Accuracy of ultrasonography performed by critical care physicians for the diagnosis of DVT.

Abstract:

BACKGROUND:DVT is common among critically ill patients. A rapid and accurate diagnosis is essential for patient care. We assessed the accuracy and timeliness of intensivist-performed compression ultrasonography studies (IP-CUS) for proximal lower extremity DVT (PLEDVT) by comparing results with the formal vascular study (FVS) performed by ultrasonography technicians and interpreted by radiologists. METHODS:We conducted a multicenter, retrospective review of IP-CUS examinations performed in an ICU by pulmonary and critical care fellows and attending physicians. Patients suspected of having DVT underwent IP-CUS, using a standard two-dimensional compression ultrasonography protocol for the diagnosis of PLEDVT. The IP-CUS data were collected prospectively as part of a quality-improvement initiative. The IP-CUS interpretation was recorded and timed at the end of the examination on a standardized report form. An FVS was then ordered, and the FVS result was used as the criterion standard for calculating sensitivity and specificity. Time delays between the IP-CUS and FVS were recorded. RESULTS:A total of 128 IP-CUS were compared with an FVS. Eighty-one percent of the IP-CUS were performed by fellows with <2 years of clinical ultrasonography experience. Prevalence of DVT was 20%. IP-CUS studies yielded a sensitivity of 86% and a specificity of 96% with a diagnostic accuracy of 95%. Median time delay between the ordering of FVS and the FVS result was 13.8 h. CONCLUSIONS:Rapid and accurate diagnosis of proximal lower extremity DVT can be achieved by intensivists performing compression ultrasonography at the bedside.

journal_name

Chest

journal_title

Chest

authors

Kory PD,Pellecchia CM,Shiloh AL,Mayo PH,DiBello C,Koenig S

doi

10.1378/chest.10-1479

subject

Has Abstract

pub_date

2011-03-01 00:00:00

pages

538-542

issue

3

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(11)60120-7

journal_volume

139

pub_type

杂志文章,多中心研究

相关文献

CHEST文献大全
  • Complications of flow-directed balloon-tipped catheters.

    abstract::Acute or short-term complications following the use of flow-directed balloon-tipped catheters are well recognized. Long-term sequelae are rarely reported. We report herein an early complication of pulmonary arterial rupture with infarction followed by the delayed development of a pulmonary arterial aneurysm. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.97.1.227

    authors: Smart FW,Husserl FE

    更新日期:1990-01-01 00:00:00

  • Addressing resource allocation issues in recommendations from clinical practice guideline panels: suggestions from an American College of Chest Physicians task force.

    abstract::Most panels that develop clinical practice guidelines are poorly equipped to address resource allocation or cost issues associated with management options. This risks neglect, arbitrariness, lack of transparency, and methodological flaws in consideration of resource allocation. We provide recommendations for guideline...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.129.1.182

    authors: Guyatt G,Baumann M,Pauker S,Halperin J,Maurer J,Owens DK,Tosteson AN,Carlin B,Gutterman D,Prins M,Lewis SZ,Schünemann H

    更新日期:2006-01-01 00:00:00

  • Comparison of titanium vascular closure staples with suture repair of the thoracic aorta in swine.

    abstract:OBJECTIVE:Devices that reduce technical difficulty and anastigmatic time when repairing large vessels such as the thoracic aorta would be beneficial. The aim of this study was to determine if titanium vascular closure staples (3 mm) could be safely and quickly applied in the repair of large vessels such as the thoracic...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.118.6.1762

    authors: Deb S,Martin B,Sun L,Burris D,Wherry D,Pikoulis E,Rhee P

    更新日期:2000-12-01 00:00:00

  • Oral corticosteroids increase esophageal acid contact times in patients with stable asthma.

    abstract:STUDY OBJECTIVES:The prevalence of gastroesophageal reflux disease (GERD) is higher in people with asthma than in control populations. Predisposing factors for GERD development may include asthma medications such as prednisone. The objective of this study was to determine whether prednisone alters GERD parameters in pe...

    journal_title:Chest

    pub_type: 临床试验,杂志文章

    doi:10.1378/chest.121.2.625

    authors: Lazenby JP,Guzzo MR,Harding SM,Patterson PE,Johnson LF,Bradley LA

    更新日期:2002-02-01 00:00:00

  • Amiodarone as a first-choice drug for restoring sinus rhythm in patients with atrial fibrillation: a randomized, controlled study.

