Name: diaphragmatic ultrasound in adults: image acquisition and interpretation
Uploaded: 2025-01-31T14:20:00.000+00:00
Duration: 5 min 51 s
Description: Diaphragm dysfunction is a widely recognized concern across numerous medical specialties and clinical settings. Timely and accurate assessment of the ...

<ol>
	<li>Bronshteyn, Y. S., Blitz, J., Hashmi, N., Krishnan, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Logistics+of+perioperative+diagnostic+point-of-care+ultrasound:+Nomenclature,+scope+of+practice,+training,+credentialing/privileging,+and+billing.">Logistics of perioperative diagnostic point-of-care ultrasound: Nomenclature, scope of practice, training, credentialing/privileging, and billing.</a> Int Anesthesiol Clin. 60 (3), 1-7 (2022).</li><li>Osman Elew, A. N. E., Abd Alrahman, A. A. H., El Khayat, H. M. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diaphragmatic+ultrasound:+Review+article.">Diaphragmatic ultrasound: Review article.</a> The Egyptian Journal of Hospital Medicine. 87 (1), 1006-1009 (2022).</li><li>Boussuges, A., Rives, S., Finance, J., Bregeon, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessment+of+diaphragmatic+function+by+ultrasonography:+Current+approach+and+perspectives.">Assessment of diaphragmatic function by ultrasonography: Current approach and perspectives.</a> World J Clin Cases. 8 (12), 2408-2424 (2020).</li><li>Volpicelli, G., 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=International+evidence-based+recommendations+for+point-of-care+lung+ultrasound.">International evidence-based recommendations for point-of-care lung ultrasound.</a> Intensive Care Med. 38 (4), 577-591 (2012).</li><li>Saad, M., 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=Ultrasonographic+assessment+of+diaphragmatic+function+and+its+clinical+application+in+the+management+of+patients+with+acute+respiratory+failure.">Ultrasonographic assessment of diaphragmatic function and its clinical application in the management of patients with acute respiratory failure.</a> Diagnostics (Basel). 13 (3), 411 (2023).</li><li>Santana, P. V., Cardenas, L. Z., Albuquerque, A. L. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diaphragm+ultrasound+in+critically+ill+patients+on+mechanical+ventilation-evolving+concepts.">Diaphragm ultrasound in critically ill patients on mechanical ventilation-evolving concepts.</a> Diagnostics (Basel). 13 (6), 1116 (2023).</li><li>Petrof, B. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diaphragm+weakness+in+the+critically+ill:+Basic+mechanisms+reveal+therapeutic+opportunities.">Diaphragm weakness in the critically ill: Basic mechanisms reveal therapeutic opportunities.</a> Chest. 154 (6), 1395-1403 (2018).</li><li>Chu, S. 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=Point-of-care+application+of+diaphragmatic+ultrasonography+in+the+emergency+department+for+the+prediction+of+development+of+respiratory+failure+in+community-acquired+pneumonia:+A+pilot+study.">Point-of-care application of diaphragmatic ultrasonography in the emergency department for the prediction of development of respiratory failure in community-acquired pneumonia: A pilot study.</a> Front Med. 9, 960847 (2022).</li><li>Suttapanit, K., Wongkrasunt, S., Savatmongkorngul, S., Supatanakij, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasonographic+evaluation+of+the+diaphragm+in+critically+ill+patients+to+predict+invasive+mechanical+ventilation.">Ultrasonographic evaluation of the diaphragm in critically ill patients to predict invasive mechanical ventilation.</a> J Intensive Care. 11 (1), 40 (2023).</li><li>Vivier, 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=Diaphragm+ultrasonography+to+estimate+the+work+of+breathing+during+non-invasive+ventilation.">Diaphragm ultrasonography to estimate the work of breathing during non-invasive ventilation.</a> Intensive Care Med. 38 (5), 796-803 (2012).</li><li>Eduardo Garrido-Aguirre, S. a. N. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diaphragmatic+ultrasonography,+a+novel+approach+in+critical+care.">Diaphragmatic ultrasonography, a novel approach in critical care.</a> Ultrasound Q. 36, 54-58 (2020).</li><li>Sferrazza Papa, G. 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=A+review+of+the+ultrasound+assessment+of+diaphragmatic+function+in+clinical+practice.">A review of the ultrasound assessment of diaphragmatic function in clinical practice.</a> Respiration. 91 (5), 403-411 (2016).</li><li>Santana, P. V., Cardenas, L. Z., Albuquerque, A. L. P., Carvalho, C. R. R., Caruso, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diaphragmatic+ultrasound:+A+review+of+its+methodological+aspects+and+clinical+uses.">Diaphragmatic ultrasound: A review of its methodological aspects and clinical uses.</a> J Bras Pneumol. 46 (6), e20200064 (2020).</li><li>Qian, Z., Yang, M., Li, L., Chen, Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasound+assessment+of+diaphragmatic+dysfunction+as+a+predictor+of+weaning+outcome+from+mechanical+ventilation:+A+systematic+review+and+meta-analysis.">Ultrasound assessment of diaphragmatic dysfunction as a predictor of weaning outcome from mechanical ventilation: A systematic review and meta-analysis.</a> BMJ Open. 8 (9), e021189 (2018).</li><li>Kharma, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dysfunction+of+the+diaphragm:+Imaging+as+a+diagnostic+tool.">Dysfunction of the diaphragm: Imaging as a diagnostic tool.</a> Curr Opin Pulm Med. 19 (4), 394-398 (2013).</li><li>Tsui, J. J., Tsui, B. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+novel+systematic+abc+approach+to+diaphragmatic+evaluation+(abcde).">A novel systematic abc approach to diaphragmatic evaluation (abcde).</a> Can J Anaesth. 63 (5), 636-637 (2016).</li><li>Da Conceicao, D., 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=Validation+of+a+novel+point-of-care+ultrasound+method+to+assess+diaphragmatic+excursion.">Validation of a novel point-of-care ultrasound method to assess diaphragmatic excursion.</a> Reg Anesth Pain Med. 49 (11), 800-804 (2023).</li><li>Haaksma, M. 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=EXpert+consensus+on+diaphragm+ultrasonography+in+the+critically+ill+(EXODUS):+A+delphi+consensus+statement+on+the+measurement+of+diaphragm+ultrasound-derived+parameters+in+a+critical+care+setting.">EXpert consensus on diaphragm ultrasonography in the critically ill (EXODUS): A delphi consensus statement on the measurement of diaphragm ultrasound-derived parameters in a critical care setting.</a> Crit Care. 26 (1), 99 (2022).</li><li>El-Boghdadly, K., Goffi, A., Chan, V. <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+diaphragmatic+ultrasound+made+easy.">Point of care diaphragmatic ultrasound made easy.</a> Can J Anaesth. 64 (3), 327-328 (2017).</li><li>Kim, D. H., 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=Superior+trunk+block:+A+phrenic-sparing+alternative+to+the+interscalene+block:+A+randomized+controlled+trial.">Superior trunk block: A phrenic-sparing alternative to the interscalene block: A randomized controlled trial.</a> Anesthesiology. 131 (3), 521-533 (2019).</li><li>Bellissimo, C. A., Morris, I. S., Wong, J., Goligher, E. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Measuring+diaphragm+thickness+and+function+using+point-of-care+ultrasound.">Measuring diaphragm thickness and function using point-of-care ultrasound.</a> J Vis Exp. 201, e65431 (2023).</li><li>Goligher, E. C., 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=Measuring+diaphragm+thickness+with+ultrasound+in+mechanically+ventilated+patients:+feasibility,+reproducibility+and+validity.">Measuring diaphragm thickness with ultrasound in mechanically ventilated patients: feasibility, reproducibility and validity.</a> Intensive Care Med. 41 (4), 642-649 (2015).</li><li>Pereira, R. O. 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=Point-of-care+lung+ultrasound+in+adults:+Image+acquisition.">Point-of-care lung ultrasound in adults: Image acquisition.</a> J Vis Exp. (193), e64722 (2023).</li></ol>

