Field Ultrasound Evaluation of Central Volume Status and Acute Mountain Sickness

Pitman, Justin; Thapa, Ghan Bahadur; Harris, N. Stuart

doi:10.1016/j.wem.2015.02.008

Cited by 9 publications

(9 citation statements)

References 35 publications

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“…Ultrasonography has been attempted as a clinical prognosticator at high altitudes [23] but with limited diagnostic success as a point estimate of AMS [24]. Similar to other high-altitude ultrasound studies [13], our results indicated that a single measurement of intravascular volume has limited applicability and is not a useful clinical adjunct to the evaluation and performance determinant of high-altitude mountaineers.…”

Section: Discussionsupporting

confidence: 52%

“…Another objective measurement of hydration status is by ultrasound measurement of the IVC-CI during the respiratory cycle. This allows direct measurement of the vascular status and has been shown to reliably predict volume status in both emergency department patients and healthy cohorts in field clinics [13]. During inspiration, generated negative intrathoracic pressure and positive intra-abdominal pressure increases venous return and collapses the IVC.…”

Section: Introductionmentioning

confidence: 99%

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Ladd

Shea

Bagley

et al. 2017

Cureus

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Section: Discussionsupporting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Correction

Ladd

Shea

Bagley

et al. 2017

Cureus

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“…The use of general anesthetics is associated with hypotension, which may lead to adverse outcomes. [37] Ultrasound can predict post-anesthesia hypotension by measuring the IVC CI and diameter A recent study [38] has also evaluated the utility of ultrasound in detecting volume status in the pre-hospital setting. Ultrasound showed that subjects with acute mountain sickness have greater intravascular volume than controls.…”

Section: Assessment Of Corrected Fl Ow Timementioning

confidence: 99%

The utility of point-of-care ultrasound in the assessment of volume status in acute and critically ill patients

Pourmand¹,

Pyle²,

Yamane³

et al. 2019

World Journal of Emergency Medicine

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BACKGROUND: Volume resuscitation has only been demonstrated to be effective in approximately fifty percent of patients. The remaining patients do not respond to volume resuscitation and may even develop adverse outcomes (such as acute pulmonary edema necessitating endotracheal intubation). We believe that point-of-care ultrasound is an excellent modality by which to adequately predict which patients may benefi t from volume resuscitation. DATA RESOURCES: We performed a search using PubMed, Scopus, and MEDLINE. The following search terms were used: fluid responsiveness, ultrasound, non-invasive, hemodynamic, fluid challenge, and passive leg raise. Preference was given to clinical trials and review articles that were most relevant to the topic of assessing a patient's cardiovascular ability to respond to intravenous fl uid administration using ultrasound. RESULTS: Point-of-care ultrasound can be easily employed to measure the diameter and collapsibility of various large vessels including the inferior vena cava, common carotid artery, subclavian vein, internal jugular vein, and femoral vein. Such parameters are closely related to dynamic measures of fluid responsiveness and can be used by providers to help guide fluid resuscitation in critically ill patients. CONCLUSION: Ultrasound in combination with passive leg raise is a non-invasive, costand time-effective modality that can be employed to assess volume status and response to fluid resuscitation. Traditionally sonographic studies have focused on the evaluation of large veins such as the inferior vena cava, and internal jugular vein. A number of recently published studies also demonstrate the usefulness of evaluating large arteries to predict volume status.

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“…Ultrasonography can also be used to determine total body fluid status in the field, most easily by measuring the inferior vena cava (IVC) collapsibility index (CI). Pitman et al used this technique in their study which compared volume status in high-altitude trekkers with symptoms of AMS to altitudematched controls without AMS (Pitman et al, 2015). The IVC CI evaluates a patient's IVC diameter throughout the respiratory cycle, comparing the smallest diameter to its largest by employing the use of M-mode on the ultrasound device.…”

Section: Vascularmentioning

confidence: 99%

Ultrasound in Austere Environments

Canepa¹,

Harris

2019

High Altitude Medicine & Biology

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Canepa, Carlo Andre, and N. Stuart Harris. Clinician's corner: ultrasound in austere environments. High Alt Med Biol. 20:103-111, 2019.-Ultrasonography is a noninvasive, reliable, repeatable, and inexpensive technology that has dramatically changed the practice of medicine. The clinical use of portable ultrasound devices has grown tremendously over the last 10 years in the fields of intensive care, emergency medicine, and anesthesiology. In this review we present the various ways that handheld portable ultrasound devices can be used in austere environments. The purpose of this review is to consider the wide-ranging applications for providers going into the austere environment, which include pulmonary, ocular, vascular, and trauma evaluations, the postdisaster setting, and the role of ultrasonography in tropical diseases. This review is not meant to be a comprehensive how-to guide for each study type, but an overview of some of the more common wilderness applications. This review also focuses on the limitation of each study type. The goal is to help wilderness medicine providers feel more comfortable incorporating ultrasonography as part of their tool kit when heading into austere environments.

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Field Ultrasound Evaluation of Central Volume Status and Acute Mountain Sickness

Cited by 9 publications

References 35 publications

Correction

Correction

The utility of point-of-care ultrasound in the assessment of volume status in acute and critically ill patients

Ultrasound in Austere Environments

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