Masui. The Japanese journal of anesthesiology
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Critical care echocardiography (CCE) using the transthoracic approach is a noninvasive imaging tool at the bedside and is of great value in the intensive care setting because of its portability, widespread availability, and rapid diagnostic capability. Time-dependent scenarios occur during shock and during cardiopulmonary resuscitation. Potentially treatable causes of shock or cardiac arrest including hypovolemia, cardiac tamponade, left ventricular failure, or massive pulmonary embolism should be detected or excluded as soon as possible. ⋯ Competence in basic CCE includes qualitative assessment of left ventricular cavity size, left ventricular systolic function, right ventricular cavity size and function, identification of pericardial fluid, and measurement of inferior vena cava diameter. Basic CCE should be a required part of the training of every ICU physician. This review discusses the application of basic CCE performed by the emphasis on focused or goal-directed assessment.
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Ultrasound guidance for regional anesthesia has gained enormous popularity in the past decade. The usage of ultrasound guidance has reawaken many block techniques in daily clinical practice. In this review, the author described how the ultrasound guidance has changed the manner of intraoperative and postoperative analgesic methods. ⋯ Those success rates increased using sonography, whereas the complications decreased. Advanced sonography shows the clear images of the detailed nerve tissues, so that we can perform the more pin-pointed nerve block considering postoperative benefits of patients. However, it must never be forgotten that both the pre-scan examination before a needle insertion and the continuous watching of an advancing needle tip are essential to perform safer regional anesthesia techniques.