<table><tbody><tr><td>Medical Ruler</td><td>MediChoice</td><td>NA</td><td>We used Medichoice as that is what is readily available at our institution and it comes with the skin marker, however any medical ruler will work. The majority of skin markers come with a type of ruler or measurement system, but if not a separate ruler can be used.</td></tr><tr><td>Skin Marker</td><td>MediChoice</td><td>NA</td><td>We again used Medichoice as that is what is readily available at our institution and it comes with the ruler, however any standard skin marker will work.</td></tr><tr><td>Ultrasound Gel</td><td>Aquasonic</td><td>NA</td><td>Any standard gel will work. Sterile packs are not necessary but can be used on a case-by-case basis at the providers discretion.</td></tr><tr><td>Ultrasound Machine&amp;nbsp;</td><td>Samsung and GE</td><td>NA</td><td>Any standard portable ultrasound machine will suffice.</td></tr></tbody></table>

diaphragmatic ultrasound in adults: image acquisition and interpretation

成人における横隔膜超音波:画像取得と解釈

Diaphragm dysfunction is a widely recognized concern across numerous medical specialties and clinical settings. Timely and accurate assessment of the ...

diaphragmatic-ultrasound-adults-image-acquisition

Research

JoVE Journal

Medicine

Diaphragmatic Ultrasound in Adults: Image Acquisition and Interpretation

365 ビュー.  University of Pittsburgh Medical Center. ポイントオブケア超音波(POCUS)は、その携帯性、非侵襲性、およびリアルタイムのイメージング機能により、横隔膜の機能障害のスクリーニングに不可欠な技術です。現在の横隔膜POCUSプロトコルは存在しますが、オペレーター間の信頼性が低く、コンセンサスガイドラインがありません。ここでは、再現性があり、簡単に実行で?...

ビデオ: 成人における横隔膜超音波:画像取得と解釈

Collecting Saliva and Measuring Salivary Cortisol and Alpha-amylase in Frail Community Residing Older Adults via Family Caregivers

Salivary measures have emerged in bio-behavioral research that are easy-to-collect, minimally invasive, and relatively inexpensive biologic markers of stress. This article we present the steps for collection and analysis of two salivary assays in research with frail, community residing older adults-salivary cortisol and salivary alpha amylase. The field of salivary bioscience is rapidly advancing and the purpose of this presentation is to provide an update on the developments for investigators interested in integrating these measures into research on aging. Strategies are presented for instructing family caregivers in collecting saliva in the home, and for conducting laboratory analyses of salivary analytes that have demonstrated feasibility, high compliance, and yield quality specimens. The protocol for sample collection includes: (1) consistent use of collection materials; (2) standardized methods that promote adherence and minimize subject burden; and (3) procedures for controlling certain confounding agents. We also provide strategies for laboratory analyses include: (1) saliva handling and processing; (2) salivary cortisol and salivary alpha amylase assay procedures; and (3) analytic considerations.

We demonstrate: (1) procedures for collection of salivary samples in cognitive impaired older adults by family caregivers in the home setting, (2) procedures for measuring stress activity via salivary cortisol and alpha amylase, and (3) representative profiles. Protocols that allow researchers to study stress-linked processes advance our understanding of biological sensitivity and susceptibility.

唾液を収集し、家族介護者を経由して高齢者を居住する虚弱コミュニティ唾液コルチゾールおよびα-アミラーゼの測定

Salivary measures have emerged in bio-behavioral research  that are easy-to-collect, minimally invasive, and relatively inexpensive  biologic markers of ...

医学

Diagnostic Ultrasound Imaging of Mouse Diaphragm Function

Function analysis of rodent respiratory skeletal muscles, particularly the diaphragm, is commonly performed by isolating muscle strips using invasive surgical procedures. Although this is an effective method of assessing in vitro diaphragm activity, it involves non-survival surgery. The application of non-invasive ultrasound imaging as an in vivo procedure is beneficial since it not only reduces the number of animals sacrificed, but is also suitable for monitoring disease progression in live mice. Thus, our ultrasound imaging method may likely assist in the development of novel therapies that alleviate muscle injury induced by various respiratory diseases. Particularly, in clinical diagnoses of obstructive lung diseases, ultrasound imaging has the potential to be used in conjunction with other standard tests to detect the early onset of diaphragm muscle fatigue. In the current protocol, we describe how to accurately evaluate diaphragm contractility in a mouse model using a diagnostic ultrasound imaging technique.

Diagnostic ultrasound imaging has proven to be effective in diagnosing various respiratory diseases in human and animal subjects. We demonstrate a comprehensive ultrasound protocol utilized by Dr. Zuo's lab to analyze diaphragm kinetics specifically in mouse models. This is also a non-invasive research technique which can provide quantitative information on mouse respiratory muscle function.

マウス絞り機能の診断用超音波イメージング

Function analysis of rodent respiratory skeletal muscles, particularly the diaphragm, is commonly performed by isolating muscle strips using invasive ...

Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults

Spatial and temporal characteristics of human walking are frequently evaluated to identify possible gait impairments, mainly in orthopedic and neurological patients1-4, but also in healthy older adults5,6. The quantitative gait analysis described in this protocol is performed with a recently-introduced photoelectric system (see&#160;Materials table) which has the potential to be used in the clinic because it is portable, easy to set up (no subject preparation is required before a test), and does not require maintenance and sensor calibration. The photoelectric system consists of series of high-density floor-based photoelectric cells with light-emitting and light-receiving diodes that are placed parallel to each other to create a corridor, and are oriented perpendicular to the line of progression7. The system simply detects interruptions in light signal, for instance due to the presence of feet within the recording area. Temporal gait parameters and 1D spatial coordinates of consecutive steps are subsequently calculated to provide common gait parameters such as step length, single limb support and walking velocity8, whose validity against a criterion instrument has recently been demonstrated7,9. The measurement procedures are very straightforward; a single patient can be tested in less than 5 min&#160;and a comprehensive report can be generated in less than 1&#160;min.

