Journal of clinical ultrasound : JCU
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BACKGROUND.: Our purpose was to evaluate the effectiveness of bedside sonography (US) in the detection of pneumothorax secondary to blunt thoracic trauma. METHODS.: In this prospective study, 240 hemithoraces of 120 consecutive patients with multiple trauma were evaluated with chest radiographs (CXR) and bedside thoracic US for the diagnosis of pneumothorax. CT examinations were performed in 68 patients. ⋯ The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of US were 91.4%, 97%, 91.4%, 97%, and 97%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CXR were 82.7%, 89.7%, 68.5%, 95%, and 89.5%, respectively. CONCLUSIONS.: Bedside thoracic US is an accurate method that can be used in trauma patients instead of CXR for the detection of pneumothorax.
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Periodic quality control (QC) for ultrasound scanners checks their overall performance, reducing the risk of inaccurate diagnoses. Data from routine annual QC activity were analyzed to optimize the scheduling and the criteria of further QC programs. Among all the ultrasound scanners (68 transducers) in use at the Regional Medical Department of the Aosta Valley, which are currently tested, 48.6% showed problems, mainly (35.3%) related to defects detectable by physical and mechanical inspection. ⋯ Failures were significantly related to the workload and to the "technological level" of the equipment. QC scheduling should therefore include a daily/weekly physical inspection in addition to a more complete, objective and software algorithms-based test, the frequency of which should be tailored on the basis of the equipment characteristics. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound, 2012.
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Vascular complications are important causes of neurologic sequelae among survivors of aneurysmal subarachnoid hemorrhage (SAH). However, little is known about the time course of cerebral hemodynamics and outcome in patients with and without angiographically confirmed cerebral vasospasm. ⋯ This study demonstrated that approximately one-third of acute phase aneurysmal SAH patients have asymptomatic delayed cerebral infarction, which was undetected by TCCS in one-third of them. This may explain why the accuracy of TCCS to predict clinical symptomatic cerebral vasospasm is suboptimal.
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Comparative Study
Demonstration of inferior vena cava compression by probe pressure during subxiphoid echocardiography.
We sought to compare the inferior vena cava diameter measured by transthoracic echocardiography and by transesophageal echocardiography in human and animals. Transthoracic echocardiography yielded lower inferior vena cava diameter values than transesophageal echocardiography. Adult and pediatric intensivists should pay attention to the risk of false measurement of the inferior vena cava anterior-posterior diameter that may be due to compression of the inferior vena cava by the sonographic probe when the subxiphoid view is used.