Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
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Randomized Controlled Trial
Integrated cardiopulmonary sonography: a useful tool for assessment of acute pulmonary edema in the intensive care unit.
Bedside sonography has become a popular method of assessment of critically ill patients with shock and dyspnea. This study evaluated the usefulness of integrated cardiopulmonary sonography for assessment of acute pulmonary edema. ⋯ Integrated cardiopulmonary sonography resulted in faster and better-informed clinical decision making, shortened the time to diagnosis of the pulmonary edema etiology, and decreased fluid use. However, the impact of this examination on prognoses requires further study. We propose that integrated cardiopulmonary sonography may be a useful bedside tool for treatment of ICU patients with acute pulmonary edema.
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Randomized Controlled Trial Comparative Study
A randomized clinical trial comparing the effectiveness of ultrasound guidance versus nerve stimulation for lateral popliteal-sciatic nerve blocks in obese patients.
Ultrasound guidance may decrease the procedural time for many peripheral nerve blocks compared to nerve stimulation, but these studies have generally excluded obese patients. This single-blinded randomized clinical trial was designed to compare procedural times and related outcomes for ultrasound- versus nerve stimulation-guided lateral popliteal-sciatic nerve blockade specifically in obese patients. ⋯ The results of this study show that, for obese patients undergoing lateral popliteal-sciatic nerve blocks, ultrasound guidance reduces the procedural time and procedure-related pain and increases patient satisfaction compared to nerve stimulation while providing similar block characteristics.
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Randomized Controlled Trial
Transition from nerve stimulator to sonographically guided axillary brachial plexus anesthesia in hand surgery: block quality and patient satisfaction during the transition period.
Sonographic guidance for peripheral nerve anesthesia has proven increasingly successful in clinical practice; however, fears that a change to sonographically guided regional anesthesia may impair the block quality and operating room work flow persist in certain units. In this retrospective cohort study, block quality and patient satisfaction during the transition period from nerve stimulator to sonographic guidance for axillary brachial plexus anesthesia in a tertiary referral center were investigated. ⋯ Transition from nerve stimulator to sonographic guidance for axillary brachial plexus blocks did not change block performance times or success rates. Patient satisfaction was improved even during the early institutional transition period.
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Randomized Controlled Trial
A randomized comparison of long-and short-axis imaging for in-plane ultrasound-guided femoral perineural catheter insertion.
Continuous femoral nerve blocks provide effective analgesia after knee arthroplasty, and infusion effects depend on reliable catheter location. Ultrasound-guided perineural catheter insertion using a short-axis in-plane technique has been validated, but the optimal catheter location relative to target nerve and placement orientation remain unknown. We hypothesized that a long-axis in-plane technique for femoral perineural catheter insertion results in faster onset of sensory anesthesia compared to a short-axis in-plane technique. ⋯ Long-axis in-plane femoral perineural catheters result in a slightly faster onset of sensory anesthesia, but placement takes longer to perform without other clinical advantages.
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Randomized Controlled Trial Comparative Study
E-point septal separation compared to fractional shortening measurements of systolic function in emergency department patients: prospective randomized study.
Rapid bedside assessment of left ventricular (LV) function can aid in the evaluation of the critically ill patient and guide clinical management. Our primary hypothesis was that mitral valve E-point septal separation measurements would correlate with contemporaneous fractional shortening measurements of LV systolic function when performed by emergency physicians. Our secondary hypothesis was that E-point septal separation as a continuous variable would predict fractional shortening using a linear regression model. ⋯ E-point septal separation and fractional shortening measurements had a moderate negative correlation. E-point septal separation, when used as a continuous variable in a linear regression model, did not reliably predict fractional shortening.