图 7B 经 Abhilash Koratala 博士的许可使用。

该协议中的所有超声都是在人类受试者身上进行的，并按照伊利诺伊大学医院的道德标准和赫尔辛基宣言及其修订版进行。作为常规教育和临床护理的一部分，在事先口头同意的情况下，对作者本人和急诊科的患者进行了影像学检查，这是该机构的标准。收集的图像说明了正常的解剖学和生理学，以及在伊利诺伊大学医院收集的异常发现。用于说明扫描技术的图像是在写作小组的成员身上进行的。所有超声图像均不含任何识别信息。随后的协议是使用同行评审期刊和书籍章节 10、15、16、17、18、19 的来源设计的。在本综述中，该协议将侧重于获取成人的美国图像。
1. 安全
注意：POCUS 研究可以使用非无菌手套（丁腈或乳胶）进行，具体取决于患者的过敏程度。根据临床情况和机构政策，可以采取额外的安全措施。
<ol><li>使用前检查超声系统的清洁度，并在使用后以适当的方式清洁机器和探头。清洗材料和工艺由超声设备制造商和机构标准决定。</li>
</ol>2. 探头的选择
<ol><li>对于大多数成年人来说，腹主动脉最好使用 2.5-3.5 MHz 的曲线探头进行可视化，该探头占地面积大，视野宽，呈凸波束形状。该探头通常将提供出色的分辨率和测量能力。</li>
	<li>或者，使用相控阵探头 （1-5 mHz），通常用于超声心动图，通常非正式地称为心脏探头。 注意：相控阵探头非常有用，尤其是在尝试观察近端腹主动脉通过膈裂孔离开时的情况。如果仅次于木突的空间太窄而无法容纳更宽的曲线探针，则尤其如此。相控阵探头具有矩形尺寸和三角形光束形状，视场比曲线探头更窄，但应足以实现成像目标。</li>
</ol>3. 机器预设
<ol><li>无论使用何种探头，都应使用机器上的 腹部 预设。</li>
	<li>将模式设置为 B 模式 或 二维灰度。</li>
	<li>将深度设置为 20 厘米。 注意：这通常足以可视化椎体，椎体是主动脉的重要标志。</li>
	<li>主动脉可视化后调整深度，使主动脉保持在屏幕的中间。</li>
	<li>如果由于肠气过多而难以成像，请考虑使用谐波成像来提供更好的可视化。 注意：谐波使用组织的共振特性，并创建具有更少伪影的更高分辨率图像。</li>
	<li>为体重指数高的患者选择较低的频率范围，以改善图像采集。</li>
</ol>4. 扫描技术
<ol><li>将超声波凝胶涂抹在换能器上。</li>
	<li>患者仰卧位，腹部暴露。如果患者能够耐受髋关节屈曲，将放松腹部肌肉，并可能改善图像采集。 注意：肠气会阻碍图像采集。为了改善存在肠道气体时的图像采集，操作者可以对扫描区域施加牢固的连续压力（称为分级压缩）几分钟，从而置换肠道气体。评估冠状平面的主动脉也可以避免在横平面中遇到肠气（见步骤4.3.5）。</li>
	<li>要对腹主动脉进行全面评估，请获取下面列出的图像。<ol><li>获取横平面中近端主动脉的图像。<ol><li>将换能器定向在横向平面上，指示器朝向患者右侧。确保指示器位置与屏幕上的指示器匹配（图 1A）。</li>
			<li>将换能器放置在患者剑突的远端，并施加轻微的压力，以可视化椎骨的前部及其高回声阴影投射弓（图1B）。 注意：肝脏将出现在屏幕的左上角，并充当声学窗口。主动脉将出现在椎体正上方，作为屏幕右侧的消声圈，对应于患者的左侧。下腔静脉 （IVC） 位于屏幕的左侧，对应于患者的右侧。IVC 的壁比主动脉壁薄，即使在轻压下也经常可折叠。</li>
			<li>向尾部滑动换能器，直到看到腹腔躯干。腹腔躯干较短，迅速分叉成肝动脉和脾动脉。当两条动脉一起观察时，这称为 海鸥征 （图2）。</li>
			<li>通过单击录制剪辑的系统上的按钮来捕获这些图像以供以后查看。</li>
