الفهرس 
HISTORICAL BACKGROUNDOnly 14 pages are availabe for public view
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Abstract
Ultrasonography is widely used in medicine. It is possible
to perform both diagnosis and therapeutic procedures, using
ultrasound to guide interventional procedures. Sonography can
be enhanced with Doppler measurements to assess whether
structures (usually blood) are moving towards or away from the
probe, and its relative velocity.
Generally ultrasound scanning can be used on almost all
body parts starting from Echocardiography, Trasnscranial
doppler, chest and abdominal scanning, even in most soft
tissues and vascular structures.
Echocardiography is a sensitive tool used to detect the
presence of specific cardiovascular abnormalities, which may
be life threatening. Transthoracic echocardiography is simpler
and several descriptions of practical approaches in the ICU are
based on this technique. Transesophageal echocardiography
has gained more attention in the ICU, because of higher quality
images and lower failure rate of examinations performed.
In trauma ultrasound detects disorders requiring immediate
management: hemothorax, pneumothorax, and peritoneal fluid
collection as well as pericardial effusion, all of which can be
summarized under the FAST protocol. It has been also proved
to be a useful tool in the diagnosis of Abdominal Aortic
Aneurysm and in evaluation of the peripheral vascular system.
Chest sonography can be used to detect pleural effusion
and pneumothorax. Thoracentesis performed under ultrasound
showed reduced rates of complications.
Summary
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Transcranial Doppler ultrasound (TCD) is a noninvasive
method for the measurement of middle cerebral artery (MCA)
blood flow velocity commonly used in standard care of TBI
patients.
Ultrasound can be used to guide many procedures as
vascular Access, suprapubic bladder catheterization and foreign
body identification/localization, lumbar puncture and
paracentesis, which increases the success rate and reduce the
complications.
Diagnostic ultrasound has a high safety profile which
make a suitable for all patients even in cases of pregnancy when
other radiation dependent imaging is better avoided.
Diagnostic errors may arise from operator inexperience in
either acquiring or reading ultrasound images, leading to
inaccurate or erroneous diagnoses. Artifacts that are
misinterpreted represent another potential safety problem for
patients. While ultrasound use in the ICU may compromise
safety in important ways, there are also ways in which it
improves care. Ultrasound as a diagnostic test can be applied
when and where it is needed for the patients most likely to
benefit. In addition, since the operator and interpreter are the
same physician, the intensivist, the vulnerability of not having
test results responded to is reduced.