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publicado em 07/05/2013 às 11h30:00
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The Use of Ultrasonography in Patients Thoracic Graves

 
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Ultrasonography (U.S.) has been applied with increasing frequency in various areas of medicine beyond radiology, such as Cardiology, Obstetrics, and Anesthesiology. Its use in Intensive Care Units (ICU) is also convenient, since the most severe patients are not always able to transport to other hospital departments, especially in the sector of Radiology, which are performed imaging. The U.S. may be performed at the bedside with handheld devices that present good image resolution for many areas of the human body. It can assist in the diagnosis of diseases in critically ill patients, as well as assisting invasive procedures such as venipuncture and deep access to pleural, peritoneal, or pericardial.

Physical examination of the patient shows severe if limited in many occasions, since many are sedated and remain supine, shortening the access mainly to the chest examination by palpation, percussion and auscultation chest. Particularly chest auscultation of patients on mechanical ventilation is confusing, mixed with noises that are not accurately recognized by all doctors or other professionals who try to differentiate snoring and crackles. There is little evaluation of the effectiveness of the method of auscultation for the different pulmonary syndromes still learned during undergraduate (Hubmayr, 2004). On the other hand, many therapeutic interventions are decided upon examination of chest auscultation, which can cause benefit or harm depending on the effectiveness of the examiner.

It is common that complements the physical examination of the patient's severe thoracic unit with requests for radiography in bed or computed tomography (CT), which have very different accuracies. The use of thoracic U.S. for years was limited to the diagnosis of pleural effusion, being proscribed for evaluation of the lung due to artifacts of sound in air contact intrapulmonary. It is known that many decisions in ICUs need to be quick and indicate categorically what should be done Point of Care. Therefore, an examination performed at the bedside, with a good level of sensitivity for diagnosis of urgency is extremely useful for the intensivist. Unlike previously advocated, artifacts lung can be helpful in this regard: indicating whether the lung tissue is normal or not, it is still useful in the study of the movements of the parietal and visceral pleura and the distinction between solid lesions and fluid (effusion consolidation x) .

Source: AIMBE
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André Miguel Japiassú    Clinical Research Institute Evandro Chagas    Fundação Oswaldo Cruz    ultrasound    Radiology    Cardiology    Obstetrics    Anesthesiology   
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