			<li>向尾部滑动换能器以遇到肠系膜上动脉 （SMA），该动脉从前主动脉脱落并很快向下移动，通常沿着与主动脉平行的路径。脾静脉在SMA前方，左肾静脉在SMA和主动脉之间（图3）。</li>
			<li>通过单击录制剪辑的系统上的按钮来捕获这些图像以供以后查看。</li>
			<li>通过优化该位置主动脉的实时图像，然后按下系统的 冻结 按钮，测量肾上主动脉的 AP 直径。</li>
			<li>按 卡尺 或 测量 并将系统的轨迹球或触摸板移动到前壁的外边缘，即外膜，然后单击 选择。</li>
			<li>再次将轨迹球或触摸板移动到后壁的外边缘，然后单击 “选择”。等待系统生成测量值（图 4）。</li>
			<li>通过单击系统上保存静止图像的按钮，将此图像保存为包含测量值的静止图像。 注意：主动脉 AP 直径的法线上限为 3.0 厘米。任何测量值>3 cm 都被认为是动脉瘤15、16、20、21。</li>
		</ol></li>
		<li>对横平面中的远端主动脉进行成像。 注意：远端主动脉占腹主动脉的三分之二，从肾动脉的远端开始。大多数 AAA 发生在该远端节段。<ol><li>与近端主动脉一样，继续在横向平面上扫描，通过分叉观察整个主动脉。</li>
			<li>通过单击录制剪辑的系统上的按钮来捕获这些图像以供以后查看。</li>
			<li>当远端主动脉的实时图像得到优化时，测量肾下主动脉的 AP 直径。</li>
			<li>按 卡尺 或 测量 并将系统的轨迹球或触摸板移动到前壁的外边缘，即外膜，然后单击 选择。</li>
			<li>再次将轨迹球或触摸板移动到后壁的外边缘，然后单击 “选择”。等待系统生成测量值。</li>
			<li>通过单击系统上保存静止图像的按钮，将此图像保存为包含测量值的静止图像。 注意：鉴于远端主动脉的长度更长且动脉瘤扩张的可能性增加，因此至少对远端主动脉进行两次测量是谨慎的。</li>
			<li>当腹主动脉经腹部尾部时调整深度，因为它变得更加浅表并略微变细。</li>
		</ol></li>
		<li>获取主动脉分叉到左右髂动脉的视频剪辑（视频 1 - 参见补充文件 1：补充图 S1）。<ol><li>继续向尾部扫描，根据需要调整深度以保持主动脉和椎体在屏幕中间。</li>
			<li>通过主动脉分叉扫描到左髂动脉和右髂动脉。</li>
			<li>在扫描分岔时捕获图像。</li>
		</ol></li>
		<li>在纵向平面上获取主动脉的图像和视频剪辑。<ol><li>将探头放在近端腹部，从剑突下区域重新开始。</li>
			<li>通常更容易从横向平面开始，指示器朝向患者右侧。优化主动脉的横视图后，顺时针旋转探头，沿着主动脉旋转，因为图像在屏幕上变得纵向并且指示器指向患者的头部（图 5A）。</li>
			<li>在扫描尾部检查动脉瘤扩张时获取图像。</li>
			<li>通过单击录制剪辑的系统上的按钮来捕获这些图像以供以后查看。 注意：在长轴视图中，腹腔主干和SMA很容易从前主动脉突出（图5B）。建议不要测量主动脉在纵轴上的直径。如果超声束与主动脉相切相交，而不是在其中线，则测量值将错误地小于通过最大 AP 直径的测量值（图 6）。</li>
		</ol></li>
		<li>可选：获取冠状平面中主动脉的纵向视图。如果难以在横向或纵向平面上获取视图，则此视图非常有用。<ol><li>从患者右侧腋窝中线冠状面上的换能器开始，指示器指向颅骨（图7A）。</li>
			<li>如果患者可以，将他们置于左侧卧位，以便更好地获取图像。</li>
			<li>扫描冠状平面中的主动脉。如果对两条血管都进行成像，主动脉将在 IVC 深处可视化（图 7B）。</li>
			<li>通过单击录制剪辑的系统上的按钮来捕获这些图像以供以后查看。</li>
		</ol></li>
	</ol></li>
</ol>

