<meta charset="utf8"></head><body>用于 IVC 评估治疗心力衰竭的 POCUS 方案

<ol>
	<li>Diaz-Gomez, J., Mayo, P. H., Koenig, S. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Point-of-care+ultrasonography.">Point-of-care ultrasonography.</a> N Engl J Med. 385, 1593-1602 (2021).</li><li>Zieleskiewicz, L., 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=Bedside+POCUS+during+ward+emergencies+is+associated+with+improved+diagnosis+and+outcome:+An+observational,+prospective,+controlled+study.">Bedside POCUS during ward emergencies is associated with improved diagnosis and outcome: An observational, prospective, controlled study.</a> Crit Care. 25 (1), 34 (2021).</li><li>Al Deeb, M., Barbic, S., Featherstone, R., Dankoff, J., Barbic, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Point-of-care+ultrasonography+of+the+diagnosis+of+acute+cardiogenic+pulmonary+edema+in+patients+presenting+with+acute+dyspnea:+A+systematic+review+and+meta-analysis.">Point-of-care ultrasonography of the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: A systematic review and meta-analysis.</a> Acad Emerg Med. 21 (8), 843-852 (2014).</li><li>Spevack, 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=Serial+lung+and+IVC+ultrasound+in+the+assessment+of+congestive+heart+failure.">Serial lung and IVC ultrasound in the assessment of congestive heart failure.</a> Crit Ultrasound J. 9 (1), 7 (2017).</li><li>Ciozda, W., 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+efficacy+of+sonographic+measurement+of+inferior+vena+cava+diameter+as+an+estimate+of+central+venous+pressure.">The efficacy of sonographic measurement of inferior vena cava diameter as an estimate of central venous pressure.</a> Cardiovascular Ultrasound. 14 (1), 33 (2015).</li><li>Kedan, I., 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=Decreasing+hospital+utilization+of+a+high+risk+heart+failure+population+in+a+large+urban+Accountable+Care+Organization:+The+use+of+a+clinical+pharmacist,+serial+biomarkers,+and+Point+of+Care+Ultrasound.">Decreasing hospital utilization of a high risk heart failure population in a large urban Accountable Care Organization: The use of a clinical pharmacist, serial biomarkers, and Point of Care Ultrasound.</a> J Am Coll Cardiol. 67, 1298 (2016).</li><li>Kehl, D., Zimmer, R., Sudan, M., Kedan, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Handheld+ultrasound+as+a+novel+predictive+tool+in+atrial+fibrillation:+Prediction+of+outcomes+following+electrical+cardioversion.">Handheld ultrasound as a novel predictive tool in atrial fibrillation: Prediction of outcomes following electrical cardioversion.</a> JMIR Cardio. 2 (1), e7 (2018).</li><li>Miller, W. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fluid+volume+homeostasis+in+heart+failure:+A+tale+of+2+circulations.">Fluid volume homeostasis in heart failure: A tale of 2 circulations.</a> J Am Heart Assoc. 11 (18), e026668 (2022).</li><li>Porter, T. 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=Guidelines+for+the+use+of+echocardiography+as+a+monitor+for+therapeutic+intervention+in+adults:+A+report+from+the+American+Society+of+Echocardiography.">Guidelines for the use of echocardiography as a monitor for therapeutic intervention in adults: A report from the American Society of Echocardiography.</a> J Am Soc Echocardiogr. 28 (1), 40-56 (2015).</li><li>Katz, S. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+search+of+euvolemia+in+heart+failure.">In search of euvolemia in heart failure.</a> J Am Cardiol HF. 2 (3), 306-307 (2014).</li><li>Bhoil, R., Ahluwalia, A., Chopra, R., Surya, M., Bhoil, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Signs+and+lines+in+lung+ultrasound.">Signs and lines in lung ultrasound.</a> J Ultrason. 21 (86), e225-e233 (2021).</li><li>Hacialiogullari, F., 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=Role+of+point-of-care+lung+and+inferior+vena+cava+ultrasound+in+clinical+decisions+for+patients+presenting+to+the+emergency+department+with+symptoms+of+acute+decompensated+heart+failure.">Role of point-of-care lung and inferior vena cava ultrasound in clinical decisions for patients presenting to the emergency department with symptoms of acute decompensated heart failure.</a> J Ultrasound Med. 40 (4), 751-761 (2021).</li><li>Gil-Rodriguez, J., 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=Ultrasound+findings+of+lung+ultrasonography+in+COVID-19:+A+systematic+review.">Ultrasound findings of lung ultrasonography in COVID-19: A systematic review.</a> Eur J Radiol. 148, 110156 (2022).</li><li>Li, S. J., Lee, J., Hall, J., Sutherland, T. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+inferior+vena+cava:+Anatomical+variants+and+acquired+pathologies.">The inferior vena cava: Anatomical variants and acquired pathologies.</a> Insights into Imaging. 12 (1), 123 (2021).</li><li>Lam, J., 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=Accelerated+remote+consultation+tele-POCUS+in+cardiopulmonary+assessment+(ARCTICA).">Accelerated remote consultation tele-POCUS in cardiopulmonary assessment (ARCTICA).</a> POCUS J. 5 (2), 55-58 (2020).</li></ol>

