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Article: Bedside echocardiography in the assessment of the critically ill.

Beaulieu, Yanick

2007 Volume 35, Issue 5 Suppl, Page(s) S235–49

Abstract: Advances in ultrasound technology continue to enhance its diagnostic applications in daily medical practice. Bedside echocardiographic examination has become useful to properly trained cardiologists, anesthesiologists, intensivists, surgeons, and ... ...

Abstract	Advances in ultrasound technology continue to enhance its diagnostic applications in daily medical practice. Bedside echocardiographic examination has become useful to properly trained cardiologists, anesthesiologists, intensivists, surgeons, and emergency room physicians. Cardiac ultrasound can permit rapid, accurate, and noninvasive diagnosis of a broad range of acute cardiovascular pathologies. Although transesophageal echocardiography was once the principal diagnostic approach using ultrasound to evaluate intensive care unit patients, advances in ultrasound imaging, including harmonic imaging, digital acquisition, and contrast for endocardial enhancement, has improved the diagnostic yield of transthoracic echocardiography. Ultrasound devices continue to become more portable, and hand-carried devices are now readily available for bedside applications. This article discusses the application of bedside echocardiography in the intensive care unit. The emphasis is on echocardiography and cardiovascular diagnostics, specifically on goal-directed bedside cardiac ultrasonography.
MeSH term(s)	Critical Illness ; Echocardiography/methods ; Echocardiography, Transesophageal ; Heart Diseases/diagnostic imaging ; Heart Function Tests ; Humans ; Point-of-Care Systems
Language	English
Publishing date	2007-05
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/01.CCM.0000260673.66681.AF
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Article: Specific skill set and goals of focused echocardiography for critical care clinicians.

Beaulieu, Yanick

Critical care medicine

2007 Volume 35, Issue 5 Suppl, Page(s) S144–9

Abstract: Echocardiography in the critical care setting can provide crucial information about the patient's cardiac anatomy, ejection fraction, valvular function, and volume status. There is a need for more involvement by intensivists in performing focused ... ...

Abstract	Echocardiography in the critical care setting can provide crucial information about the patient's cardiac anatomy, ejection fraction, valvular function, and volume status. There is a need for more involvement by intensivists in performing focused echocardiographic studies as this modality has been well shown to improve patient care. Several factors limit the widespread use of this technology by intensivists that are noncardiologists. One of them is the lack of formal didactic and practical training programs in "goal-directed" echocardiography specifically oriented for the critical care specialist. Although it is clear that extensive training and experience are needed to perform and interpret a complete echocardiographic study, a growing body of literature demonstrates that noncardiology medical professionals can be trained to acquire and interpret echocardiographic imaging in a goal-directed or "focused" manner with an acceptable overall level of accuracy. Performance of such focused echocardiography by intensivists has been shown to provide new information not assessable by physical examination, and often leads to change in therapeutic management at the bedside. Echocardiography using the transthoracic approach is a noninvasive imaging modality and is of great value in the critical care setting because of its portability, widespread availability, and rapid diagnostic capability. Programs for intensivists should cover both the transthoracic and transesophageal approach. Focused training with the transthoracic approach should be offered to all intensivists, while training with the transesophageal approach should be offered to intensivists who desire more advanced training. This article will go over important issues regarding current and potential avenues for training of critical care physicians in performance of focused bedside echocardiography.
MeSH term(s)	Clinical Competence ; Critical Care ; Curriculum ; Echocardiography ; Education, Medical ; Humans ; Point-of-Care Systems
Language	English
Publishing date	2007-05
Publishing country	United States
Document type	Comment ; Journal Article
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/01.CCM.0000260682.62472.67
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Article: Implémentation de l'ultrasonographie ciblée dans une unité de soins critiques.

Tagan, Damien / Beaulieu, Yanick

Praxis

2014 Volume 103, Issue 12, Page(s) 705–709

Abstract: The legitimacy of intensivists and emergency physicians to use ultrasound in their daily practice is no longer questioned. This new tool is now considered essential in the acute care setting. After overcoming the technological and political obstacles, ... ...

