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  1. Article: Airway Pressure Release Ventilation With Time-Controlled Adaptive Ventilation (TCAV™) in COVID-19: A Community Hospital's Experience.

    Rola, Philippe / Daxon, Benjamin

    Frontiers in physiology

    2022  Volume 13, Page(s) 787231

    Abstract: Santa Cabrini Ospedale, a community hospital in Montreal, Canada, used the airway pressure release ventilation following a time-controlled adaptive ventilation (APRV-TCAV™) approach for several patients in the first wave of the coronavirus disease 2019 ( ... ...

    Abstract Santa Cabrini Ospedale, a community hospital in Montreal, Canada, used the airway pressure release ventilation following a time-controlled adaptive ventilation (APRV-TCAV™) approach for several patients in the first wave of the coronavirus disease 2019 (COVID-19) outbreak in the spring of 2021. Based on favorable patient responses, it became the primary mode of invasive mechanical ventilation-from initiation through extubation-during the second and third waves of COVID-19. In this article, we describe our success with APRV-TCAV™ over more conventional modes and protocols and look at three cases that aptly demonstrate our experience. We then outline several risks with our approach and the lessons learned from our experience. While we generally saw improvement in patients' clinical course with APRV-TCAV™, there are inherent risks with this approach that others must prepare for if they attempt to implement it in their practice.
    Language English
    Publishing date 2022-04-05
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2564217-0
    ISSN 1664-042X
    ISSN 1664-042X
    DOI 10.3389/fphys.2022.787231
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: What every intensivist should know about the IVC.

    Rola, Philippe / Haycock, Korbin / Spiegel, Rory

    Journal of critical care

    2023  Volume 80, Page(s) 154455

    Abstract: Assessment of the IVC by point-of-care ultrasound in the context of resuscitation has been a controversial topic in the last decades. Most of the focus had been on its use as a surrogate marker for fluid responsiveness, with results being equivocal. We ... ...

    Abstract Assessment of the IVC by point-of-care ultrasound in the context of resuscitation has been a controversial topic in the last decades. Most of the focus had been on its use as a surrogate marker for fluid responsiveness, with results being equivocal. We review its important anatomical aspects as well as the physiological rationale behind ultrasound assessment and propose a new way to do so, as well as explain its central role in the concept of fluid tolerance.
    MeSH term(s) Humans ; Vena Cava, Inferior/diagnostic imaging ; Vena Cava, Inferior/physiology ; Fluid Therapy/methods ; Resuscitation/methods ; Ultrasonography/methods ; Point-of-Care Testing ; Point-of-Care Systems
    Language English
    Publishing date 2023-11-07
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 632818-0
    ISSN 1557-8615 ; 0883-9441
    ISSN (online) 1557-8615
    ISSN 0883-9441
    DOI 10.1016/j.jcrc.2023.154455
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2152: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  3. Article ; Online: Intra-abdominal pressure monitoring in cardiac surgery: is this the canary in the coalmine for kidney injury?

    Dabrowski, Wojciech / Rola, Philippe / Malbrain, Manu L N G

    Journal of clinical monitoring and computing

    2022  Volume 37, Issue 2, Page(s) 351–358

    MeSH term(s) Humans ; Kidney ; Cardiac Surgical Procedures ; Acute Kidney Injury
    Language English
    Publishing date 2022-12-22
    Publishing country Netherlands
    Document type Research Support, Non-U.S. Gov't ; Editorial ; Comment
    ZDB-ID 1418733-4
    ISSN 1573-2614 ; 1387-1307 ; 0748-1977
    ISSN (online) 1573-2614
    ISSN 1387-1307 ; 0748-1977
    DOI 10.1007/s10877-022-00933-y
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2054: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
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  4. Article ; Online: A Wireless, Wearable Carotid Doppler Ultrasound Aids Diagnosis and Monitoring of Pericardial Tamponade: A Case Report.

    Prager, Ross / Pratte, Michael / Kenny, Jon-Emile / Rola, Philippe

    Critical care explorations

    2023  Volume 5, Issue 5, Page(s) e0911

    Abstract: Pericardial tamponade can often be diagnosed through clinical findings and echocardiography; however, the diagnosis can be aided by demonstrating the hemodynamic consequences of the effusion. We describe the use of a wearable carotid Doppler device to ... ...

    Abstract Pericardial tamponade can often be diagnosed through clinical findings and echocardiography; however, the diagnosis can be aided by demonstrating the hemodynamic consequences of the effusion. We describe the use of a wearable carotid Doppler device to help diagnose and monitor pericardial tamponade.
    Case summary: A 54-year-old man developed hypotension after an endobronchial biopsy for a lung mass. Echocardiography showed a pericardial effusion with sonographic evidence of tamponade. A wearable carotid Doppler device demonstrated low corrected carotid flow time (CFT) (a surrogate for stroke volume) with significant respiratory variation, supporting the diagnosis of tamponade. The patient underwent pericardiocentesis which revealed purulent pericardial fluid from a mediastinal abscess. After drainage there was increased CFT and reduced respiratory variability in Doppler, surrogates of improved stroke volume.
    Conclusion: A wearable carotid Doppler device is a noninvasive tool that can help determine the hemodynamic impact of a pericardial effusion, and potentially aid in the diagnosis of pericardial tamponade.
    Language English
    Publishing date 2023-05-08
    Publishing country United States
    Document type Case Reports
    ISSN 2639-8028
    ISSN (online) 2639-8028
    DOI 10.1097/CCE.0000000000000911
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Unifying Fluid Responsiveness and Tolerance With Physiology: A Dynamic Interpretation of the Diamond-Forrester Classification.