<table><tbody><tr><td>Aquasonic Ultrasound Gel 100</td><td>Parker</td><td>ECO #20-0299</td><td>The company and the catalog number is one example</td></tr><tr><td>Epic Electronic Health Record</td><td>Epic</td><td></td><td>The company and the catalog number is one example</td></tr><tr><td>GE Vscan Extend</td><td>General Electric</td><td>5721203-100 Rev.13</td><td>Broad-bandwidth linear array: 3.3-8.0 MHz</td></tr><tr><td>Haiku</td><td>Epic</td><td>10.3</td><td>The company and the catalog number is one example</td></tr></tbody></table>

workflow and framework for collecting and implementing point-of-care ultrasound data in the management of heart failure patients

<meta charset="utf8"></head><body>作者聚焦:将 POCUS 数据集成到 EHR 中以管理心力衰竭患者的工作流程

在心力衰竭患者管理中收集和实施床旁超声数据的工作流程和框架 

Management and prevention of acute decompensated heart failure remain highly prevalent and challenging medical conditions. Incorporation of Point-of-Care ...

workflow-framework-for-collecting-implementing-point-care-ultrasound

Research

JoVE Journal

Medicine

Workflow and Framework for Collecting and Implementing Point-of-Care Ultrasound Data in the Management of Heart Failure Patients

676 次观看.  Smidt Heart Institute. 我们的工作旨在展示一种获取 POCUS 数据并将其集成到电子健康记录中以管理心力衰竭患者的工作流程。我们打算分享我们已开发和标准化的工作流程，作为将 POCUS 数据纳入心力衰竭管理的模板。目前的一些实验挑战包括获得低成本的 POCUS 设备、不同的用户专业知识、专家指导的可用性有限以及在临床护理环境中实施的易于整合的 POCUS 工作流程数量...

视频: 作者聚焦:将 POCUS 数据集成到 EHR 中以管理心力衰竭患者的工作流程

In Silico Clinical Trials for Cardiovascular Disease

The SILICOFCM project mainly aims to develop a computational platform for in silico clinical trials of familial cardiomyopathies (FCMs). The unique characteristic of the platform is the integration of patient-specific biological, genetic, and clinical imaging data. The platform allows the testing and optimization of medical treatment to maximize positive therapeutic outcomes. Thus, adverse effects and drug interactions can be avoided, sudden cardiac death can be prevented, and the time between the commencement of drug treatment and the desired result can be shortened. This article presents a parametric model of the left ventricle automatically generated from patient-specific ultrasound images by applying an electromechanical model of the heart. Drug effects were prescribed through specific boundary conditions for inlet and outlet flow, ECG measurements, and calcium function for heart muscle properties. Genetic data from patients were incorporated through the material property of the ventricle wall. Apical view analysis involves segmenting the left ventricle using a previously trained U-net framework and calculating the bordering rectangle based on the length of the left ventricle in the diastolic and systolic cycle. M-mode view analysis includes bordering of the characteristic areas of the left ventricle in the M-mode view. After extracting the dimensions of the left ventricle, a finite elements mesh was generated based on mesh options, and a finite element analysis simulation was run with user-provided inlet and outlet velocities. Users can directly visualize on the platform various simulation results such as pressure-volume, pressure-strain, and myocardial work-time diagrams, as well as animations of different fields such as displacements, pressures, velocity, and shear stresses.