使用床旁超声对腹主动脉进行成像

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L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Emergency+department+ultrasound+scanning+for+abdominal+aortic+aneurysm:+accessible,+accurate,+and+advantageous.">Emergency department ultrasound scanning for abdominal aortic aneurysm: accessible, accurate, and advantageous.</a> Annals of Emergency Medicine. 36 (3), 219-223 (2000).</li><li>Cazes, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Emergency+ultrasound:+a+prospective+study+on+sufficient+adequate+training+for+military+doctors.">Emergency ultrasound: a prospective study on sufficient adequate training for military doctors.</a> Diagnostic and Interventional Imaging. 94 (11), 1109-1115 (2013).</li><li>Bonnafy, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reliability+of+the+measurement+of+the+abdominal+aortic+diameter+by+novice+operators+using+a+pocket-sized+ultrasound+system.">Reliability of the measurement of the abdominal aortic diameter by novice operators using a pocket-sized ultrasound system.</a> Archives of Cardiovascular Diseases. 106 (12), 644-650 (2013).</li><li>Baliga, R. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+role+of+imaging+in+aortic+dissection+and+related+syndromes.">The role of imaging in aortic dissection and related syndromes.</a> Journal of the American College of Cardiology: Cardiovascular Imaging. 7 (4), 406-424 (2014).</li><li>Lewiss, R. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=CORD-AEUS:+consensus+document+for+the+emergency+ultrasound+milestone+project.">CORD-AEUS: consensus document for the emergency ultrasound milestone project.</a> Academic Emergency Medicine. 20 (7), 740-745 (2013).</li></ol>

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及时诊断 AAA 和主动脉夹层是治疗这些高发病率疾病的关键。与传统影像学相比，用于 AAA 诊断的 POCUS 可改善结果并显着缩短诊断和手术干预的时间27。POCUS 对 AAA 具有高敏感性和特异性，对主动脉夹层具有高特异性12、13、19、21、28、29...

床旁超声 （POCUS） 的使用在过去几年中有所增加，并越来越多地被纳入各种住院医师培训计划 1,2。POCUS在急诊科和重症监护室等重症监护领域具有很大的实用性，特别是有助于快速诊断危及生命的腹腔内紧急情况，如急性主动脉夹层，以及腹主动脉瘤，特别是那些有破裂风险的动脉瘤和那些已经破裂到腹膜的动脉瘤。
AAA 破裂和急性主动脉夹层与高死亡率相关。主动脉瘤破裂的死亡率为 67% 至 94%3,4。急性夹层后，A 型主动脉夹层的死亡率以每小时 1% 的速度增加，B 型主动脉夹层的死亡率在 30 天时为 10% 至 25%5。孤立的腹主动脉夹层很少见，仅占所有主动脉夹层的0.2%-4%6,7,8,9,10。由于大多数腹主动脉夹层是胸主动脉夹层的延伸，因此评估腹主动脉的夹层证据可能有助于胸主动脉夹层的诊断11。
计算机断层扫描与血管造影 （CTA） 是腹主动脉相关影像学病理学的金标准;但是，它有几个缺点。这可能很耗时，尤其是在不稳定的患者中，并且需要技术人员执行，并需要放射科医生或血管外科医生来解释图像。CTA 使用电离辐射，需要使用静脉注射造影剂以最佳方式检测病理学。此外，CTA 的性能要求潜在不稳定的患者离开重症监护区。相比之下，POCUS 是非侵入性的、具有成本效益的，并且缺乏 CT 所需的电离辐射和造影剂。它也可以由同一个人实时执行和解释，不需要患者离开监测区域。
Rubano 等人对急诊科 POCUS 诊断 AAA 的系统评价显示，其敏感性为 99%，特异性为 98%，阳性似然比为 99，阴性似然比为 0.0112。这项汇总分析评估了不同操作员组的测试特征，包括接受过广泛 POCUS 培训的住院医师和主治医师。
腹主动脉夹层 POCUS 评估的测试特征与 AAA 不同，并且可能因夹层的起源而异。内膜瓣分离真腔和假腔的超声检查结果对主动脉夹层的敏感性为 67%-79%，特异性为 99%-100%13,14。由于在腹部发现的大多数主动脉夹层是胸主动脉夹层的延伸，因此可以进行心脏和肺部的额外 POCUS 应用以评估心包积液、主动脉根部扩张和左胸腔积液，但不是本文的重点13。
最后，需要注意的是，美国预防服务工作组为对 65-75 岁曾经吸烟的男性进行一次性 AAA 超声筛查提供了 B 级建议。这与初级保健环境特别相关。
本综述将描述POCUS在腹主动脉床旁评估中表现的分步方案，特别是评估AAA和腹主动脉夹层。该协议假定诊断超声的基本知识，包括物理学、仪器，以及腹主动脉和主要分支动脉的解剖学和病理状态的医学知识。建议读者参考其他来源以获取先决条件知识。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>M9 Ultrasound Machine&#160;</td>
			<td>Mindray&#160;</td>
			<td>n/a</td>
			<td>Used to obtain all adequate and inadequate images/clips</td>
		</tr>
	</tbody>
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an approach to point-of-care ultrasound evaluation of the abdominal aorta

