重症床旁即时超声检查的流程
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摘要
多项床旁超声检查整合起来,可形成各种床旁超声诊疗流程,将这些流程应用于创伤、呼吸衰竭、休克等特定的重症患者,不仅可以提高评估的准确性,还能在很大程度上避免遗漏临床信息。笔者简介创伤的重点超声评估流程、急诊床边肺脏超声检查流程、目标导向的经胸心脏超声评估流程、休克患者快速超声评估流程四种常用的检查流程。
Integration of a number of beside ultrasound examination can form various kinds of protocols. These protocols can be used in critical patients with trauma,respiratory failure and shock. Those can not only improve the accuracy of the assessment,but also avoid missing clinical information. In this paper,we focus on four common protocols,the focus assessment with sonography in trauma( FAST),the beside lung ultrasound in emergency( BLUE),the focus assessed transthoracic echocardiography( FATE) and the rapid ultrasound in shock( RUSH).
Integration of a number of beside ultrasound examination can form various kinds of protocols. These protocols can be used in critical patients with trauma,respiratory failure and shock. Those can not only improve the accuracy of the assessment,but also avoid missing clinical information. In this paper,we focus on four common protocols,the focus assessment with sonography in trauma( FAST),the beside lung ultrasound in emergency( BLUE),the focus assessed transthoracic echocardiography( FATE) and the rapid ultrasound in shock( RUSH).
引文
[1]王锦权.重症患者救治的临床思维特征[J/CD].中华诊断学电子杂志,2017,5(1):42-45.
[2]Richards JR,Schleper NH,Woo BD,et al.Sonographic assessment of blunt abdominal trauma:a 4-year prospective study[J].J Clin Ultrasound,2002,30(2):59-67.
[3]Kirkpatrick AW,sirois M,Laupland KB,et al.Hand-held thoracic sonography for detecting post-traumatic pneumothoraces:the Extend Focused Assessment with sonography for trauma(EFAST)[J].J Trauma,2004,57(2):288-295.
[4]Sheng AY,Dalziel P,Liteplo AS,et al.Focused assessment with sonography in trauma and abdominal computed tomography utilization in adult trauma patients:trends over the last decade[J].Emerg Med Int,2013:678380.
[5]Zamani M,Masoumi B,Esmailian M,et al.A comparative analysis of diagnostic accuracy of focused assessment with sonography for trauma performed by emergency medicine and radiology residents[J].Iran Red Crescent Med J,2015,17(12):e20302.
[6]O'keeffe M,Clark S,Kbsoa F,et al.Imaging protocols for trauma patients:trauma series,extended focused assessment with sonography for trauma,and selective and whole body computed tomography[J].Semin Roentgenol,2016,51(3):130-142.
[7]Sauter TC,Hoess S,Lehmann B,et al.Detection of pneumothoraces in patients with multiple blunt trauma:use and limitations of e FAST[J].Emerg Med J,2016,5(12):205980.
[8]Lichtenstein DA,Mezière GA.Relevance of lung ultrasound in the diagnosis of acute respiratory failure:the BLUE protocol[J].Chest,2008,134(1):117-125.
[9]Lichtenstein DA.BLUE-protocol and FALLS-protocol:two applications of lung ultrasound in the critically ill[J].Chest,2015,147(6):1659-70.
[10]Jensen MB,Sloth E,Larsen KM,et al.Transthoracic echocardiography for cardiopulmonary monitoring in intensive care[J].Eur J Anaesthesiol,2004(2):700-707
[11]Frederiksen CA,Knudsen L,Juhl-Olsen P,et al.Focus-assessed transthoracic echocardiography in the sitting position:two lifesaving cases[J].Acta Anaesthesiol Scand,2011,55(1):126-129.
[12]范立,王春生,程蕾蕾.超声心动图评估主动脉瓣置换术后早期并发症的临床应用[J/CD].中华诊断学电子杂志,2014,2(1):1-8.
[13]Perera P,Mailhot T,Riley D,et al.The RUSH exam:rapid ultrasound in shock in the evaluation of the criticallyⅢ[J].Emerg Med Clin North Am,2010,28(1):29-56.
[14]Schefold JC,Storm C,Bercher S,et al.Inferior vena cava diameter correlates with invasive hemodynamic measures in mechanically ventilated intensive care unit patients with sepsis[J].J Emerg Med,2010,38(5):632-637.
[15]Stawicki SP,Braslow BM,Panebianco NL,et al.Intensivist use of hand-carried ultrasonography to measure I VC collapsibility in estimating in travascularvolu mestatus:correlations with CVP[J].J Am Coll Surg,2009,209(1):55-61.