In Silico Clinical Trials for Cardiovascular Disease

This protocol demonstrates the workflow of the SILICOFCM platform for automatically generating a parametric model of the left ventricle from patient-specific ultrasound images by applying a multi-scale electromechanical model of the heart. This platform enables in silico clinical trials intended to reduce real clinical trials and maximize positive therapeutic outcomes.

在计算机中 心血管疾病的临床试验

The SILICOFCM project mainly aims to develop a computational platform for in silico clinical trials of familial cardiomyopathies (FCMs). The unique ...

科研

生物工程

Hydra, a Computer-Based Platform for Aiding Clinicians in Cardiovascular Analysis and Diagnosis

Cardiovascular diseases (CVDs) are the leading cause of death throughout the world. The total risk of developing CVD is determined by the combined effect of different cardiovascular risk factors (e.g., diabetes, raised blood pressure, unhealthy diet, tobacco use, stress, etc.) that commonly coexist and act multiplicatively. Most CVDs can be prevented by an early identification of the highest risk factors and an appropriate treatment. The stratification of cardiovascular risk factors involves a wide range of parameters and tests that specialists use in their clinical practice. In addition to cardiovascular (CV) risk stratification, ambulatory blood pressure monitoring (ABPM) also provides relevant information for diagnostic and treatment purposes. This work presents a list of protocols based on the Hydra platform, a web-based system for clinical decision support which incorporates a set of functionalities and services that are required for complete cardiovascular analysis, risk assessment, early diagnosis, treatment and monitoring of patients over time. The program includes tools for inputting and managing comprehensive patient data, organized into different checkups to track the evolution over time. It also has a risk stratification tool to compute a CV risk factor based upon several risk stratification tables of reference. Additionally, the program includes a tool that incorporates ABPM analysis and allows the extraction of valuable information by monitoring blood pressure over a specific period of time. Finally, the reporting service summarizes the most relevant information in a set of reports that aid clinicians in their clinical decision-making process.

This article presents a protocol based on Hydra &#8212; a web-based system for clinical decision support that integrates a full and detailed set of functionalities and services required by physicians for complete cardiovascular analysis, risk assessment, early diagnosis, treatment, and monitoring over time.

一种计算机辅助心血管分析诊断平台的研究

Cardiovascular diseases (CVDs) are the leading cause of death throughout the world. The total risk of developing CVD is determined by the combined effect ...

医学

Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies

Longitudinal evaluations of critically ill patients by combinations of clinical examination, biochemical analysis and critical care ultrasonography (CCUS) may detect adverse events of interventions such as fluid overload at an early stage. The Simple Intensive Care Studies (SICS) is a research line that focuses on the prognostic and diagnostic value of combinations of clinical variables.
The SICS-I specifically focused on the use of clinical variables obtained within 24 h of acute admission for prediction of cardiac output (CO) and mortality. Its sequel, SICS-II, focuses on repeated evaluations during ICU admission. The first clinical examination by trained researchers is performed within 3 h after admission consisting of physical examination and educated guessing. The second clinical examination is performed within 24 h after admission and includes physical examination and educated guessing, biochemical analysis and CCUS assessments of heart, lungs, inferior vena cava (IVC) and kidney. This evaluation is repeated at days 3 and 5 after admission. CCUS images are validated by an independent expert, and all data is registered in an online secured database. Follow-up at 90 days includes registration of complications and survival status according to patient&#39;s medical charts and the municipal person registry. The primary focus of SICS-II is the association between venous congestion and organ dysfunction.
The purpose of publishing this protocol is to provide details on the structure and methods of this on-going prospective observational cohort study allowing answering multiple research questions. The design of the data collection of combined clinical examination and CCUS assessments in critically ill patients are explicated. The SICS-II is open for other centers to participate and is open for other research questions that can be answered with our data.