    abstract:STUDY OBJECTIVES:To investigate the efficacy and safety of amiodarone administered as the drug of first choice in the conversion of atrial fibrillation, regardless of its duration. DESIGN:: Prospective, randomized, controlled clinical study. SETTING:: Tertiary cardiac referral center. PATIENTS:Two-hundred eight cons...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.117.6.1538

    authors: Vardas PE,Kochiadakis GE,Igoumenidis NE,Tsatsakis AM,Simantirakis EN,Chlouverakis GI

    更新日期:2000-06-01 00:00:00

  • Hydrofluoroalkane-134a beclomethasone dipropionate, 400 microg, is as effective as chlorofluorocarbon beclomethasone dipropionate, 800 microg, for the treatment of moderate asthma.

    abstract:OBJECTIVE:The improved lung deposition of hydrofluoroalkane-134a beclomethasone dipropionate (HFA-BDP) extrafine aerosol compared with chlorofluorocarbon beclomethasone dipropionate (CFC-BDP) suggests that lower doses of HFA-BDP may be required to provide equivalent asthma control. The present study was undertaken to t...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1378/chest.115.2.343

    authors: Gross G,Thompson PJ,Chervinsky P,Vanden Burgt J

    更新日期:1999-02-01 00:00:00

  • Nebulized 3% hypertonic saline solution treatment in hospitalized infants with viral bronchiolitis.

    abstract:OBJECTIVE:To determine the utility of inhaled hypertonic saline solution to treat infants hospitalized with viral bronchiolitis. DESIGN:Randomized, double-blind, controlled trial. Fifty-two hospitalized infants (mean +/- SD age, 2.9 +/- 2.1 months) with viral bronchiolitis received either inhalation of epinephrine, 1....

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.123.2.481

    authors: Mandelberg A,Tal G,Witzling M,Someck E,Houri S,Balin A,Priel IE

    更新日期:2003-02-01 00:00:00

  • Idiopathic hypertrophic subaortic stenosis with ostium secundum atrial septal defect: successful surgical correction.

    abstract::The first report of coincident IHSS and ostium secundum ASD is corroborated and successful septal myotomy and myectomy with patch closure of the ASD is described. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.68.2.246

    authors: Smith DC,Vieweg WV,Folkerth TL,Hagan AD

    更新日期:1975-08-01 00:00:00

  • Recent developments in the diagnosis and management of severe sepsis.

    abstract::The last 5 years have brought dramatic changes to the care of patients with severe sepsis. While early diagnosis remains a challenge and, regrettably, a rapid, sensitive, and specific diagnostic test is still lacking, the methods to identify those critically ill patients who are likely to die have become clearer. The ...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.06-2535

    authors: Wheeler AP

    更新日期:2007-12-01 00:00:00

  • Advanced presentation of lung cancer in Asian immigrants: a case-control study.

    abstract:STUDY OBJECTIVES:To determine if Asian immigrants to the United States present with more advanced lung cancer compared to non-Asians. DESIGN:A 5-year retrospective case-control study (January 1, 1992, to December 31, 1996) of patients with lung cancer identified using the New England Medical Center cancer center datab...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.122.6.1938

    authors: Finlay GA,Joseph B,Rodrigues CR,Griffith J,White AC

    更新日期:2002-12-01 00:00:00

  • Atrial fibrillation following pulse methylprednisolone therapy in an adult.

    abstract::The authors believe this to be the first case report of atrial fibrillation following pulse methylprednisolone therapy in an adult. The literature regarding the complications of pulse methylprednisolone therapy is reviewed, with particular emphasis on the incidence and pathogenesis of arrhythmias. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.104.2.622

    authors: McLuckie AE,Savage RW

    更新日期:1993-08-01 00:00:00

  • Ventilation-perfusion scintiscanning in tropical pulmonary eosinophilia.

    abstract::We report the findings of ventilation and perfusion scintiscanning performed in three untreated patients with acute tropical pulmonary eosinophilia (TPE). In a 26-year-old man whose arterial blood gas values were normal, the lung scan showed normal radioactivity. The scintigrams of a 20-year-old woman who had hypoxemi...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.104.2.497

    authors: Ray D,Jayachandran CA

    更新日期:1993-08-01 00:00:00

  • Clinical staging of patients with non-small cell lung cancer.

    abstract::This article is the first in a planned series from the Section on Lung Cancer of the ACCP addressing the important and clinically relevant aspects of what is now the most common malignancy in the world, lung cancer. This initial report addresses the problem of staging of lung cancer. Staging, or identifying the anatom...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.97.6.1431

    authors: Little AG,Stitik FP

    更新日期:1990-06-01 00:00:00

  • Diagnostic value of medical thoracoscopy in pleural disease: a 6-year retrospective study.