腹主动脉疾病，包括动脉瘤和夹层，具有潜在的高发病率和死亡率。虽然计算机断层扫描 （CT） 是目前腹主动脉成像的金标准，但获得 CT 的过程可能很耗时，需要使用静脉注射造影剂，并且涉及暴露于电离辐射。床旁超声（POCUS）可以在床旁进行，对腹主动脉瘤的诊断具有极好的敏感性和特异性，对腹主动脉夹层的诊断具有极好的特异性。此外，POCUS 是非侵入性的、具有成本效益的、没有电离辐射的，不需要静脉注射造影剂，并且可以在不将患者从重症监护区带走的情况下进行。腹主动脉瘤 （AAA） 的筛查也可以在初级保健机构进行。 
本文将回顾腹主动脉 POCUS 的评估方法，以评估此类关键病理学。在本文中，我们将回顾腹主动脉的超声解剖结构以及超声探头的选择、POCUS 图像采集的描述以及使用 POCUS 帮助诊断可能危及生命的腹主动脉病变的一些细节和陷阱。

充分的检查 从腹主动脉超声中获得准确结果的最大挑战之一是缺乏对测量的共识。如协议步骤 4.3.1.10 所述，腹主动脉的任何直径大于 3 cm 都被认为是动脉瘤15、16、22、23。然而，用于测量主动脉直径的方法存在很大差异，并且对于测量腹主动脉尚无国际共识。目前使用的有三种方法：?...

Watch this Scientific Journal Video about An Approach to Point-Of-Care Ultrasound Evaluation of the Abdominal Aorta at JoVE.com

作者聚焦：使用床旁超声全面评估腹主动脉

该方案回顾了使用床旁超声对腹主动脉进行成像的步骤。我们讨论了图像采集、成像陷阱和伪影的故障排除，以及危及生命的腹主动脉病变的识别。

腹主动脉床旁超声评估方法

Disorders of the abdominal aorta, including aneurysms and dissection, have potentially high rates of morbidity and mortality. While computed tomography ...

我们试图展示使用床旁超声或 POCUS 来评估腹主动脉的解剖结构和病理学。POCUS对腹主动脉瘤的评估具有优异的敏感性和特异性，对腹主动脉夹层的评估具有优异的特异性。其中一些挑战包括确保 POCUS 用户接受足够的培训，并确保他们能够准确地识别病理和伪影。该协议是全面的，可以由同一个人在不到五分钟的时间内执行和解释。这比计算机断层扫描血管造影更快，特别是当患者病情危重且病情不稳定，无法离开重症监护区进行影像学检查时。

an-approach-to-point-care-ultrasound-evaluation-abdominal

Research

JoVE Journal

Medicine

An Approach to Point-Of-Care Ultrasound Evaluation of the Abdominal Aorta

1.8K 次观看.  University of Illinois Hospital. 我们试图展示使用床旁超声或 POCUS 来评估腹主动脉的解剖结构和病理学。POCUS对腹主动脉瘤的评估具有优异的敏感性和特异性，对腹主动脉夹层的评估具有优异的特异性。其中一些挑战包括确保 POCUS 用户接受足够的培训，并确保他们能够准确地识别病理和伪影。该协议是全面的，可以由同一个人在不到五分钟的时间内执行和解释。这比计算机断层扫描血管造影更快，特...

视频: 作者聚焦：使用床旁超声全面评估腹主动脉

Ultrasound Imaging of the Thoracic and Abdominal Aorta in Mice to Determine Aneurysm Dimensions

Contemporary high-resolution ultrasound instruments have sufficient resolution to facilitate the measurement of mouse aortas. These instruments have been widely used to measure aortic dimensions in mouse models of aortic aneurysms. Aortic aneurysms are defined as permanent dilations of the aorta, which occur most frequently in the ascending and abdominal regions. Sequential measurements of aortic dimensions by ultrasound are the principal approach for assessing the development and progression of aortic aneurysms in vivo. Although many reported studies used ultrasound imaging to measure aortic diameters as a primary endpoint, there are confounding factors, such as probe position and cardiac cycle, that may impact the accuracy of data acquisition, analysis, and interpretation. The purpose of this protocol is to provide a practical guide on the use of ultrasound to measure the aortic diameter in a reliable and reproducible manner. This protocol introduces the preparation of mice and instruments, the acquisition of appropriate ultrasound images, and data analysis.