<meta charset="utf8"></head><body>简单重症监护研究中重复临床检查和重症监护超声检查的观察性研究方案

Structured protocols are necessary to provide answers on research questions in critically ill patients. The Simple Intensive Care Studies (SICS) provides an infrastructure for repeated measurements in critically ill patients including clinical examination, biochemical analysis and ultrasonography. SICS projects have specific focus but the structure is flexible to other investigations.

简单重症监护研究中重复临床检查和重症监护超声检查的观察性研究方案

Longitudinal evaluations of critically ill patients by combinations of clinical examination, biochemical analysis and critical care ultrasonography (CCUS) ...

Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus

Ultrasound is a safe bedside imaging tool that obviates the use of ionizing radiation diagnostic procedures. Due to its convenience, the lung ultrasound has received increasing attention from neonatal physicians. Nevertheless, clear reference standards and guideline limits are needed for accurate application of this diagnostic modality. This document aims to summarize expert opinions and to provide precise guidance to help facilitate the use of the lung ultrasound in the diagnosis of neonatal lung diseases.

Lung ultrasound is a noninvasive and valuable tool for bedside evaluation of neonatal lung diseases. However, a relative lack of reference standards, protocols and guidelines may limit its application. Here, we aim to develop a standardized neonatal lung ultrasound diagnostic protocol to be used in clinical decision-making.

基于国际专家共识的护理点肺超声诊断新生儿肺病的协议和指南

Ultrasound is a safe bedside imaging tool that obviates the use of ionizing radiation diagnostic procedures. Due to its convenience, the lung ultrasound ...

Integration of Brain Tissue Saturation Monitoring in Cardiopulmonary Exercise Testing in Patients with Heart Failure

Cerebral hypo-oxygenation during rest or exercise negatively impacts the exercise capacity of patients with heart failure with reduced ejection fraction (HF). However, in clinical cardiopulmonary exercise testing (CPET), cerebral hemodynamics is not assessed. NIRS is used to measure cerebral tissue oxygen saturation (SctO2) in the frontal lobe. This method is reliable and valid and has been utilized in several studies. SctO2 is lower during both rest and peak exercise in patients with HF than in healthy controls (66.3 &#177; 13.3% and 63.4 &#177; 13.8% vs. 73.1 &#177; 2.8% and 72 &#177; 3.2%). SctO2 at rest is significantly linearly correlated with peak VO2 (r = 0.602), oxygen uptake efficiency slope (r = 0.501), and brain natriuretic peptide (r = -0.492), all of which are recognized prognostic and disease severity markers, indicating its potential prognostic value. SctO2 is determined mainly by end-tidal CO2 pressure, mean arterial pressure, and hemoglobin in the HF population. This article demonstrates a protocol that integrates SctO2 using NIRS into incremental CPET on a calibrated bicycle ergometer.

This protocol integrated near-infrared spectroscopy into conventional cardiopulmonary exercise testing to identify the involvement of the cerebral hemodynamic response in exercise intolerance in patients with heart failure.

心力衰竭患者心肺运动测试中脑组织饱和监测的集成

Cerebral hypo-oxygenation during rest or exercise negatively impacts the exercise capacity of patients with heart failure with reduced ejection fraction ...

Troubleshooting FoCUS Image Acquisition: Patient Positioning, Transducer Manipulation, and Image Optimization

Focused cardiac ultrasound (FoCUS) is a limited, clinician-performed application of echocardiography to add real-time information to patient care. These bedside exams are problem oriented, rapidly and repeatedly performed, and largely qualitative in nature. Competency in FoCUS includes mastery of the stereotactic and psychomotor skills required for transducer manipulation and image acquisition. Competency also requires the ability to optimize the setup, troubleshoot image acquisition, and understand the sonographic limitations because of complex clinical environments and patient pathology. This article presents concepts for successful, high-quality two-dimensional (B-mode) image acquisition in FoCUS.
Concepts of high-quality image acquisition can be applied to all established sonographic windows of the FoCUS exam: the parasternal long-axis (PLAX), parasternal short-axis (PSAX), apical four chamber (A4C), subcostal fourchamber (SC4C), and the inferior vena cava (IVC). The apical five-chamber (A5C) and subcostal short-axis (SCSA) views are mentioned, but are not discussed in-depth. A pragmatic figure illustrating the movements of the phased array transducer is also provided to serve as a cognitive aid during FoCUS image acquisition.

