Abdominal Ultrasound and Genitourinary Ultrasound in the Intensive Care Unit

Part of the Respiratory Medicine book series (RM)

Abstract

Ultrasound imaging of the abdomen can be a valuable tool in the bedside assessment of the critically ill patient. A systematic and reproducible approach to critical care ultrasound assessment of the abdomen is outlined in this chapter, using a four-point, location-specific approach adapted from the Focused Assessment with Sonography for Trauma (FAST) exam. This system allows for the rapid assessment of multiple organs and pathologies pertinent to the critically ill patient, including assessment of the urinary tract, diagnosis of free fluid, and imaging of important vascular structures. Limitations of this approach and common pitfalls in imaging acquisition and interpretation are discussed. Adoption of this location-specific approach will provide the novice critical care ultrasonographer with a structure for approaching abdominal ultrasound in the intensive care unit.

Keywords

Catheter Attenuation Cage Transportation Hydronephrosis 

References

  1. 1.
    Miletic D, Fuckar Z, Sustic A, Mozetic V, Stimac D, Zauhar G. Sonographic measurement of absolute and relative renal length in adults. J Clin Ultrasound. 1998;26:185–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Mayo PH, Beaulieu Y, Doelken P, et al. American college of chest physicians/La Societe de Reanimation de Langue Francaise statement on competence in critical care ultrasonography. Chest. 2009;135:1050–60.CrossRefPubMedGoogle Scholar
  3. 3.
    Scalea TM, Rodriguez A, Chiu WC, et al. Focused assessment with sonography for trauma (FAST): results from an international consensus conference. J Trauma. 1999;46:466–72.CrossRefPubMedGoogle Scholar
  4. 4.
    KDOQI. Clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. 2004. http://www.kidney.org/professionals/kdoqi/guidelines_ckd/p5_lab_g6.htm. Accessed 22 May 2014.
  5. 5.
    Lichtenstein D, Lichtenstein D. Whole body ultrasonography in the critically ill. Heidelberg/New York: Springer; 2010.CrossRefGoogle Scholar
  6. 6.
    Atkinson PR, McAuley DJ, Kendall RJ, Abeyakoon O, Reid CG, Connolly J, Lewis D. Abdominal and cardiac evaluation with sonography in shock (ACES): an approach by emergency physicians for the use of ultrasound in patients with undifferentiated hypotension. Emerg Med J. 2009;26:87–91.CrossRefPubMedGoogle Scholar
  7. 7.
    Dent B, Kendall RJ, Boyle AA, Atkinson PR. Emergency ultrasound of the abdominal aorta by UK emergency physicians: a prospective cohort study. Emerg Med J. 2007;24:547–9.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Bentz S, Jones J. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. Accuracy of emergency department ultrasound scanning in detecting abdominal aortic aneurysm. Emerg Med J. 2006;23:803–4.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Rubano E, Mehta N, Caputo W, Paladino L, Sinert R. Systematic review: emergency department bedside ultrasonography for diagnosing suspected abdominal aortic aneurysm. Acad Emerg Med. 2013;20(2):128–38.CrossRefPubMedGoogle Scholar
  10. 10.
    Gaspari RJ, Horst K. Emergency ultrasound and urinalysis in the evaluation of flank pain. Acad Emerg Med. 2005;12:1180–4.CrossRefPubMedGoogle Scholar
  11. 11.
    Torres-Macho J, Antón-Santos JM, García-Gutierrez I, de Castro-García M, Gámez-Díez S, de la Torre PG, Latorre-Barcenilla G, Majo-Carbajo Y, Reparaz-González JC, de Casasola GG, Working Group of Clinical Ultrasound, Spanish Society of Internal Medicine. Initial accuracy of bedside ultrasound performed by emergency physicians for multiple indications after a short training period. Am J Emerg Med. 2012;30:1943–9.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Division of Pulmonary, Critical Care and Sleep MedicineMemorial Hospital of Rhode IslandPawtucketUSA

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