Philips Lumify case study
Philips Lumify case study
In this Lumify case study and summary video, Dr. Sara Nikravan discusses how she used her Philips Lumify handheld ultrasound system to guide the diagnosis and treatment of a patient experiencing shortness of breath.
Studies advocating point-of-care ultrasound (POCUS) for the assessment of unstable patients by non-cardiologists were first published over twenty years ago because of the feasibility, time-effectiveness, and diagnostic accuracy of POCUS when compared to more invasive measures. Over the last twenty years further validation has led to the release of consensus statements from the American College of Chest Physicians (ACCP), the American Society of Echocardiography (ASE), and the American College of Emergency Physicians (ACEP).1
Stanford University Hospital & Clinics Department of Anesthesiology,
Peri-operative and Pain Medicine Division of Cardiothoracic
Anesthesiology
Division of Critical Care Medicine
Given his renal failure and anticipated limitations to aggressive diuresis with medical therapy, arrangements were made to emergently intubate the patient, augment ionotropic support, escalate diuresis attempts with diuretics while calling the family to discuss care options including likely need for dialysis. As the patient was being prepped for intubation, X-ray imaging was obtained confirming the diagnosis of pulmonary edema.
By then, though, the patient had already been given aggressive diuretic therapy, received escalating ionotropic support, bronchoscopy was set up at the bedside for endobronchial evaluation after the intubation given his fevers, and the family had been notified.
POCUS with a small, extremely portable device had allowed for convenient and rapid evaluation, diagnosis, and intervention in a complex patient. A repeat chest X-ray just one hour after intubation showed marked improvement in the patient’s pulmonary edema.
Determining the cause of respiratory distress in the acutely ill can be challenging. POCUS with a three-point exam (F-TTE, IVC collapsibility, and lung ultrasound), as performed above, has been endorsed in this patient population as it can increase diagnostic accuracy in a timely fashion, especially as it pertains to acute decompensated heart failure.4 Furthermore, the use of a small portable device allows for convenience with rapid setup and use while minimizing the uptake of space. This becomes especially important when caring for patients that often have many providers attempting to provide care and initiate interventions at the same time, given the acute nature of their illness and potential for further rapid de-compensation.
*Results from case studies are not predictive of results in other cases. Results in other cases may vary.
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