Point-of-Care Ultrasound Techniques for the Small Animal Practitioner. Группа авторов
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Care 18(3):258–269.
25 Lisciandro GR, Lagutchik MS, Mann KA, et al. 2009. Evaluation of an abdominal fluid scoring system determined using abdominal focused assessment with sonography for trauma in 101 dogs with motor vehicle trauma. J Vet Emerg Crit Care 19(5):426–437.
26 Lisciandro GR, Fosgate GT, Romero LA, Bridgeman CH. 2015. Abdominal FAST (AFAST) and abdominal fluid scores in adult and juvenile cats. Abstract. J Vet Emerg Crit Care 25(S1):S8.
27 Lisciandro GR, Fosgate GT, Romero LA, et al. 2019. The expected frequency and amount of free peritoneal fluid estimated using the abdominal FAST‐applied abdominal fluid scores in clinically normal adult and juvenile dogs. J Vet Emerg Crit Care, in press.
28 McMurray J, Boysen S, Chalhoub S. 2016. Focused assessment with sonography in nontruamtized dogs and cats in the emergency and critical care setting. J Vet Emerg Crit Care 26(1):64–73.
29 Narasimhan M, Koenig SJ, Mayo PH. 2016. A whole‐body approach to point of care ultrasound. Chest 150(4):772–776.
30 Nelson NC, Drost WT, Lerche P, et al. 2011. Noninvasive estimation of central venous pressure in anesthetized dogs by measurement of hepatic venous blood flow velocity and abdomen al venous diameter. Vet Radiol Ultrasound 51(3):313–323.
31 Ollerton JE, Sugrue M, Balogh Z, et al. 2006. Prospective study to evaluate the influence of FAST on trauma patient management. J Trauma 60(4):785–791.
32 Powell LL, Rozanski EA, Tidwell AS, et al. 1999. A retrospective analysis of pulmonary contusions secondary to motor vehicle accidents in 143 dogs: 1994–1997. J Vet Emerg Crit Care 9(3):127–136.
33 Romero LA, Lisciandro GR, Fosgate GT, Bridgeman CH. 2015. Abdominal FAST (AFAST) and abdominal fluid scores in adult and juvenile dogs. Abstract. J Vet Emerg Crit Care 25(S1):S7–S8.
34 Sigrist NE, Adamik KN, Doherr MG, et al. 2011. Evaluation of respiratory parameters at presentation as clinical indicators of the respiratory localization in dogs and catswith respiratory distress. J Vet Emerg Crit Care 21(1):13–23.
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37 Stander N, Wagner WM, Goddard A, et al. 2010. Normal canine pediatric gastrointestinal ultrasonography. Vet Radiol Ultrasound 51(1):75–78.
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Further Reading
1 Culp WT, Weisse C, Kellogg ME, et al. 2010. Spontaneous hemoperitoneum in cats: 65 cases (1994–2006). J Am Vet Med Assoc 236(9):978–982.
2 Kirkpatrick AW, Sirois M, Ball CG, et al. 2004. The hand‐held ultrasound for penetrating abdominal trauma. Am J Surg 187:660–665.
3 Kolata RJ, Dudley EJ. 1075. Motor vehicle accidents in urban dogs: a study of 600 cases. J Am Vet Med Assoc 167:938–941.
4 Mandell DC, Drobatz K. 1995. Feline hemoperitoneum: 16 cases (1986–1993). J Vet Emerg Crit Care 5(2):93–97.
5 Matsushima K, Frankel HL. 2011. Beyond focused assessment with sonongraphy for trauma: ultrasound creep in the trauma resuscitation area and beyond. Curr Opin Crit Care 17(6):606–612.
6 Mohammadi A, Ghasemi‐Rad M. 2012. Evaluation of gastrointestinal injury in blunt abdominal trauma “FAST is not reliable”: the role of repeated ultrasonography. World J Emerg Surg 7(1):2.
7 Mongil CM, Drobatz KJ, Hendricks JC. 1995. Traumatic hemoperitoneum in 28 cases: a retrospective review. J Am Anim Hosp Assoc 31:217–222.
8 Muir W. 2006. Trauma: physiology, pathophysiology, and clinical implications. J Vet Emerg Crit Care 16(4):253–263.
9 Pintar J, Breitschwerdt EB, Hardie EM, et al. 2003. Acute nontraumatic hemoabdomen in the dog : a retrospective analysis of 39 cases (1987–2001). J Am Anim Hosp Assoc 37:518–522.
10 Quantz JE, Miles MS, Reed AL, et al. 2009. Elevation of alanine transaminase and gallbladder wall abnormalities as biomarkers of anaphylaxis in canine hypersensitivity patients. J Vet Emerg Crit Care 19(6):536–544.
11 Rozycki GS. 1998. Surgeon performed US: its use in clinical practice. Ann Surg 228:16–28.
12 Rozycki GS, Pennington SD, Feliciano DV. 2001. Surgeon‐performed ultrasound in the critical care setting: its use as an extension of the physical examination to detect pleural effusion. J Trauma 50(4):636–642.
13 Sgourakis G, Lanitis S, Zacharioudakis C, et al. 2012. Incidental findings in trauma patients during focused assessment with sonography for trauma. Am Surg 78(3):366–372.
Chapter Seven POCUS: AFAST – Clinical Integration
Gregory R. Lisciandro
Introduction
The AFAST, having exact clarity to its five acoustic windows, is a standardized, rapid screening test of the abdominal cavity, retroperitoneal space, and pleural cavity, including the pericardial sac, heart, and lung. Even for the novice sonographer, the AFAST examination likely will take no more than 3½–4 minutes. In the previous AFAST chapter, we covered image acquisition and the AFAST target organ approach, examples of typical negative and positive images, pitfalls, and artifacts.
In this AFAST chapter, we will discuss clinical integration of AFAST findings as well as its limitations. Enjoy this wild AFAST ride of patient information that gives evidence‐based information by “seeing” your patient's problem list for a better working diagnosis, a better way to manage bleeding patients, a better way to track effusions, a better diagnostic plan for picking the next best test, and much more.
We will cover the following (Table 7.1).
The abdominal fluid scoring system in different subsets of bleeding patients including blunt trauma, penetrating trauma, postinterventional, and nontrauma.
The use of the diaphragmatico‐hepatic (DH) view for pericardial and pleural effusion.
The use of the DH view for lung pathology along the pulmonary‐diaphragmatic interface.
The use of the DH view and the caudal vena cava for volume status.
The detection and interpretation of gallbladder wall edema, the so‐called “gallbladder halo sign,” that is a marker for canine anaphylaxis as well as cardiac conditions in the acute collapse, triaged setting.
Target organ conditions at respective AFAST views that may be easily recognized as “abnormal” to capture cases otherwise missed without ultrasound.
What AFAST Clinical Integration Can Do
Can detect free fluid within the abdomen, retroperitoneal space, pleural cavity, pericardial sac superior to physical examination and abdominal radiography and comparable to the gold standard of computed tomography (CT).
Can semiquantitate intraabdominal hemorrhagic and nonhemorrhagic effusions using its AFAST‐applied abdominal fluid scoring system.
Can anticipate degree of anemia in hemorrhaging dogs and cats by using its abdominal fluid scoring system and the small volume versus large volume principle.
Can help with decision