Emergency Ultrasound: State of the Art and Perspectives

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Emergency Medicine".

Deadline for manuscript submissions: 25 June 2025 | Viewed by 3098

Special Issue Editors


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Guest Editor
Department of Internal Medicine, Hospital Universitario La Paz, Madrid, Spain
Interests: point-of-care ultrasound; lung ultrasound; venous thromboembolic disease; systemic venous congestion; body composition

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Guest Editor
Department of Emergency Medicine, Hospital Universitario Fundación de Alcorcón, Calle Budapest 1, 28922 Alcorcón, Spain
Interests: point-of-care ultrasound; lung ultrasound; emergency ultrasound; focus cardiac ultrasound

Special Issue Information

Dear Colleagues,

Point-of-care ultrasound in emergency medicine has undergone significant advancements in its implementation across various departments that handle patients with acute and exacerbated chronic conditions, both in in-hospital and out-of-hospital settings. The goal in this care setting is to use ultrasound at the point of care to aid in the diagnosis and management of any urgent, emergent, or critical condition prompting assistance, including severely injured and polytraumatized patients and cardiopulmonary resuscitation, as well as guiding procedures and monitoring certain pathologies, their initial evolution, and the treatment instituted. In this Special Issue, we invite authors to submit papers on the advances of point-of-care ultrasound in terms of the diagnosis, monitoring, and prognosis of acutely ill patients.

Dr. Yale Tung-Chen
Dr. Gonzalo Garcia Casasola
Guest Editors

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Keywords

  • point-of-care ultrasound
  • emergency ultrasound
  • focus cardiac ultrasound
  • lung ultrasound
  • shock
  • venous thromboembolic disease
  • systemic venous congestion
  • resuscitation
  • polytrauma

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Published Papers (2 papers)

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Research

16 pages, 1219 KiB  
Article
The Usefulness of Carotid Artery Doppler Measurement as a Predictor of Early Death in Sepsis Patients Admitted to the Emergency Department
by Su-Il Kim, Yun-Deok Jang, Jae-Gu Ji, Yong-Seok Kim, In-Hye Kang, Seong-Ju Kim, Seong-Min Han and Min-Seok Choi
J. Clin. Med. 2024, 13(22), 6912; https://doi.org/10.3390/jcm13226912 - 16 Nov 2024
Viewed by 1069
Abstract
Background: This study aims to verify whether the blood flow velocity and the diameter size, measured through intra-carotid artery Doppler measurements performed on sepsis patients visiting the emergency department, are useful as tools for predicting the risk of early death. Methods: As a [...] Read more.
Background: This study aims to verify whether the blood flow velocity and the diameter size, measured through intra-carotid artery Doppler measurements performed on sepsis patients visiting the emergency department, are useful as tools for predicting the risk of early death. Methods: As a prospective study, this research was performed on sepsis patients who visited a local emergency medical center from August 2021 to February 2023. The sepsis patients’ carotid artery was measured using Doppler imaging, and they were divided into patients measured for the size of systolic and diastolic mean blood flow velocity and diameter size: those measured for their qSOFA (quick sequential organ failure assessment) score and those measured using the SIRS (systemic inflammatory response syndrome) criteria. By measuring and comparing their mortality prediction accuracies, this study sought to verify the usefulness of blood flow velocity and the diameter size of the intra-carotid artery as tools to predict early death. Results: This study was conducted on 1026 patients, excluding 45 patients out of the total of 1071 patients. All sepsis patients were measured using systolic and diastolic blood flow velocity and diameter by Doppler imaging of the intra-carotid artery, assessed using qSOFA and evaluated using SIRS criteria. The results of the analysis performed to compare the mortality prediction accuracy were as follows. First, the hazard ratio (95% CI) of the intra-carotid artery was significant (p < 0.05), at 1.020 (1.004–1.036); the hazard ratio (95% CI) of qSOFA was significant (p < 0.05), at 3.871 (2.526–5.931); and the hazard ratio (95% CI) of SIRS showed no significant difference, at 1.002 (0.995–1.009). After 2 h of infusion treatment, the diameter size was 4.72 ± 1.23, showing a significant difference (p < 0.05). After 2 h of fluid treatment, the blood flow velocity was 101 m/s ± 21.12, which showed a significant difference (p < 0.05). Conclusions: Measuring the mean blood flow velocity in the intra-carotid arteries of sepsis patients who visit the emergency department is useful for predicting the risk of death at an early stage. And this study showed that Doppler measurement of the diameter size of the carotid artery significantly increased after performing fluid treatment after early recognition. Full article
(This article belongs to the Special Issue Emergency Ultrasound: State of the Art and Perspectives)
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11 pages, 8910 KiB  
Article
The Cardiac Pulsed Wave Doppler Pattern of the Common Femoral Vein in Diagnosing the Likelihood of Severe Pulmonary Hypertension: Results from a Prospective Multicentric Study
by Marta Torres-Arrese, Pablo Barberá-Rausell, Jie-Wei Oscar Li-Zhu, Rocío Salas-Dueñas, Alma Elena Real-Martín, Arantzazu Mata-Martínez, Begoña Gonzalo-Moreno, Joaquín Hernández Núñez, Davide Luordo, Juan Gabriel Sánchez Cano, Tomás Villén Villegas, Luis Caurcel-Díaz, Gonzalo García de Casasola-Sánchez and Yale Tung-Chen
J. Clin. Med. 2024, 13(13), 3860; https://doi.org/10.3390/jcm13133860 - 30 Jun 2024
Cited by 1 | Viewed by 1337
Abstract
Background and Objectives: Pulmonary hypertension (PH) is a clinical condition with high mortality rates, particularly in patients over 65. Current guidelines recommend assessing the likelihood of pulmonary hypertension (LPH) using advanced echocardiography before proceeding to right heart catheterization. This study proposed using [...] Read more.
Background and Objectives: Pulmonary hypertension (PH) is a clinical condition with high mortality rates, particularly in patients over 65. Current guidelines recommend assessing the likelihood of pulmonary hypertension (LPH) using advanced echocardiography before proceeding to right heart catheterization. This study proposed using the common femoral vein (CFV), an accessible vein that reflects right atrial pressure, as an alternative method to assess the high likelihood of pulmonary hypertension (H-LPH). Materials and Methods: This prospective observational study included 175 emergency patients from three hospitals. Ultrasound assessed the pulsed wave Doppler (PW-Doppler) morphology of the CFV. This diagnostic yield for H-LPH was evaluated alongside traditional ultrasound parameters (right-to-left ventricular basal diameter ratio greater than 1 (RV > LV), septal flattening, right ventricular outflow acceleration time (RVOT) of less than 105 ms and/or mesosystolic notching, pulmonary artery diameter greater than the aortic root (AR) diameter or over 25 mm, early pulmonary regurgitation maximum velocity > 2.2 m/s; TAPSE/PASP less than 0.55, inferior vena cava (IVC) diameter over 21 mm with decreased inspiratory collapse, and right atrial (RA) area over 18 cm2). Results: The CFV’s PW-Doppler cardiac pattern correlated strongly with H-LPH, showing a sensitivity (Sn) of 72% and a specificity (Sp) of 96%. RA dilation and TAPSE/PASP < 0.55 also played significant diagnostic roles. Conclusions: The CFV’s PW-Doppler cardiac pattern is an effective indicator of H-LPH, allowing reliable exclusion of this condition when absent. This approach could simplify initial LPH evaluation in emergency settings or where echocardiographic resources are limited. Full article
(This article belongs to the Special Issue Emergency Ultrasound: State of the Art and Perspectives)
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