Title translation	Implementation of focused ultrasonography in an acute care setting.
Abstract	The legitimacy of intensivists and emergency physicians to use ultrasound in their daily practice is no longer questioned. This new tool is now considered essential in the acute care setting. After overcoming the technological and political obstacles, the current challenge is to implement technology in units. Here we give some recommendations based on our experience of the last fifteen years.
MeSH term(s)	Clinical Competence ; Cooperative Behavior ; Critical Care/organization & administration ; Curriculum ; Echocardiography/instrumentation ; Education, Medical, Continuing ; Emergency Service, Hospital/organization & administration ; Equipment Design ; Health Plan Implementation/organization & administration ; Hospital Units/organization & administration ; Humans ; Interdisciplinary Communication ; Manikins ; Resuscitation/education ; Resuscitation/instrumentation ; Switzerland ; Telemedicine/instrumentation ; Telemedicine/organization & administration ; Ultrasonography/instrumentation
Language	French
Publishing date	2014-06-04
Publishing country	Switzerland
Document type	English Abstract ; Journal Article ; Review
ZDB-ID	209026-0
ISSN	1661-8165 ; 1661-8157 ; 0369-8394
ISSN (online)	1661-8165
ISSN	1661-8157 ; 0369-8394
DOI	10.1024/1661-8157/a001689
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Article: Concept novateur de formation en ultrasonographie ciblée pour l'intensiviste utilisant l'e-learning et la simulation.

Tagan, Damien / Fumeaux, Thierry / Beaulieu, Yanick

Revue medicale suisse

2015 Volume 11, Issue 468, Page(s) 785–786

Title translation	Innovative concept in ultrasonography training targeted for the intensivist using e-learning and simulation.
MeSH term(s)	Computer Simulation ; Computer-Assisted Instruction ; Critical Care/methods ; Humans ; Ultrasonics/education ; Ultrasonography/methods
Language	French
Publishing date	2015-04-01
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2177010-4
ISSN	1660-9379
ISSN	1660-9379
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Article ; Online: Tamponade Relief by Active Clearance of Chest Tubes.

Vistarini, Nicola / Gabrysz-Forget, Fanny / Beaulieu, Yanick / Perrault, Louis P

The Annals of thoracic surgery

2016 Volume 101, Issue 3, Page(s) 1159–1163

Abstract: Purpose: Chest tubes are used in every case of cardiac surgery to evacuate shed blood from around the heart and lungs. Chest tubes can become partially or totally occluded, leading to tamponade. The purpose of this article is to discuss a novel method ... ...

Abstract	Purpose: Chest tubes are used in every case of cardiac surgery to evacuate shed blood from around the heart and lungs. Chest tubes can become partially or totally occluded, leading to tamponade. The purpose of this article is to discuss a novel method of maintaining chest tube patency in the early recovery after cardiothoracic surgery. Description: The PleuraFlow Active Clearance Technology is a system to prevent chest tube clogging that can be used to help routinely maintain chest tube patency at the bedside in the intensive care unit. Evaluation: A patient exhibited physiologic tamponade that was confirmed by transthoracic echocardiography. The chest tube was successfully reopened by actively clearing the chest tube using Active Clearance Technology, resulting in resolution of the tamponade. Conclusions: The present study reports the case of a patient with massive postoperative pericardial effusion with tamponade, successfully managed by active clearance chest tube. Further studies will help define the role for this technology in routine cardiac surgery.
MeSH term(s)	Aged ; Cardiac Tamponade/diagnostic imaging ; Cardiac Tamponade/etiology ; Cardiac Tamponade/therapy ; Chest Tubes ; Coronary Artery Bypass/adverse effects ; Coronary Artery Bypass/methods ; Coronary Stenosis/diagnostic imaging ; Coronary Stenosis/surgery ; Drainage/instrumentation ; Drainage/methods ; Echocardiography/methods ; Equipment Design ; Equipment Safety ; Follow-Up Studies ; Humans ; Male ; Myocardial Infarction/diagnosis ; Myocardial Infarction/surgery ; Pericardial Effusion/diagnostic imaging ; Pericardial Effusion/etiology ; Pericardial Effusion/therapy ; Postoperative Complications/diagnosis ; Postoperative Complications/therapy ; Radiography ; Risk Assessment ; Treatment Outcome
Language	English
Publishing date	2016-03
Publishing country	Netherlands
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/j.athoracsur.2015.10.098
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Article ; Online: The Diagnostic and Therapeutic Impact of Point-of-Care Ultrasonography in the Intensive Care Unit.