    abstract:STUDY OBJECTIVES:Unlike thoracocentesis and closed pleural biopsy (CPB), medical thoracoscopy permits biopsy with direct visualization. In a 6-year retrospective study of patients having undergone at least one medical thoracoscopy, we analyzed the diagnostic yield of thoracoscopy and its value in the management of pleu...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.121.5.1677

    authors: Blanc FX,Atassi K,Bignon J,Housset B

    更新日期:2002-05-01 00:00:00

  • Diaphragm Weakness in the Critically Ill: Basic Mechanisms Reveal Therapeutic Opportunities.

    abstract::The diaphragm is the primary muscle of inspiration. Its capacity to respond to the load imposed by pulmonary disease is a major determining factor both in the onset of ventilatory failure and in the ability to successfully separate patients from ventilator support. It has recently been established that a very large pr...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1016/j.chest.2018.08.1028

    authors: Petrof BJ

    更新日期:2018-12-01 00:00:00

  • Is delayed introduction of inhaled corticosteroids harmful in patients with obstructive airways disease (asthma and COPD)? The Dutch CNSLD Study Group. The Dutch Chronic Nonspecific Lung Disease Study Groups.

    abstract:BACKGROUND:The institution of inhaled corticosteroids is generally advocated for effective treatment of patients with asthma. It is yet unknown what is the best time to start inhaled corticosteroid therapy and especially whether delayed introduction is harmful. PHASE 1: In a previous study in patients with asthma and C...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1378/chest.110.1.35

    authors: Overbeek SE,Kerstjens HA,Bogaard JM,Mulder PG,Postma DS

    更新日期:1996-07-01 00:00:00

  • Alternans of the ST segment in variant angina. Incidence, time course and relation to ventricular arrhythmias during ambulatory electrocardiographic recording.

    abstract::The ST alternans was recorded during at least one ischemic attack with ST elevation in nine of 65 patients with variant angina. The magnitude and duration of ST elevation during ischemic attacks were significantly greater in patients with than in those without ST alternans. It always appeared during the occlusion phas...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.93.3.587

    authors: Turitto G,El-Sherif N

    更新日期:1988-03-01 00:00:00

  • Treatment failure in community-acquired pneumonia.

    abstract::Treatment failure (TF) is defined as a clinical condition with inadequate response to antimicrobial therapy. Clinical response should be evaluated within the first 72 h of treatment, whereas infiltrate images may take up to 6 weeks to resolve. Early failure is considered when ventilatory support and/or septic shock ap...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.06-1995

    authors: Menendez R,Torres A

    更新日期:2007-10-01 00:00:00

  • Echocardiographic recognition of silent aortic root dilatation in Marfan's syndrome.

    abstract::Echocardiography has proven a useful and sensitive means to determine noninvasively the cardiac dimensions. This report describes the echocardiographic detection of progressive dilatation of the aortic root over an 18-month period, which led to death in a 33-year-old man with Marfan's syndrome; however, at no time was...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.72.6.789

    authors: Come PC,Bulkley BH,McKusick VA,Fortuin NJ

    更新日期:1977-12-01 00:00:00

  • Nonfebrile mitral valve endocarditis due to Neisseria subflava.

    abstract::Native valve endocarditis normally presents with fever and only later in its course demonstrates dysfunction of the affected valve. We describe a case of endocarditis due to Neisseria subflava, a Gram-negative diplococcal saprophyte of the oral cavity, which was unsuspected clinically and found unexpectedly during a m...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.109.1.280

    authors: Amsel BJ,Moulijn AC

    更新日期:1996-01-01 00:00:00

  • The use of learning resource centers in the teaching of pulmonary medicine.

    abstract::Learning resource centers (LRC) are areas designed for individual study which contain a variety of self-instructional materials. To evaluate the use of LRC in teaching pulmonary medicine, a survey was conducted of medical school pulmonary sections; responses were obtained from 30 sections with an NHLBI pulmonary Acade...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.82.5.639

    authors: Make BJ

    更新日期:1982-11-01 00:00:00

  • Diagnosis of tracheoesophageal fistula by analysis of gastric air.

