Novel ultrasound techniques
Keywords:novel ultrasound techniques, high-resolution images, anatomic structures
Ultrasonography allows for rapid acquisition of high-resolution images of anatomic structures in real time. Urgent diagnostic uses of ultrasound (US) will include a rapid diagnosis or confirmation of perioperative haemodynamic instability, shock, cardiac dysfunction, acute respiratory failure, airway issues, intra-abdominal pathology or trauma, bladder distention and abnormal urine output. Multi organ point-of-care ultrasound (POCUS) including lung ultrasound (LUS) and focussed cardiac ultrasound (FOCUS) as a clinical adjunct has played a significant role in triaging, diagnosis and medical management of COVID-19 patients.
An optic US can be done with the width of the optic nerve sheath being used as a marker for intracranial pressure. Perioperative POCUS of the airway has been shown to aid in the identification of a difficult airway, detection of the appropriate location of the endotracheal tube within the trachea, and with assistance with emergent cricothyrotomy procedures. LUS can be used to detect lung sliding which will be absent in any condition in which the pleurae are not directly opposed, stuck together, or in absent respiration. Interstitial lung syndromes, pneumothorax, alveolar syndrome, pleural effusions, pulmonary emboli and acute respiratory failure can be assessed.
Cardiovascular US is a safe and cost‑effective tool for non‑invasive examination of the real time cardiac status. Views include the subcostal view, apical four chamber view, parasternal long axis and parasternal short axis view.
By visualising the contents of the stomach, the risk of pulmonary aspiration can be determined more accurately compared to relying solely on predefined fasting times. The advent of focussed assessment with sonography in trauma enables clinicians to rapidly screen for injury. A qualitative assessment of bladder distension can be performed.
Ultrasonography identifies thrombus as non-compressibility of the imaged vein. The use of US guidance is frequently used for placement of venous and arterial catheters.
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