Ultrasound imaging has become a common modality to determine the luminal dimensions of thoracic and abdominal aortic aneurysms in mice. This protocol describes the procedure to acquire reliable and reproducible two-dimensional ultrasound images of the ascending and abdominal aorta in mice.

小鼠胸腹主动脉超声检查确定动脉瘤大小

Contemporary high-resolution ultrasound instruments have sufficient resolution to facilitate the measurement of mouse aortas. These instruments have been ...

科研

医学

Point-of-Care Lung Ultrasound in Adults: Image Acquisition

Consultative ultrasound performed by radiologists has traditionally not been used for imaging the lungs, as the lungs&#39; air-filled nature normally prevents direct visualization of the lung parenchyma. When showing the lung parenchyma, ultrasound typically generates a number of non-anatomic artifacts. However, over the past several decades, these artifacts have been studied by diagnostic point-of-care ultrasound (POCUS) practitioners, who have identified findings that have value in narrowing the differential diagnoses of cardiopulmonary dysfunction. For instance, in patients presenting with dyspnea, lung POCUS is superior to chest radiography (CXR) for the diagnosis of pneumothorax, pulmonary edema, lung consolidations, and pleural effusions. Despite its known diagnostic value, the utilization of lung POCUS in clinical medicine remains variable, in part because training in this modality across hospitals remains inconsistent. To address this educational gap, this narrative review describes lung POCUS image acquisition in adults, including patient positioning, transducer selection, probe placement, acquisition sequence, and image optimization.

Point-of-care ultrasound (POCUS) of the lungs provides quick answers in rapidly changing clinical scenarios. We present an efficient and informative protocol for image acquisition for use in acute care settings.

成人床旁肺部超声:图像采集

Consultative ultrasound performed by radiologists has traditionally not been used for imaging the lungs, as the lungs&#39; air-filled nature normally ...

Point-of-Care Ultrasound: A Review of Ultrasound Parameters for Predicting Difficult Airways

Airway management remains a crucial part of perioperative care. The conventional approach to assessing potentially difficult airways emphasizes the LEMON method, which looks for and evaluates the Mallampati classification, signs of obstruction, and neck mobility. Clinical findings help predict a higher likelihood of difficult tracheal intubation, but no clinical result reliably excludes difficult intubation. Ultrasound as an adjunct to clinical examination can provide the clinician with a dynamic anatomical airway assessment, which is impossible with clinical examination alone. In the hands of anesthesiologists, ultrasound is becoming more popular in the perioperative period. This method is particularly applicable for identifying proper endotracheal tube positioning in specific patient populations, such as those who are morbidly obese and patients with head and neck cancer or trauma. The focus is on identifying the normal anatomy, correctly positioning the endotracheal tube, and refining the parameters that predict difficult intubation. Several ultrasound measurements are clinical indicators of difficult direct laryngoscopy in the literature. A meta-analysis revealed that the distance from the skin to the epiglottis (DSE) is most associated with a difficult laryngoscopy. An ultrasound of the airway could be applied in routine practice as an adjunct to the clinical examination. A full stomach, rapid sequence intubation, gross visual anatomical abnormalities, and restricted neck flexibility prevent using ultrasound to assess the airway. The airway evaluation is performed with a linear array transducer of 12-4 MHz, with the patient in the supine position, with no pillow, and with the head and neck in a neutral position. The central axis of the neck is where the ultrasound parameters are measured. These image acquisitions guide the standard ultrasound examination of the airway.

A point-of-care ultrasound (POCUS) is a simple, non-invasive, and portable tool that enables dynamic airway assessment. Several studies have attempted to determine the role of ultrasound parameters as an adjunct to clinical examination in predicting difficult laryngoscopies.

床旁超声:预测困难气道的超声参数综述

Airway management remains a crucial part of perioperative care. The conventional approach to assessing potentially difficult airways emphasizes the LEMON ...