Here, we present a protocol to allow providers to perform focused cardiac ultrasound (FoCUS) in the clinical environment. We describe methods of transducer manipulation, review common pitfalls of transducer movements, and suggest tips to optimize phased array transducer use.

FoCUS 图像采集故障排除:患者定位、换能器操作和图像优化

Focused cardiac ultrasound (FoCUS) is a limited, clinician-performed application of echocardiography to add real-time information to patient care. These ...

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 ...

围手术期虚弱评估的超声方案

Identifying Frailty Using Point-of-Care Ultrasonography: Image Acquisition and Assessment

Frailty is a significant predictor of a range of adverse outcomes in surgical patients, including increased mechanical ventilation time, longer hospital stays, unplanned readmissions, stroke, delirium, and death. However, accessible tools for screening in clinical settings are limited. Computed tomography of the psoas muscle is the current standard imaging device for measuring frailty, but it is expensive, time-consuming, and exposes the patient to ionizing radiation. Recently, the use of point-of-care ultrasound (POCUS) has emerged as a potential tool to determine the presence of frailty and has been shown to accurately predict frailty and postoperative outcomes. In this article, we will describe the image acquisition of the quadriceps muscles and explain how they can be used to determine frailty and predict postoperative adverse events. We will present information on probe selection, patient positioning, and troubleshooting. Images from a demonstration will be used to present the POCUS technique and example results. The article will culminate in a discussion of the use of these images in medical decision-making and potential limitations.

作者聚焦:使用股四头肌床旁超声评估手术虚弱

Here, we present a protocol to assess frailty in the perioperative setting using point-of-care ultrasound to measure quadriceps thickness. This method offers a practical, non-invasive alternative to traditional assessment methods, potentially enhancing perioperative care by quickly identifying frail patients.

使用床旁超声识别虚弱:图像采集和评估

Frailty is a significant predictor of a range of adverse outcomes in surgical patients, including increased mechanical ventilation time, longer hospital ...

在心力衰竭患者管理中收集和实施床旁超声数据的工作流程和框架

副本

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在计算机中心血管疾病的临床试验

一种计算机辅助心血管分析诊断平台的研究

简单重症监护研究中重复临床检查和重症监护超声检查的观察性研究方案

简单重症监护研究中重复临床检查和重症监护超声检查的观察性研究方案

基于国际专家共识的护理点肺超声诊断新生儿肺病的协议和指南

心力衰竭患者心肺运动测试中脑组织饱和监测的集成

FoCUS 图像采集故障排除:患者定位、换能器操作和图像优化

成人床旁肺部超声:图像采集

使用床旁超声识别虚弱:图像采集和评估

使用床旁超声识别虚弱:图像采集和评估

在心力衰竭患者管理中收集和实施床旁超声数据的工作流程和框架

副本

摘要

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此视频中的章节

在计算机中 心血管疾病的临床试验

一种计算机辅助心血管分析诊断平台的研究

简单重症监护研究中重复临床检查和重症监护超声检查的观察性研究方案

简单重症监护研究中重复临床检查和重症监护超声检查的观察性研究方案

基于国际专家共识的护理点肺超声诊断新生儿肺病的协议和指南

心力衰竭患者心肺运动测试中脑组织饱和监测的集成

FoCUS 图像采集故障排除:患者定位、换能器操作和图像优化

成人床旁肺部超声:图像采集

使用床旁超声识别虚弱:图像采集和评估

使用床旁超声识别虚弱:图像采集和评估

在计算机中心血管疾病的临床试验