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Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

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Nội dung chi tiết: Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

Part IIThe BLUE-Protocol in Clinical UseThe Ultrasound Approach of an Acute Respiratory Failure: The BLUE-Protocol20Severe dyspnea is one of the most

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2 distressing situations for a patient. Aiming at a therapy based on immediate diagnosis is a legitimate target.The acute incapacity to breathe is one

of the most distressing situations one can live 111. The BLUE-protocol concentrates 18 years of efforts (mainly repeated submissions) aiming at prompt Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

ly relieving these patients.The idea of performing an ultrasound examination in time-dependent patients was not far from a blaspheme in 1985. definite

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

ly not envisageable according to the rules. Our approach possibly intrigued some doctors and nurses in the ERs of our institutions. During the managem

Part IIThe BLUE-Protocol in Clinical UseThe Ultrasound Approach of an Acute Respiratory Failure: The BLUE-Protocol20Severe dyspnea is one of the most

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2ded ER and eventually rushed after duty for a deserved nap, end of the story) did not fully see was that, after a few minutes, we were able to give to

the nurse therapeutic options, while organizing the transfer to the ICU. And what they did not see at all (occupied by 1,000 other tasks, medical, ad Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

ministrative, familial, etc.: this was not time for international guidelines on lung ultrasound) was that these options were in accordance with the fi

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

nal diagnosis.In the emergency setting, we use familiar tools since decades and centuries, mainly physicalexamination [2] and radiography [3Ị, two bas

Part IIThe BLUE-Protocol in Clinical UseThe Ultrasound Approach of an Acute Respiratory Failure: The BLUE-Protocol20Severe dyspnea is one of the most

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2ue [4-8]. One-quarter of the patients of the BLL’E-protocol in the first hour of management received erroneous or uncertain initial diagnoses, and man

y more received inappropriate therapy. The online document of Chest 134:117-125 details these 26 % of wrong diagnoses. CT seems a solution, but Chap. Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

29 will demonstrate its heavy drawbacks. One day. the community w ill maybe find this tool definitely too much irradiating [9].We initiated this long

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

work using an ADR-4000 (from 1982) then shifted for our Hitachi-405 (from 1992. last update 2008). Their 3 MHz sectorial probe and 5 MHz microconvex p

Part IIThe BLUE-Protocol in Clinical UseThe Ultrasound Approach of an Acute Respiratory Failure: The BLUE-Protocol20Severe dyspnea is one of the most

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2Some protocols are possibly built for exempting doctors to think, but this one requires to keep on being a doctor. It is permanently "piloted.” In som

e situations. it will just confirm an obvious diagnosis. In others, it will confidently invalidate a diagnosis which looked the likely one.For being p Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

erfectly understood (and anticipating remarks), the BLL'E-protocol should beD.A. Lichtenstein. Lung Ultrasound in the Critically III: The BLUE Protoco

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

l.157DOI 10.1007/978-3-319-15371-l_20,€> Springer International Publishing Switzerland 201615820 The Ultrasound Approach of an Acute Respiratory Failu

Part IIThe BLUE-Protocol in Clinical UseThe Ultrasound Approach of an Acute Respiratory Failure: The BLUE-Protocol20Severe dyspnea is one of the most

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2 used alone. Countless articles are now using lung ultrasound. and many propose various algorithms including echocardiography and other items, advocat

ing a "multiorgan approach." This is not the spirit of our protocol: it associates these various items but does not include them (the difference is su Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

bstantial). Comparing these studies with our approach would therefore make little sense. Regarding, for instance, the heart, see at the end of this ch

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

apter and at the end of Chap. 24 that we did not "forget" it (it is known that searchers may sometimes be absent minded, but up to forgetting the hear

Part IIThe BLUE-Protocol in Clinical UseThe Ultrasound Approach of an Acute Respiratory Failure: The BLUE-Protocol20Severe dyspnea is one of the most

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2f this chapter, and we invite the readers to make an opinion.Same remark for all clinical signs. Some academicians reproached to the BLUE-protocol to

forget these precious signs 110) (don't miss the discussion at the end of Ref. 110]). The clinical signs are. ironically, in the center of the Extende Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

d BLUE-protocol. for an improved accuracy (Chap. 35). The BLUE-profiles are here, available, up to this respected physician to integrate his favorite

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

clinical data at will in his clinical approach.The Design of the BLUE-ProtocolThe BLƯE-protocol was conceived in an observational study in a Parisian

Part IIThe BLUE-Protocol in Clinical UseThe Ultrasound Approach of an Acute Respiratory Failure: The BLUE-Protocol20Severe dyspnea is one of the most

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2y failure. Acute respiratory failure was defined based on clinical criteria requiring admission to the ICU.The gold standard was the tinal diagnosis c

onsidered in the hospitalization report, made by a medical ICU team (expert panel) who did not take into account the lung ultrasound data and used tra Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

ditional approaches. Uncertain diagnoses, multiple diagnoses, and rare causes (frequency <3 %) were excluded (see Chap. 21).After years necessary for

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

the publication of the preliminary background (mostly lung terminology). we were able to propose the analysis of three items at the lung area - with d

Part IIThe BLUE-Protocol in Clinical UseThe Ultrasound Approach of an Acute Respiratory Failure: The BLUE-Protocol20Severe dyspnea is one of the most

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2ts at the anterior wall (present or absent)3Alveolar and/or pleural syndrome (called PLAPS if posterior or/and lateral) (yes or no) We added an adapte

d venous analysis (indicated in 54 % of cases). Note that the venous analysis takes the major time (2 min of a 3 min examination), which is nonetheles Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

s short, since we use a simple machine with fast start-up. the same microconvex probe, time-saving maneuvers. only one setting, and a contact product

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

which allows major time savings. This will be repealed again, intentionally.The BLUE-Profiles: How Many in the BLUE-Protocol?A w ork of a "profiler.”

Part IIThe BLUE-Protocol in Clinical UseThe Ultrasound Approach of an Acute Respiratory Failure: The BLUE-Protocol20Severe dyspnea is one of the most

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2 20.1).There are eight profiles. The anterior analysis, which initiates the BLUE-protocol. can describe six situations. Five of them conclude the prot

ocol: the B-, B'-. A/B-. C-. and A'-profile. One of them is the A-profile (Video 10.1). The A-prolile designates an anterior chest wall with predomina Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

nt A-lines and lung sliding. The A-profile opens to three more profiles (A-DVT. A-no-V-PLAPS. and nude profile).Here are the profiles, which were assi

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2

milated to specific diseases. The term "profile" assumes an association of signs (two), plus a location (Fig. 20.2).1The A-profile plus DVT was assimi

Part IIThe BLUE-Protocol in Clinical UseThe Ultrasound Approach of an Acute Respiratory Failure: The BLUE-Protocol20Severe dyspnea is one of the most

Ebook Lung ultrasound in the critically ill - The BLUE protocol: Part 2A-no-V-PLAPS profile is a temporarylabel which designates an A-profile with noThe BLUE-Profiles: How Many in the BLUE-Protocol?159B-prolilc

Part IIThe BLUE-Protocol in Clinical UseThe Ultrasound Approach of an Acute Respiratory Failure: The BLUE-Protocol20Severe dyspnea is one of the most

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