in the ED. This refined clinical decision rule has a favorable sensitivity and negative predictive value in a patient population with low incidence of disease. Further validation is needed prior to use in practice. This article is protected by copyright. All rights reserved. PMID: 29427301 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - Category: Emergency Medicine Authors: Tags: Acad Emerg Med Source Type: research
Objective: To compare clinical features and short term hospital outcome in COPD patients with and without heart failure.Methods: This was a prospective cohort study among COPD patients admitted to tertiary care hospital with and without heart failure (HF), who were followed till their hospital outcome. Comparison of presenting clinical features and outcome were documented on a structured proforma. Patients with chronic kidney or liver disease, cancer, pace- maker, pneumothorax, pneumonia, Implantable- defibrillator, stroke, dementia were excluded to eliminate bias.Results: Total of 60 COPD patients with HF ( group 1) and 8...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Monitoring Airway Disease Source Type: research
CONCLUSIONS: PoCUS represents a feasible and reliable diagnostic approach to the dyspnoic patient, allowing a reduction of the diagnostic time. This protocol could help to stratify patients who should undergo a more detailed evaluation. PMID: 28212836 [PubMed - as supplied by publisher]
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
Conclusion. Risk factors for the development of postoperative medical complications after correction of ASD include smoking, hypertension, and duration of symptoms. Patients who have one or more of these risk factors should be identified and informed during informed consent of their increased risks. They should be optimized preoperatively, and followed closely during the postoperative period. Level of Evidence: 3
Source: Spine - Category: Orthopaedics Tags: Deformity Source Type: research
Conclusion: Infectious causes remains the most common cause of acute exacerbation of COPD.The absence of exacerbation cause is an independent risk factor for mortality while acute bronchitis is a protective factor.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 2.1 Acute Critical Care Source Type: research
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