Bernier-Jean, Amélie / Albert, Martin / Shiloh, Ariel L / Eisen, Lewis A / Williamson, David / Beaulieu, Yanick

Journal of intensive care medicine

2017 Volume 32, Issue 3, Page(s) 197–203

Abstract: Purpose: In light of point-of-care ultrasonography's (POCUS) recent rise in popularity, assessment of its impact on diagnosis and treatment in the intensive care unit (ICU) is of key importance.: Methods: Ultrasound examinations were collected ... ...

Abstract	Purpose: In light of point-of-care ultrasonography's (POCUS) recent rise in popularity, assessment of its impact on diagnosis and treatment in the intensive care unit (ICU) is of key importance. Methods: Ultrasound examinations were collected through an ultrasound reporting software in 6 multidisciplinary ICU units from 3 university hospitals in Canada and the United States. This database included a self-reporting questionnaire to assess the impact of the ultrasound findings on diagnosis and treatment. We retrieved the results of these questionnaires and analyzed them in relation to which organs were assessed during the ultrasound examination. Results: One thousand two hundred and fifteen ultrasound studies were performed on 968 patients. Intensivists considered the image quality of cardiac ultrasound to be adequate in 94.7% compared to 99.7% for general ultrasound ( P < .001). The median duration of a cardiac examination was 10 (interquartile range [IQR] 10) minutes compared to 5 (IQR 8) minutes for a general examination ( P < .001). Overall, ultrasound findings led to a change in diagnosis in 302 studies (24.9%) and to a change in management in 534 studies (44.0%). A change in diagnosis or management was reported more frequently for cardiac ultrasound than for general ultrasound (108 [37.1%] vs 127 [16.5%], P < .001) and (170 [58.4%] vs 270 [35.1%], P < .001). Assessment of the inferior vena cava for fluid status emerged as the critical care ultrasound application associated with the greatest impact on management. Conclusion: Point-of-care ultrasonography has the potential to optimize care of the critically ill patients when added to the clinical armamentarium of the intensive care physician.
MeSH term(s)	Canada ; Critical Care/standards ; Critical Care/statistics & numerical data ; Critical Illness/therapy ; Female ; Humans ; Intensive Care Units/standards ; Intensive Care Units/statistics & numerical data ; Male ; Middle Aged ; Point-of-Care Systems/trends ; Quality of Health Care/standards ; Quality of Health Care/trends ; Retrospective Studies ; Ultrasonography, Interventional/trends ; United States
Language	English
Publishing date	2017-03
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	632828-3
ISSN	1525-1489 ; 0885-0666
ISSN (online)	1525-1489
ISSN	0885-0666
DOI	10.1177/0885066615606682
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Article ; Online: Point-of-care ultrasound education: the increasing role of simulation and multimedia resources.

Lewiss, Resa E / Hoffmann, Beatrice / Beaulieu, Yanick / Phelan, Mary Beth

Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine

2014 Volume 33, Issue 1, Page(s) 27–32

Abstract: This article reviews the current technology, literature, teaching models, and methods associated with simulation-based point-of-care ultrasound training. Patient simulation appears particularly well suited for learning point-of-care ultrasound, which is ... ...

