ultrasound pericardial effusion - university of florida...pericardial effusion rohit patel, md...
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UltrasoundPericardial Effusion
Rohit Patel, MDUniversity of Florida Health
Director, Critical Care Ultrasound Surgical ICUCenter for Intensive Care
Gainesville, Florida
Sunday, August 14, 16
Clinical CasePt presents speaking partial sentences saturations 78%, confused
What do you do?
Grai. Acta Anaesthesiology. 2001Sunday, August 14, 16
Golden hour
Problem
OrderTech Reader
Back to you
Treatment
Grai. Acta Anaesthesiology. 2001Sunday, August 14, 16
Golden hour
Problem
OrderTech Reader
Back to you
Treatment
Point of care
Grai. Acta Anaesthesiology. 2001Sunday, August 14, 16
Sunday, August 14, 16
Sunday, August 14, 16
Sunday, August 14, 16
The PumpPericardial effusion?
Global contractility of left ventricle?
Relative size of right ventricle to left ventricle?
Joseph M, et al. Transthoracic echocardiography to identify or exclude cardiac cause of shock. Chest 2004Bealieu Y, et al. Specific skill set and gaols of focused echocardiography for critical care physicians. Crit Care Med 2007Sunday, August 14, 16
Back to the pump
Sunday, August 14, 16
Back to the pump
Sunday, August 14, 16
Effusion around the pump
Sunday, August 14, 16
Video
Perera P. "http://www.sound-bytes.tv"
Sunday, August 14, 16
Video
Perera P. "http://www.sound-bytes.tv"
Sunday, August 14, 16
Effusion around the pump
Grades
Small less than 10 mm
Moderate 10-15 mm
Large greater than 15 mm
Sunday, August 14, 16
Video
Perera P. "http://www.sound-bytes.tv"
Descending Aorta
Sunday, August 14, 16
Video
Perera P. "http://www.sound-bytes.tv"
Descending Aorta
Sunday, August 14, 16
Video
Perera P. "http://www.sound-bytes.tv"
Descending Aorta
Sunday, August 14, 16
Video
Perera P. "http://www.sound-bytes.tv"
Descending Aorta
Sunday, August 14, 16
Video
Perera P. "http://www.sound-bytes.tv"
Sunday, August 14, 16
Video
Perera P. "http://www.sound-bytes.tv"
Sunday, August 14, 16
Video
Perera P. "http://www.sound-bytes.tv"
Sunday, August 14, 16
Video
Perera P. "http://www.sound-bytes.tv"
Sunday, August 14, 16
Effusion around the pumpTamponade or not?
Hallmark: RV free wall inversion, best recognized during diastole
Right atrial inversion during systole (more common and early finding)
Increased respiratory variation of mitral or aortic inflow velocities (greater than 25%)
Dilated inferior vena cava with decreased inspiratory collapse
ASE Committee Recomendations. Am Soc Echocardiography. 2005Sunday, August 14, 16
Effusion around the pump - tamponade
Sunday, August 14, 16
Video
Perera P. "http://www.sound-bytes.tv"
Sunday, August 14, 16
Video
Perera P. "http://www.sound-bytes.tv"
Sunday, August 14, 16
Video
Perera P. "http://www.sound-bytes.tv"
Sunday, August 14, 16
Video
Perera P. "http://www.sound-bytes.tv"
Sunday, August 14, 16
Sunday, August 14, 16
Sunday, August 14, 16
Sunday, August 14, 16
Sunday, August 14, 16
Effusion around the pumpTamponade or not?
Hallmark: RV free wall inversion, best recognized during diastole
Right atrial inversion during systole (more common and early finding)
Increased respiratory variation of mitral or aortic inflow velocities (greater than 25%)
Dilated inferior vena cava with decreased inspiratory collapse
ASE Committee Recomendations. Am Soc Echocardiography. 2005Sunday, August 14, 16
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