[16]Kory PD,Pellecchia CM,Shiloh AL,et al.Accuracy of ultrasonography performed by critical care physicians for the diagnosis of DVT[J].Chest,2011,139(3):538-542.
[17]Blanco P,Aguiar FM,Blaivas M.Rapid ultrasound in shock(RUSH)velocity-time integral:a proposal to expand the RUSH protocol[J].J Ultrasound Med,2015,34(9):1691-1700.
[18]Bateille B,Riu B,Ferre F,et al.Integrated use of beside lung ultrasound and echocardiography in acute respiratory failure:a prospective observational study in ICU[J].Chest,2014,146(6):1586-1593.
[19]Nazerian P,Vanni S,Volpicelli G,et al.Accuracy of point of care multiorgan ultrasonography for the diagnosis of pulmonary embolism[J].Chest,2014,145(5):950-957.
[2]Richards JR,Schleper NH,Woo BD,et al.Sonographic assessment of blunt abdominal trauma:a 4-year prospective study[J].J Clin Ultrasound,2002,30(2):59-67.
[3]Kirkpatrick AW,sirois M,Laupland KB,et al.Hand-held thoracic sonography for detecting post-traumatic pneumothoraces:the Extend Focused Assessment with sonography for trauma(EFAST)[J].J Trauma,2004,57(2):288-295.
[4]Sheng AY,Dalziel P,Liteplo AS,et al.Focused assessment with sonography in trauma and abdominal computed tomography utilization in adult trauma patients:trends over the last decade[J].Emerg Med Int,2013:678380.
[5]Zamani M,Masoumi B,Esmailian M,et al.A comparative analysis of diagnostic accuracy of focused assessment with sonography for trauma performed by emergency medicine and radiology residents[J].Iran Red Crescent Med J,2015,17(12):e20302.
[6]O'keeffe M,Clark S,Kbsoa F,et al.Imaging protocols for trauma patients:trauma series,extended focused assessment with sonography for trauma,and selective and whole body computed tomography[J].Semin Roentgenol,2016,51(3):130-142.
[7]Sauter TC,Hoess S,Lehmann B,et al.Detection of pneumothoraces in patients with multiple blunt trauma:use and limitations of e FAST[J].Emerg Med J,2016,5(12):205980.
[8]Lichtenstein DA,Mezière GA.Relevance of lung ultrasound in the diagnosis of acute respiratory failure:the BLUE protocol[J].Chest,2008,134(1):117-125.
[9]Lichtenstein DA.BLUE-protocol and FALLS-protocol:two applications of lung ultrasound in the critically ill[J].Chest,2015,147(6):1659-70.
[10]Jensen MB,Sloth E,Larsen KM,et al.Transthoracic echocardiography for cardiopulmonary monitoring in intensive care[J].Eur J Anaesthesiol,2004(2):700-707
[11]Frederiksen CA,Knudsen L,Juhl-Olsen P,et al.Focus-assessed transthoracic echocardiography in the sitting position:two lifesaving cases[J].Acta Anaesthesiol Scand,2011,55(1):126-129.
[12]范立,王春生,程蕾蕾.超声心动图评估主动脉瓣置换术后早期并发症的临床应用[J/CD].中华诊断学电子杂志,2014,2(1):1-8.
[13]Perera P,Mailhot T,Riley D,et al.The RUSH exam:rapid ultrasound in shock in the evaluation of the criticallyⅢ[J].Emerg Med Clin North Am,2010,28(1):29-56.
[14]Schefold JC,Storm C,Bercher S,et al.Inferior vena cava diameter correlates with invasive hemodynamic measures in mechanically ventilated intensive care unit patients with sepsis[J].J Emerg Med,2010,38(5):632-637.
[15]Stawicki SP,Braslow BM,Panebianco NL,et al.Intensivist use of hand-carried ultrasonography to measure I VC collapsibility in estimating in travascularvolu mestatus:correlations with CVP[J].J Am Coll Surg,2009,209(1):55-61.
[16]Kory PD,Pellecchia CM,Shiloh AL,et al.Accuracy of ultrasonography performed by critical care physicians for the diagnosis of DVT[J].Chest,2011,139(3):538-542.
[17]Blanco P,Aguiar FM,Blaivas M.Rapid ultrasound in shock(RUSH)velocity-time integral:a proposal to expand the RUSH protocol[J].J Ultrasound Med,2015,34(9):1691-1700.
[18]Bateille B,Riu B,Ferre F,et al.Integrated use of beside lung ultrasound and echocardiography in acute respiratory failure:a prospective observational study in ICU[J].Chest,2014,146(6):1586-1593.
[19]Nazerian P,Vanni S,Volpicelli G,et al.Accuracy of point of care multiorgan ultrasonography for the diagnosis of pulmonary embolism[J].Chest,2014,145(5):950-957.