The utility of point-of-care ultrasound in the assessment of volume status in acute and critically ill patients / 世界急诊医学杂志（英文）

BACKGROUND@# Volume resuscitation has only been demonstrated to be effective in approximately fifty percent of patients. The remaining patients do not respond to volume resuscitation and may even develop adverse outcomes (such as acute pulmonary edema necessitating endotracheal intubation). We believe that point-of-care ultrasound is an excellent modality by which to adequately predict which patients may benefit from volume resuscitation.@*DATA RESOURCES@#We performed a search using PubMed, Scopus, and MEDLINE. The following search terms were used: fluid responsiveness, ultrasound, non-invasive, hemodynamic, fluid challenge, and passive leg raise. Preference was given to clinical trials and review articles that were most relevant to the topic of assessing a patient’s cardiovascular ability to respond to intravenous fluid administration using ultrasound.@*RESULTS@#Point-of-care ultrasound can be easily employed to measure the diameter and collapsibility of various large vessels including the inferior vena cava, common carotid artery, subclavian vein, internal jugular vein, and femoral vein. Such parameters are closely related to dynamic measures of fluid responsiveness and can be used by providers to help guide fluid resuscitation in critically ill patients.@*CONCLUSION@# Ultrasound in combination with passive leg raise is a non-invasive, cost- and time-effective modality that can be employed to assess volume status and response to fluid resuscitation. Traditionally sonographic studies have focused on the evaluation of large veins such as the inferior vena cava, and internal jugular vein. A number of recently published studies also demonstrate the usefulness of evaluating large arteries to predict volume status.

Elderly male with blurry vision / 世界急诊医学杂志（英文）

@#We present a case of an elderly gentleman who was punched in the face and subsequently diagnosed by an emergency physician with acute angle closure glaucoma secondary to a posterior lens dislocation. Slit lamp evaluation, ocular ultrasound, and computed tomography (CT) imaging, can identify a dislocated lens. A rare complication of a lens dislocation includes secondary acute angle closure glaucoma. Treatment of lens dislocation includes prosthetic lens placement or reattachment in cases of a partial lens dislocation.