This protocol is used to evaluate spatial and temporal gait variables of neurological/orthopedic patients and older persons by means of a recently-introduced floor-based photocell system.

患者と高齢者における時空間歩行パラメータの臨床的評価

Spatial and temporal characteristics of human walking are frequently evaluated to identify possible gait impairments, mainly in orthopedic and ...

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.

プロトコルおよび国際専門家のコンセンサスに基づいた新生児の肺疾患の診断にポイント ・ オブ ・ ケア肺超音波のためのガイドライン

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

Knee Arthrocentesis in Adults

Arthrocentesis of the knee is a procedure in which a needle is inserted into the knee joint, and synovial fluid is aspirated. An arthrocentesis can be diagnostic or therapeutic. Synovial fluid may be removed for testing to determine the nature of the knee effusion. If septic arthritis is suspected, urgent arthrocentesis before initiation of antibiotic treatment is indicated. Moreover, arthrocentesis can also aid in diagnosing crystal-induced arthritis such as gout or pseudogout, or non-inflammatory arthritis such as osteoarthritis. Identifying the cause of the knee effusion can guide treatment. Furthermore, removing fluid from a knee can reduce intraarticular pressure to decrease pain and improve range of motion. There is no absolute contraindication to performing this procedure, but in selecting the needle entry site, an area of skin that is infected should be avoided. Therefore, caution should be exercised when a patient presents with suspected cellulitis over the knee joint to avoid the potential risk of causing iatrogenic septic arthritis. A knee that has undergone arthroplasty should be assessed for arthrocentesis by an orthopedic surgeon. Arthrocentesis of the knee is typically performed with the patient supine. The site for needle insertion is marked, and then the skin is disinfected. After a local anesthetic is administered, a needle is inserted along the pathway that was anesthetized. Synovial fluid is aspirated, and then the needle is withdrawn. Pressure is applied until any bleeding stops. The synovial fluid can be analyzed for infection and inflammation but cannot directly confirm a diagnosis of internal derangement or autoimmune causes of arthritis. In addition to the history and physical examination, laboratory findings and imaging can clarify the etiology of a knee effusion.

Here the protocol describes arthrocentesis of the knee, a procedure in which a needle is inserted into the knee joint, and synovial fluid is aspirated. Synovial fluid may be removed for testing to determine the nature of the knee effusion. Arthrocentesis of the knee is typically performed with the patient supine.

成人の膝関節穿刺

Arthrocentesis of the knee is a procedure in which a needle is inserted into the knee joint, and synovial fluid is aspirated. An arthrocentesis can be ...

Drug Treatment by Central Venous Catheter in a Mouse Model of Angiotensin II Induced Abdominal Aortic Aneurysm and Monitoring by 3D Ultrasound

Since pharmaceutical treatment options are lacking in the clinical management of abdominal aortic aneurysm (AAA), animal models, in particular mouse models, are applied to advance the understanding of the disease pathogenesis and to identify potential therapeutic targets. Testing novel drug candidates to block AAA growth in these models generally requires repeated drug administration during the time course of the experiment. Here, we describe a compiled protocol for AAA induction, insertion of an intravenous catheter to facilitate prolonged therapy, and serial AAA monitoring by 3D ultrasound. Aneurysms are induced in apolipoprotein E (ApoE) deficient mice by angiotensin II release over 28 days from osmotic mini-pumps implanted subcutaneously into the mouse back. Subsequently, the surgical procedure for external jugular vein catheterization is conducted to allow for daily intravenous drug treatment or repeated blood sampling via a subcutaneous vascular access button. Despite the two dorsal implants, the monitoring of AAA development is readily facilitated by sequential semi-automated 3D ultrasound analysis, which yields comprehensive information on the expansion of aortic diameter and volume and on aneurysm morphology, as illustrated by experimental examples.

This protocol describes the consecutive implantation of an osmotic pump to induce abdominal aortic aneurysm by angiotensin II release in apolipoprotein E (ApoE) deficient mice and of a vascular access port with a jugular vein catheter for repeated drug treatment. Monitoring of aneurysm development by 3D ultrasound is effectively conducted despite dorsal implants.

