A5053108935- Hemodynamic Monitoring and Therapy
- Ultrasound in Clinical Applications
- Sepsis Diagnosis and Treatment
- Cardiac Arrest and Resuscitation
- Non-Invasive Vital Sign Monitoring
- Acute Kidney Injury Research
- Respiratory Support and Mechanisms
- Cardiac, Anesthesia and Surgical Outcomes
- Renal function and acid-base balance
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Venous Thromboembolism Diagnosis and Management
- Blood Pressure and Hypertension Studies
- Abdominal Surgery and Complications
- Heart Rate Variability and Autonomic Control
- Appendicitis Diagnosis and Management
- Muscle and Compartmental Disorders
- Cardiovascular Health and Disease Prevention
- Acute Ischemic Stroke Management
- Clinical Reasoning and Diagnostic Skills
- Emergency and Acute Care Studies
- Long-Term Effects of COVID-19
- Multiple Sclerosis Research Studies
- Social Media in Health Education
- Healthcare cost, quality, practices
- Clinical practice guidelines implementation
Université de Montréal
2024-2025
Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l'Île-de-Montréal
2020-2024
Centres Intégré Universitaires de Santé et de Services Sociaux
2022-2024
Cabrini Hospital
2021
Abstract Background Organ congestion is a mediator of adverse outcomes in critically ill patients. Point-Of-Care ultrasound (POCUS) widely available and could enable clinicians to detect signs venous at the bedside. The aim this study was develop several grading system prototypes using POCUS determine their respective ability predict acute kidney injury (AKI) after cardiac surgery. This post-hoc analysis single-center prospective 145 patients undergoing surgery for which repeated daily...
Abstract The importance of functional right ventricular failure and resultant splanchnic venous congestion has long been under-appreciated is difficult to assess by traditional physical examination standard diagnostic imaging. recent development the excess ultrasound score (VExUS) growth point-of-care in last decade made for a potentially very useful clinical tool. We review rationale its use several pathologies illustrate with cases where VExUS was pivotal management.
Abstract Background Current recommendations support guiding fluid resuscitation through the assessment of responsiveness. Recently, concept tolerance and prevention venous congestion (VC) have emerged as relevant aspects to be considered avoid potentially deleterious side effects resuscitation. However, there is paucity data on relationship responsiveness VC. This study aims compare prevalence in responsive unresponsive critically ill patients after intensive care (ICU) admission. Methods...
Abstract Background Changes in Doppler flow patterns of hepatic veins (HV), portal vein (PV) and intra-renal (RV) reflect right atrial pressure venous congestion; the feasibility obtaining these assessments clinical relevance findings is unknown a general ICU population. This study compares morphology HV, PV RV waveform abnormalities prediction major adverse kidney events at 30 days (MAKE30) critically ill patients. Study design methods We conducted prospective observational enrolling adult...
Fluid overload is deleterious in critically ill patients. It can lead to venous congestion, thereby increasing pressure, theoretically the backpressure, and reducing renal blood flow. Venous congestion thus be an important contributor acute kidney injury (AKI), with no validated tools objectively identify bedside.Patients above 18 years admitted ICU a provisional diagnosis of cardiorenal syndrome were included study. Those inadequate window, inferior vena cava (IVC) thrombus, known case...
Background: The likelihood of a patient being preload responsive—a state where the cardiac output or stroke volume (SV) increases significantly in response to preload—depends on both filling and function. This relationship is described by canonical Frank-Starling curve. Research Question: We hypothesize that novel method for phenotyping hypoperfused patients (ie, “Doppler Starling curve”) using synchronously measured jugular venous Doppler as marker central pressure (CVP) corrected flow time...
<b><i>Introduction:</i></b> Optimal method for noninvasive assessment of venous congestion remains an unresolved issue. Portal vein (PV) and intrarenal flow alterations are markers abdominal have been associated with acute kidney injury (AKI) in cardiac surgery patients. It is currently unknown if portal (PVF) heart failure can be reversed diuretic treatment track decongestion. <b><i>Objective:</i></b> The aim this study to evaluate PVF...
Introduction Venous congestion is a pathophysiological state where high venous pressures cause organ oedema and dysfunction. associated with worse outcomes, particularly acute kidney injury (AKI), for critically ill patients. can be measured by Doppler ultrasound at the bedside through interrogation of inferior vena cava (IVC), hepatic vein (HV), portal (PV) intrarenal veins (IRV). The objective this study to quantify association between identified need renal replacement therapy (RRT) or...
Point of care ultrasound (POCUS) is a first-line tool to assess hemodynamically unstable patients, however, there confusion surrounding intertwined concepts such as: "flow," "congestion," "fluid responsiveness (FR)," and tolerance." We argue that the Frank-Starling relationship clarifying because it describes interplay between "congestion" "flow" on x-axis y-axis, respectively. Nevertheless, single, simultaneous assessment congestion flow via POCUS remains static approach. To expand this, we...
Abstract Background Cardiorenal syndrome poses significant diagnostic and therapeutic challenges. The Venous Excess Ultrasound (VExUS) grading system based on the combination of venous Doppler assessments has shown potential in predicting acute kidney injury cardiovascular outcomes, but its relevance regarding management acutely decompensated heart failure (ADHF) remains to be fully understood. Methods In this prospective study, patients with ADHF (AKI) were enrolled from a medical intensive...
The resuscitation of the patient in shock is a highly complex endeavor which should go beyond normalizing mean arterial pressure and protocolized fluid loading. We propose holistic, four interface conceptual model we feel can benefit both clinicians at bedside researchers. circulatory interfaces whose uncoupling result are left ventricle to arterial, capillary, capillary venular finally right pulmonary artery. review pathophysiology clinical consequences behind these as well how assess them...
The venous excess ultrasound (VExUS) score is a multi-organ Doppler approach to assess congestion. Despite growing use of VExUS in research and clinical practice, other veins can be visualized for hypertension, which may overcome acquisition barriers the exam. In this pilot, observational study, we used wearable relationship between jugular under different preload conditions. We hypothesized that morphology would accurately distinguish conditions, it most closely relate hepatic fully supine...
Background: Right ventricular dysfunction (RVD) is a complication following congenital cardiac surgery in children and can lead to systemic venous congestion, low output, organ dysfunction.Venous congestion be transmitted backwards adversely affect encapsulated organs such as the kidneys.Primary objective: To investigate association between estimated by Venous Excess Ultrasound (VExUS), occurrence of acute kidney injury (AKI) with RVD heart surgery.Secondary objectives included comparing...