    abstract::Two patients receiving positive pressure ventilation experienced marked gaseous abdominal distension. Analysis of gases from the stomach, ventilator, and room air suggested that the gastric gases came from the ventilator in one patient. The diagnosis of tracheoesophageal fistula was confirmed by esophagoscopy. Analysi...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.104.2.641

    authors: Kovitz KL,Siebens A,Brower RG

    更新日期:1993-08-01 00:00:00

  • Mycobacterium avium complex pulmonary disease presenting as an isolated lingular or middle lobe pattern. The Lady Windermere syndrome.

    abstract:BACKGROUND:Pulmonary disease due to Mycobacterium avium complex (MAC-PD) radiographically resembles that due to tuberculosis; it preferentially affects elderly white men with predisposing pulmonary disorders (PDPD). METHODS:Twenty-nine patients with MAC-PD were identified from a community-based population, and the med...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.101.6.1605

    authors: Reich JM,Johnson RE

    更新日期:1992-06-01 00:00:00

  • Breathing pattern and arterial blood gases during Nd-YAG laser photoresection of endobronchial lesions under general anesthesia: use of negative pressure ventilation: a preliminary study.

    abstract:STUDY OBJECTIVE:To evaluate the efficacy of negative pressure ventilation (NPV) in avoiding or reducing apneas and related hypoxemia and respiratory acidosis during laser therapy (LT) of endobronchial lesions. DESIGN:A prospective, controlled, randomized study. SETTING:An operating theater of a respiratory endoscopy ...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.112.6.1466

    authors: Vitacca M,Natalini G,Cavaliere S,Clini E,Foccoli P,Candiani A,Ambrosino N

    更新日期:1997-12-01 00:00:00

  • Slow-release theophylline in pregnant asthmatics.

    abstract:STUDY OBJECTIVE:Oral theophylline treatment may be helpful in controlling severe asthma during pregnancy. This treatment, however, has been suspected of causing both complications and malformations. The objective of this investigation was to study the influence of theophylline treatment on the course of pregnancy and d...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.107.3.642

    authors: Stenius-Aarniala B,Riikonen S,Teramo K

    更新日期:1995-03-01 00:00:00

  • Acute lung disease in the immunocompromised host. Diagnostic accuracy of the chest radiograph.

    abstract:PURPOSE:To assess the diagnostic accuracy of the chest radiograph in the evaluation of acute pulmonary complications in immunocompromised patients. METHODS:The study included the chest radiographs in 149 consecutive acute pulmonary complications seen in immunocompromised patients in whom a definitive diagnosis was mad...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.108.5.1283

    authors: Logan PM,Primack SL,Staples C,Miller RR,Müller NL

    更新日期:1995-11-01 00:00:00

  • Fatal pulmonary edema due to nitric acid fume inhalation in three pulp-mill workers.

    abstract::Three young men died of rapidly progressive pulmonary edema of delayed onset after inhalation of fumes from an accidental nitric acid explosion. Electron microscopy revealed altered neutrophils and necrotic endothelial cells in alveolar capillaries. Immunohistochemistry showed small and large serum proteins, including...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.97.2.487

    authors: Hajela R,Janigan DT,Landrigan PL,Boudreau SF,Sebastian S

    更新日期:1990-02-01 00:00:00

  • Varying ejection fractions of both ventricles in paradoxical pulses: demonstration by radionuclide study.

    abstract::A noninvasive radionuclide study of the paradoxical pulse in pericardial effusion is described. The study shows complementary changes of the right and left ventricular ejection fractions in a patient with paradoxical pulse, supporting the theory that the inspiratory reduction of the left ventricular stroke volume is a...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.74.6.687

    authors: Yeh EL

    更新日期:1978-12-01 00:00:00

  • Prevalence of physician-diagnosed COPD and its association with smoking among urban and rural residents in regional mainland China.

    abstract:OBJECTIVES:To investigate the prevalence of physician-diagnosed COPD and to explore the relationship between the total amount of cigarettes smoked (TACS) and COPD among urban and rural adults in Nanjing, China. DESIGN:Population-based, cross-sectional study conducted between October 2000 and March 2001. SETTING:Admin...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.128.4.2818

    authors: Xu F,Yin X,Zhang M,Shen H,Lu L,Xu Y

    更新日期:2005-10-01 00:00:00

  • Perforated aneurysm of the anterior mitral valve. A Doppler and two-dimensional echocardiographic report.

    abstract::Antemortem diagnosis of a perforated MV aneurysm by Doppler echocardiography, as well as two-dimensional echocardiography (2-DE), has not been reported. Herein we present such a case. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.97.3.753

    authors: Chua SO,Chiang CW,Lee YS,Chang CH,Hung JS

    更新日期:1990-03-01 00:00:00