Abstract	This article reviews the current technology, literature, teaching models, and methods associated with simulation-based point-of-care ultrasound training. Patient simulation appears particularly well suited for learning point-of-care ultrasound, which is a required core competency for emergency medicine and other specialties. Work hour limitations have reduced the opportunities for clinical practice, and simulation enables practicing a skill multiple times before it may be used on patients. Ultrasound simulators can be categorized into 2 groups: low and high fidelity. Low-fidelity simulators are usually static simulators, meaning that they have nonchanging anatomic examples for sonographic practice. Advantages are that the model may be reused over time, and some simulators can be homemade. High-fidelity simulators are usually high-tech and frequently consist of many computer-generated cases of virtual sonographic anatomy that can be scanned with a mock probe. This type of equipment is produced commercially and is more expensive. High-fidelity simulators provide students with an active and safe learning environment and make a reproducible standardized assessment of many different ultrasound cases possible. The advantages and disadvantages of using low- versus high-fidelity simulators are reviewed. An additional concept used in simulation-based ultrasound training is blended learning. Blended learning may include face-to-face or online learning often in combination with a learning management system. Increasingly, with simulation and Web-based learning technologies, tools are now available to medical educators for the standardization of both ultrasound skills training and competency assessment.
MeSH term(s)	Computer Simulation ; Computer-Assisted Instruction/methods ; Humans ; Inservice Training/methods ; Internet ; Models, Biological ; Multimedia ; Point-of-Care Systems ; Radiology/education ; Technology Assessment, Biomedical ; Ultrasonography ; United States
Language	English
Publishing date	2014-01
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	604829-8
ISSN	1550-9613 ; 0278-4297
ISSN (online)	1550-9613
ISSN	0278-4297
DOI	10.7863/ultra.33.1.27
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Article ; Online: Outcomes from extensive training in critical care echocardiography: Identifying the optimal number of practice studies required to achieve competency.

Millington, Scott J / Hewak, Michael / Arntfield, Robert T / Beaulieu, Yanick / Hibbert, Benjamin / Koenig, Seth / Kory, Pierre / Mayo, Paul / Schoenherr, Jordan R

Journal of critical care

2017 Volume 40, Page(s) 99–102

Abstract: Purpose: Optimal instruction and assessment of critical care ultrasound (CCUS) skills requires an assessment tool to measure learner competency and changes over time. In this study, a previously published tool was used to monitor the development of ... ...

Abstract	Purpose: Optimal instruction and assessment of critical care ultrasound (CCUS) skills requires an assessment tool to measure learner competency and changes over time. In this study, a previously published tool was used to monitor the development of critical care echocardiography (CCE) competencies, the attainment of performance plateaus, and the extent to which previous experience influenced learning. Materials and methods: A group of experts used the Rapid Assessment of Competency in Echocardiography (RACE) scale to rate a large pool of CCE studies performed by novices in a longitudinal design. A total of 380 studies performed by twelve learners were assessed; each study was independently rated by two experts. Results: Learners demonstrated improvement in mean RACE scores over time, with peak performance occurring early in training and a performance plateau thereafter. Learners with little experience received the greatest benefit from training, with an average performance plateau reached at the twentieth study. Conclusions: Supporting earlier results, the RACE scale provided a straightforward means to assess learner performance with minimal requirements for evaluator training. The results of the present study suggest that novices experience the greatest gains in competency during their first twenty practice studies, a threshold which should serve to guide training initiatives.
Language	English
Publishing date	2017-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	632818-0
ISSN	1557-8615 ; 0883-9441
ISSN (online)	1557-8615
ISSN	0883-9441
DOI	10.1016/j.jcrc.2017.03.020
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Article ; Online: Early experience with critically ill patients with COVID-19 in Montreal.