アンジオテンシンII誘発腹部大動脈瘤のマウスモデルにおける中心静脈カテーテルによる薬物治療と3D超音波によるモニタリング

Since pharmaceutical treatment options are lacking in the clinical management of abdominal aortic aneurysm (AAA), animal models, in particular mouse ...

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.

成人におけるポイントオブケア肺超音波:画像取得

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

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

The use of routine point-of-care ultrasound (POCUS) is increasing in neonatal intensive care units (NICUs), with several centers advocating for 24 h equipment availability. In 2018, the sonographic algorithm for life-threatening emergencies (SAFE) protocol was published, which allows the assessment of neonates with sudden decompensation to identify abnormal contractility, tamponade, pneumothorax, and pleural effusion. In the study unit (with a consulting neonatal hemodynamics and POCUS service), the algorithm was adapted by including consolidated core steps to support at-risk newborns, aiding clinicians in managing cardiac arrest, and adding views to verify correct intubation. This paper presents a protocol that can be applied in the NICU and the delivery room (DR) in relation to three scenarios: cardiac arrest, hemodynamic deterioration, or respiratory decompensation. 
This protocol can be performed with a state-of-the-art ultrasound machine or an affordable handheld device; the image acquisition protocol is carefully detailed. This method was designed to be learned as a general competence to obtain the timely diagnosis of life-threatening scenarios; the method aims to save time but does not represent a substitute for comprehensive and standardized hemodynamic and radiological analyses by a multidisciplinary team, which might not universally be on call but needs to be involved in the process. From January 2019 to July 2022, in our center, 1,045 hemodynamic consultation/POCUS consults were performed with 25 patients requiring the modified SAFE protocol (2.3%), and a total of 19 procedures were performed. In five cases, trained fellows on call resolved life-threatening situations. Clinical examples are provided that show the importance of including this technique in the care of critical newborns.

Here, we present a protocol that can be applied in the neonatal intensive care unit and the delivery room in relation to three scenarios: cardiac arrest, hemodynamic deterioration, or respiratory decompensation. This protocol can be performed with a state-of-the-art ultrasound machine or an affordable handheld device; an image acquisition protocol is carefully detailed.

重症新生児の生命を脅かす緊急事態における画像取得のための修正超音波アルゴリズム

The use of routine point-of-care ultrasound (POCUS) is increasing in neonatal intensive care units (NICUs), with several centers advocating for 24 h ...

周術期の誤嚥リスクを軽減するための胃超音波技術

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.

著者スポットライト:周術期ケアにおける胃内容物評価とリスク層別化のためのポイントオブケア超音波 

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.

成人における胃のポイントオブケア超音波検査:画像の取得と解釈

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

成人における横隔膜超音波:画像取得と解釈

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唾液を収集し、家族介護者を経由して高齢者を居住する虚弱コミュニティ唾液コルチゾールおよびα-アミラーゼの測定

マウス絞り機能の診断用超音波イメージング

患者と高齢者における時空間歩行パラメータの臨床的評価

プロトコルおよび国際専門家のコンセンサスに基づいた新生児の肺疾患の診断にポイント・オブ・ケア肺超音波のためのガイドライン

成人の膝関節穿刺

アンジオテンシンII誘発腹部大動脈瘤のマウスモデルにおける中心静脈カテーテルによる薬物治療と3D超音波によるモニタリング

成人におけるポイントオブケア肺超音波:画像取得

重症新生児の生命を脅かす緊急事態における画像取得のための修正超音波アルゴリズム

成人における胃のポイントオブケア超音波検査:画像の取得と解釈

成人における胃のポイントオブケア超音波検査:画像の取得と解釈

成人における横隔膜超音波:画像取得と解釈

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唾液を収集し、家族介護者を経由して高齢者を居住する虚弱コミュニティ唾液コルチゾールおよびα-アミラーゼの測定

マウス絞り機能の診断用超音波イメージング

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プロトコルおよび国際専門家のコンセンサスに基づいた新生児の肺疾患の診断にポイント ・ オブ ・ ケア肺超音波のためのガイドライン

成人の膝関節穿刺

アンジオテンシンII誘発腹部大動脈瘤のマウスモデルにおける中心静脈カテーテルによる薬物治療と3D超音波によるモニタリング

成人におけるポイントオブケア肺超音波:画像取得

重症新生児の生命を脅かす緊急事態における画像取得のための修正超音波アルゴリズム

成人における胃のポイントオブケア超音波検査:画像の取得と解釈

成人における胃のポイントオブケア超音波検査:画像の取得と解釈

プロトコルおよび国際専門家のコンセンサスに基づいた新生児の肺疾患の診断にポイント・オブ・ケア肺超音波のためのガイドライン