Speckle Tracking in Pneumothorax
What?! How? Why?
By Michael Prats on 11/25/19 06:00 AM
Speckle tracking is a relatively new ultrasound technology that lets you graph the movement of tissue over time. We know this can be useful to look at cardiac function, but no one dared to try it out on the lung...until now! The idea here is that by using speckle tracking on the pleural line, there might be a higher accuracy in detecting pneumothorax on ultrasound! It sounds crazy...but maybe it's just crazy enough to work. https://www.ultrasoundgel.org/81 https://www.ncbi.nlm.nih.gov/pubmed/31359081
Early Systolic Notching for Pulmonary Embolism
A New Doppler Sign of Massive and Submassive PE
By Michael Prats on 11/11/19 06:00 AM
A focused echo can go a long way in a patient with a suspected pulmonary embolus (PE). It can be especially valuable in those that are so sick and unstable that you need answers right away. In this way, point-of-care echo has been shown to help to diagnose submassive and massive pulmonary emboli by identifying signs of right heart strain. Echo parameters such as right ventricle diameter and right ventricular function (such as in TAPSE) are often part of the evaluation, but these are not as accurate as we would like. These authors propose a new doppler marker of a submassive or massive PE- enter the Early Systolic Notching pattern. https://www.ncbi.nlm.nih.gov/pubmed/31056367
Anterior vs Lateral Lung Fields in Heart Failure
Do we need both?
By Michael Prats on 10/28/19 06:00 AM
Suspected acute heart failure is a great reason to use point-of-care ultrasound. It can tell you in seconds if this patient is up to their neck in pulmonary edema. Knowing that interstitial edema is more common in dependent areas of the lung, one would think that the lateral areas of the lung fields would be most sensitive for the diagnosis. Likewise, if there is enough pulmonary edema to fill up the anterior lung fields, this theoretically should be pretty specific. But is this actually true?! These authors investigate the issue. https://www.ncbi.nlm.nih.gov/pubmed/30665807