Cavayas, Yiorgos Alexandros / Noël, Alexandre / Brunette, Veronique / Williamson, David / Frenette, Anne Julie / Arsenault, Christine / Bellemare, Patrick / Lagrenade-Verdant, Colin / LeGuillan, Soazig / Levesque, Emilie / Lamarche, Yoan / Giasson, Marc / Rico, Philippe / Beaulieu, Yanick / Marsolais, Pierre / Serri, Karim / Bernard, Francis / Albert, Martin

Canadian journal of anaesthesia = Journal canadien d'anesthesie

2020 Volume 68, Issue 2, Page(s) 204–213

Abstract: Purpose: Montreal has been the epicentre of the coronavirus disease (COVID-19) pandemic in Canada. Given the regional disparities in incidence and mortality in the general population, we aimed to describe local characteristics, treatments, and outcomes ... ...

Title translation	Expériences initiales avec les patients atteints de la COVID-19 en état critique à Montréal.
Abstract	Purpose: Montreal has been the epicentre of the coronavirus disease (COVID-19) pandemic in Canada. Given the regional disparities in incidence and mortality in the general population, we aimed to describe local characteristics, treatments, and outcomes of critically ill COVID-19 patients in Montreal. Methods: A single-centre retrospective cohort of consecutive adult patients admitted to the intensive care unit (ICU) of Hôpital du Sacré-Coeur de Montréal with confirmed COVID-19 were included. Results: Between 20 March and 13 May 2020, 75 patients were admitted, with a median [interquartile range (IQR)] age of 62 [53-72] yr and high rates of obesity (47%), hypertension (67%), and diabetes (37%). Healthcare-related infections were responsible for 35% of cases. The median [IQR] day 1 sequential organ failure assessment score was 6 [3-7]. Invasive mechanical ventilation (IMV) was used in 57% of patients for a median [IQR] of 11 [5-22] days. Patients receiving IMV were characterized by a moderately decreased median [IQR] partial pressure of oxygen:fraction of inspired oxygen (day 1 PaO Conclusions: Characteristics and outcomes of critically ill patients with COVID-19 in Montreal were similar to those reported in the existing literature. We found an increased physiologic dead space, supporting the hypothesis that pulmonary vascular injury may be central to COVID-19-induced lung damage.
MeSH term(s)	Aged ; Aged, 80 and over ; COVID-19/mortality ; COVID-19/physiopathology ; COVID-19/therapy ; Canada ; Critical Illness ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Respiration, Artificial ; Retrospective Studies
Keywords	covid19
Language	English
Publishing date	2020-09-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	91002-8
ISSN	1496-8975 ; 0832-610X
ISSN (online)	1496-8975
ISSN	0832-610X
DOI	10.1007/s12630-020-01816-z
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Article: Tako-tsubo cardiomyopathy.

Lalonde, G / Beaulieu, Yanick

The Canadian journal of cardiology

2005 Volume 21, Issue 13, Page(s) 1213–1216

Abstract: A 48-year-old woman presented to her local hospital with chest pain. Her electrocardiogram showed incomplete right bundle branch block, diffuse ST segment elevation and QTc prolongation. Shortly after admission, she became hypotensive and was referred ... ...

Abstract	A 48-year-old woman presented to her local hospital with chest pain. Her electrocardiogram showed incomplete right bundle branch block, diffuse ST segment elevation and QTc prolongation. Shortly after admission, she became hypotensive and was referred for a coronary angiogram. Her coronary arteries were normal, but left ventriculography showed morphological changes typical of apical ballooning, as found in tako-tsubo cardiomyopathy. An echocardiogram confirmed complete akinesis of the left ventricular apex, with hyperkinesis of basal segments and an ejection fraction of 35% to 40%. Dynamic left ventricular outflow tract obstruction was also noted. After temporary support with intra-aortic balloon counterpulsation, fluids and noradrenaline, she recovered promptly. The present paper reviews the characteristic features of tako-tsubo cardiomyopathy.
MeSH term(s)	Cardiomyopathies/diagnosis ; Cardiomyopathies/physiopathology ; Electrocardiography ; Female ; Heart Ventricles/physiopathology ; Hemodynamics ; Humans ; Intra-Aortic Balloon Pumping ; Middle Aged
Language	English
Publishing date	2005-11
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
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