    Kenny, Jon-Émile S / Prager, Ross / Rola, Philippe / Haycock, Korbin / Basmaji, John / Hernández, Glenn

    Critical care explorations

    2023  Volume 5, Issue 12, Page(s) e1022

    Abstract: Point of care ultrasound (POCUS) is a first-line tool to assess hemodynamically unstable patients, however, there is confusion surrounding intertwined concepts such as: "flow," "congestion," "fluid responsiveness (FR)," and "fluid tolerance." We argue ... ...

    Abstract Point of care ultrasound (POCUS) is a first-line tool to assess hemodynamically unstable patients, however, there is confusion surrounding intertwined concepts such as: "flow," "congestion," "fluid responsiveness (FR)," and "fluid tolerance." We argue that the Frank-Starling relationship is clarifying because it describes the interplay between "congestion" and "flow" on the
    Language English
    Publishing date 2023-12-12
    Publishing country United States
    Document type Journal Article
    ISSN 2639-8028
    ISSN (online) 2639-8028
    DOI 10.1097/CCE.0000000000001022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Multiorgan evaluation of perfusion and congestion using ultrasound in patients with shock.

    Tavazzi, Guido / Spiegel, Rory / Rola, Philippe / Price, Susanna / Corradi, Francesco / Hockstein, Maxwell

    European heart journal. Acute cardiovascular care

    2023  Volume 12, Issue 5, Page(s) 344–352

    Abstract: There is increasing evidence on the role of ultrasound in the evaluation of multiorgan hypoperfusion and congestion in patients with cardiocirculatory shock both to identify the underlying pathophysiological mechanism and to drive and monitor the ... ...

    Abstract There is increasing evidence on the role of ultrasound in the evaluation of multiorgan hypoperfusion and congestion in patients with cardiocirculatory shock both to identify the underlying pathophysiological mechanism and to drive and monitor the treatment. The cardiac and lung ultrasound is included as an integrated multiparametric approach to the very early phase of patients with haemodynamic instability/cardiogenic shock. Splanchnic ultrasound has been mainly applied in heart failure and predominant circulatory failure. Although poorly validated in the critically ill, many ultrasound parameters have a strong physiological background to support their use in the acute setting those that apply either for heart/lung and for splanchnic organ evaluation. This review summarizes the ultrasonographic parameters that have shown evidence in literature in the diagnostic/therapeutic pathway to define the congestion/perfusion profile of the organs that are involved in the pathophysiological cascade of cardiocirculatory shock.
    MeSH term(s) Humans ; Shock/diagnostic imaging ; Shock, Cardiogenic/therapy ; Ultrasonography ; Heart Failure ; Perfusion
    Language English
    Publishing date 2023-03-16
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 2663340-1
    ISSN 2048-8734 ; 2048-8726
    ISSN (online) 2048-8734
    ISSN 2048-8726
    DOI 10.1093/ehjacc/zuad025
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Bedside Ultrasound in the Management of Cardiorenal Syndromes: An Updated Review.

    Argaiz, Eduardo R / Romero-Gonzalez, Gregorio / Rola, Philippe / Spiegel, Rory / Haycock, Korbin H / Koratala, Abhilash

    Cardiorenal medicine

    2023  Volume 13, Issue 1, Page(s) 372–384

    Abstract: Background: Cardiorenal syndromes constitute a spectrum of disorders involving heart and kidney dysfunction modulated by a complex interplay of neurohormonal, inflammatory, and hemodynamic derangements. The management of such patients often poses a ... ...

    Abstract Background: Cardiorenal syndromes constitute a spectrum of disorders involving heart and kidney dysfunction modulated by a complex interplay of neurohormonal, inflammatory, and hemodynamic derangements. The management of such patients often poses a diagnostic and therapeutic challenge to physicians owing to gaps in understanding of pathophysiology, paucity of objective bedside diagnostic tools, and individual biases.
    Summary: In this narrative review, we discuss the role of clinician who performed bedside ultrasound in the management of patients with cardiorenal syndromes. Novel sonographic applications such as venous excess ultrasound score (VExUS) are reviewed in addition to the lung and focused cardiac ultrasound. Further, underrecognized causes of heart failure such as high-flow arteriovenous fistula are discussed.
    Key message: Bedside ultrasound allows a comprehensive hemodynamic characterization of cardiorenal syndromes.
    MeSH term(s) Humans ; Cardio-Renal Syndrome/diagnostic imaging ; Cardio-Renal Syndrome/therapy ; Heart Failure/complications ; Heart Failure/diagnostic imaging ; Heart Failure/therapy ; Heart ; Ultrasonography ; Hemodynamics
    Language English
    Publishing date 2023-11-18
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2595659-0
    ISSN 1664-5502 ; 1664-3828
    ISSN (online) 1664-5502
    ISSN 1664-3828
    DOI 10.1159/000534976
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Fluid management in acute kidney injury: from evaluating fluid responsiveness towards assessment of fluid tolerance.

