Publications news

Lung ultrasound for early diagnosis of postoperative need for ventilatory support: a prospective observational study

30

Sep 19


Pulmonary complications have a significant impact on morbidity and mortality in patients after major surgery. We conducted a prospective observational study in Dijon and Pavia to evaluate whether lung ultrasound could be used as a predictive marker for postoperative ventilatory support in high-risk surgical patients. We included 109 patients admitted to the intensive care unit while having mechanical ventilation of the lungs following major surgery. Patients with a lung ultrasound score ≥ 10 had a lower PaO2 /FiO2 ratio, and needed more postoperative ventilatory support, than patients with lung ultrasound score < 10. The presence of ≥ 2 areas of consolidated lung was associated with a lower PaO2/FiO2 ratio, postoperative ventilatory support, longer intensive care stay and episodes of ventilator-associated pneumonia requiring antibiotics. Our results suggest that at intensive care unit admission, lung ultrasound scoring and detection of atelectasis can predict postoperative pulmonary outcomes after major visceral surgery, and could enhance bed-side decision making.   Anaesthesia. 2019 Sep 23. doi: 10.1111/anae.14859. From PubMed  

“Thoracic ultrasound: a narrative review” on ICM

17

Aug 19


This narrative review focuses on thoracic ultrasonography (lung and pleural) with the aim of outlining its utility for the critical care clinician. The article summarizes the applications of thoracic ultrasonography for the evaluation and management of pneumothorax, pleural effusion, acute dyspnea, pulmonary edema, pulmonary embolism, pneumonia, interstitial processes, and the patient on mechanical ventilatory support. Mastery of lung and pleural ultrasonography allows the intensivist to rapidly diagnose and guide the management of a wide variety of disease processes that are common features of critical illness. Its ease of use, rapidity, repeatability, and reliability make thoracic ultrasonography the "go to" modality for imaging the lung and pleura in an efficient, cost effective, and safe manner, such that it can largely replace chest imaging in critical care practice. It is best used in conjunction with other components of critical care ultrasonography to yield a comprehensive evaluation of the critically ill patient at point of care. From PubMed  

Lung Ultrasound for Daily Monitoring and Management of ARDS Patients

2

Aug 19


Have a look to this narrative review on Clinical Pulmonary Medicine from the GRIP on how and when lung ultrasound may be used for the daily monitoring and management of ARDS patients.    

Right ventricular total isovolumic time: Reference value study

23

Jul 19


Improve your knowledge of the right heart with this innovative study on references values of RV total isovolumic time on 181 healthy volunteers.

Ultrasound Diagnosis of Cardiac Arrest in a Patient With Hematologic Disease

8

Jan 19


A didactic case on information provided by point-of-care ultrasound during resuscitation to understand the underlying mechanism of a cardiac arrest. On CHEST, free full-text and didactic videos freely available until February 23rd at Science Direct

Use of tracheal ultrasound combined with clinical parameters to select left double-lumen tube size: A prospective observational study

17

Dec 18


Find out how to use tracheal ultrasound to improve the choice of left double-lumen tube in thoracic anaesthesia and to prevent the choice of too large and potentially harmful tubes. A prospective observational study conducted in Dijon by Prof. Bouhemad, with Dr. E. Roldi and the GRIP. Abstract here from the European Journal of Anaesthesiology.

Lung ultrasound for diagnosis and monitoring of ventilator-associated pneumonia

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4

Dec 18


From the "ultrasound section" of the GRIP and Pr. Bouhemad of the University of Dijon, a review on how to use lung ultrasound for an accurate early diagnosis of ventilator-associated pneumonia and to monitor its response to treatment. Soon on Pubmed, Free full text already available on ATM website

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Technical aspects of bedside respiratory monitoring of transpulmonary pressure

20

Nov 18


How to correctly place, calibrate and use esophageal catheter to mesure transpulmonary pressure and respiratory mechanics?   Have a look to the review article "Technical aspects of bedside respiratory monitoring of transpulmonary pressure" from Pr. Mojoli and the "Ventilation section" of The GRIP (Francesca Torriglia, Anita Orlando, Isabella Bianchi, Eric Arisi, Marco Pozzi).   Soon on Pubmed, but Free full text already available at the ATM website   Abstract: Transpulmonary pressure, that is the difference between airway pressure (Paw) and pleural pressure, is considered one of the most important parameters to know in order to set a safe mechanical ventilation in acute respiratory distress syndrome (ARDS) patients but also in critically ill obese patients, in abdominal pathologies or in pathologies affecting the chest wall itself. Transpulmonary pressure should rely on the assessment of intrathoracic pleural pressure. Esophageal pressure (Pes) is considered the best surrogate of pleural pressure in critically ill patients, but concerns about its reliability exist. The aim of this article is to describe the technique of Pes measurement in mechanically ventilated patients: the catheter insertion, the proper balloon placement and filling, the validation test and specific procedures to remove the main artifacts will be discussed.  

The GRIP on the Blue: “Lung ultrasound for Critically Ill Patients”

30

Oct 18


Take a look to our narrative review for the Blue Journal on lung ultrasound in critical care!   Abstract: Point-of-care ultrasound is increasingly used at the bedside to integrate the clinical assessment of the critically ill; in particular, lungultrasound greatly developed in the last decade. This review describes basic lung ultrasound signs and focuses on their applications in critical care. Lung semiotic is made both of artifacts (derived by air/tissue interface) and real images (i.e. effusions and consolidations), both providing significant information to identify the main acute respiratory disorders. Lung ultrasound signs, either alone or combined to other point-of-care ultrasound techniques, are helpful in the diagnostic approach to patients with acute respiratory failure, circulatory shock or cardiac arrest. Moreover, a semi-quantification of lung aeration can be performed at the bedside and used in mechanically ventilated patients to guide PEEP setting, to assess the efficacy of treatments, to monitor the evolution of the respiratory disorder, and to help the weaning process. Finally, lung ultrasound can be used for early detection and management of respiratory complications under mechanical ventilation, such as pneumothorax, ventilator-associated pneumonia, atelectasis and pleural effusions. In conclusion, lung ultrasound is a useful diagnostic and monitoring tool that might become in the next future part of the basic knowledge of physicians taking care of the critically ill patient.   From Pubmed

Assessment of Lung Aeration and Recruitment by CT Scan and Ultrasound in Acute Respiratory Distress Syndrome Patients.

8

Aug 18


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Is Lung ultrasound score a reliable tool to assess lung aeration? Definitely yes!

In this study newly published study conducted by the GRIP with Milan ICU we demonstrated a significant correlation between LUS score and lung density.

Have a look at the abstract!