Optic Nerve Sheath Point of Care Ultrasound: Image Acquisition

The goal of this protocol is to develop a standardized method for acquiring images of the optic nerve sheath and measuring the optic nerve sheath diameter (ONSD). Diagnostic ultrasound of the ONSD to detect intracranial hypertension has traditionally faced many problems because of methodologic discrepancies. Due to inconsistencies in the measuring techniques, the potential for ONSD to become a non-invasive bedside monitoring tool for ICP has been hampered. However, establishing a transparent, consistent methodology for measuring the ONSD would support its use as a valid and reliable method of identifying intracranial hypertension. This is important as it has both high sensitivity and specificity in acute care settings. This narrative review describes ONSD POCUS image acquisition, including patient positioning, transducer selection, probe placement, the acquisition sequence, and image optimization. Further, visual aids are provided to assist in real-time during image acquisition. This method should be considered for patients for whom there are concerns regarding intracranial hypertension but who do not have an intracranial monitor in place.

Point-of-care ultrasound (POCUS) of the optic nerve sheath diameter (ONSD) has been shown to be useful in identifying patients with increased intracranial pressure (ICP). However, the non-standardized technique for this POCUS has hampered its use. We present a standardized image acquisition protocol for use in the acute care setting.

视神经鞘床旁超声:图像采集

The goal of this protocol is to develop a standardized method for acquiring images of the optic nerve sheath and measuring the optic nerve sheath diameter ...

胃超声技术减轻围手术期误吸风险

Gastric Point of Care Ultrasound in Adults: Image Acquisition and Interpretation

Over the past two decades, diagnostic point-of-care ultrasound (POCUS) has emerged as a rapid and non-invasive bedside tool for addressing clinical inquiries related to gastric content. One emerging concern pertains to patients about to undergo sedation and/or endotracheal intubation: the elevated risk of aspiration from the patient&#39;s stomach contents. Aspiration of gastric contents into the lungs poses a serious and potentially life-threatening complication. This occurs more frequently when the stomach is considered &#34;full&#34; and can be affected by the techniques employed for airway management, making it potentially preventable. To mitigate the risk of peri-procedural aspiration, two distinct medical specialties (anesthesiology and critical care medicine) have independently developed techniques to utilize ultrasonography for identifying patients requiring &#34;full stomach&#34; precautions. Due to these separate specialties, the work of each group remains relatively unfamiliar outside its respective field. This article presents descriptions of both techniques for gastric ultrasound. Furthermore, it explains how these approaches can complement each other when one of them falls short. Regarding image acquisition, the article covers the following topics: indications and contraindications, selection of the appropriate probe, patient positioning, and troubleshooting. The article also delves into image interpretation, complete with example images. Additionally, it demonstrates how one of the two techniques can be employed to estimate gastric fluid volume. Lastly, the article briefly discusses medical decision-making based on the findings of this examination.

作者聚焦：用于围手术期护理中胃内容物评估和风险分层的床旁超声 

This protocol introduces two methods for image acquisition in gastric ultrasonography. Additionally, tips are provided for interpreting this information to assist in medical decision-making.

成人胃旁超声：图像采集和解释

Over the past two decades, diagnostic point-of-care ultrasound (POCUS) has emerged as a rapid and non-invasive bedside tool for addressing clinical ...

超声评估膈肌功能障碍和监测治疗

Measuring Diaphragm Thickness and Function Using Point-of-Care Ultrasound

The diaphragm is the main component of the respiratory muscle pump. Diaphragm dysfunction can cause dyspnea and exercise intolerance, and predisposes affected individuals to respiratory failure. In mechanically ventilated patients, the diaphragm is susceptible to atrophy and dysfunction through disuse and other mechanisms. This contributes to failure to wean and poor long-term clinical outcomes. Point-of-care ultrasound provides a valid and reproducible method for evaluating diaphragm thickness and contractile activity (thickening fraction during inspiration) that can be readily employed by clinicians and researchers alike. This article presents best practices for measuring diaphragm thickness and quantifying diaphragm thickening during tidal breathing or maximal inspiration. Once mastered, this technique can be used to diagnose and prognosticate diaphragm dysfunction, and guide and monitor response to treatment over time in both healthy individuals and acute or chronically ill patients.

作者聚焦:揭示机械通气对隔膜功能和患者预后的影响 

Diaphragm thickness and function can be assessed in healthy individuals and critically ill patients using point-of-care ultrasound. This technique offers an accurate, reproducible, feasible, and well-tolerated method for evaluating diaphragm structure and function.

使用床旁超声测量隔膜厚度和功能

The diaphragm is the main component of the respiratory muscle pump. Diaphragm dysfunction can cause dyspnea and exercise intolerance, and predisposes ...