    Argaiz, Eduardo R / Rola, Philippe / Haycock, Korbin H / Verbrugge, Frederik H

    European heart journal. Acute cardiovascular care

    2022  Volume 11, Issue 10, Page(s) 786–793

    Abstract: Despite the widespread use of intravenous fluids in acute kidney injury (AKI), solid evidence is lacking. Intravenous fluids mainly improve AKI due to true hypovolaemia, which is difficult to discern at the bedside unless it is very pronounced. Empiric ... ...

    Abstract Despite the widespread use of intravenous fluids in acute kidney injury (AKI), solid evidence is lacking. Intravenous fluids mainly improve AKI due to true hypovolaemia, which is difficult to discern at the bedside unless it is very pronounced. Empiric fluid resuscitation triggered only by elevated serum creatinine levels or oliguria is frequently misguided, especially in the presence of fluid intolerance syndromes such as increased extravascular lung water, capillary leak, intra-abdominal hypertension, and systemic venous congestion. While fluid responsiveness tests clearly identify patients who will not benefit from fluid administration (i.e. those without an increase in cardiac output), the presence of fluid responsiveness does not guarantee that fluid therapy is indicated or even safe. This review calls for more attention to the concept of fluid tolerance, incorporating it into a practical algorithm with systematic venous Doppler ultrasonography assessment to use at the bedside, thereby lowering the risk of detrimental kidney congestion in AKI.
    MeSH term(s) Humans ; Oliguria/therapy ; Acute Kidney Injury/therapy ; Fluid Therapy ; Kidney
    Language English
    Publishing date 2022-09-07
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 2663340-1
    ISSN 2048-8734 ; 2048-8726
    ISSN (online) 2048-8734
    ISSN 2048-8726
    DOI 10.1093/ehjacc/zuac104
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Dynamic Changes in Portal Vein Flow during Decongestion in Patients with Heart Failure and Cardio-Renal Syndrome: A POCUS Case Series.

    Argaiz, Eduardo R / Rola, Philippe / Gamba, Gerardo

    Cardiorenal medicine

    2021  Volume 11, Issue 1, Page(s) 59–66

    Abstract: Introduction: Optimal method for noninvasive assessment of venous congestion remains an unresolved issue. Portal vein (PV) and intrarenal venous flow alterations are markers of abdominal venous congestion and have been associated with acute kidney ... ...

    Abstract Introduction: Optimal method for noninvasive assessment of venous congestion remains an unresolved issue. Portal vein (PV) and intrarenal venous flow alterations are markers of abdominal venous congestion and have been associated with acute kidney injury (AKI) in cardiac surgery patients. It is currently unknown if portal vein flow (PVF) alterations in heart failure can be reversed with diuretic treatment and track decongestion.
    Objective: The aim of this study is to evaluate PVF alterations in patients with ADHF at arrival and after decongestive treatment.
    Methods: Assessment of venous congestion using point-of-care ultrasound was performed in 12 patients with ADHF (6 patients with left-sided heart failure and 6 patients with right-sided heart failure). Evaluation included inferior vena cava (IVC) size and collapsibility in addition to PV Doppler to determine pulsatility fraction (PF).
    Results: Increased PV PF (81.75 ± 13%) was found on admission. After effective decongestive treatment, it improved to (17.43 ± 2.2%). Improvement in IVC size and collapsibility was seen in most patients with left-sided heart failure and none of the patients with right-sided heart failure. Improvement in PV PF coincided with return to baseline of Serum Cr in patients that presented with AKI.
    Conclusions: Evaluation of abdominal venous congestion by point-of-care ultrasound could aid in diagnosis and follow-up of patients with congestive kidney injury.
    MeSH term(s) Cardiac Surgical Procedures ; Cardio-Renal Syndrome ; Heart Failure/complications ; Humans ; Portal Vein/diagnostic imaging ; Ultrasonography
    Language English
    Publishing date 2021-01-21
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2595659-0
    ISSN 1664-5502 ; 1664-3828
    ISSN (online) 1664-5502
    ISSN 1664-3828
    DOI 10.1159/000511714
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Author's response: "What is meant by "fluid tolerance"?"

    Kattan, Eduardo / Castro, Ricardo / Miralles-Aguiar, Francisco / Hernández, Glenn / Rola, Philippe

    Journal of critical care

    2022  Volume 72, Page(s) 154158

    Language English
    Publishing date 2022-09-26
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 632818-0
    ISSN 1557-8615 ; 0883-9441
    ISSN (online) 1557-8615
    ISSN 0883-9441
    DOI 10.1016/j.jcrc.2022.154158
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    In stock of ZB MED Cologne/Königswinter

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