Point-of-Care Echocardiography in the Difficult-to-Image Patient in the ICU: A Narrative Review.

Objectives: The objective of this narrative review was to address common obstacles encountered in the ICU to acquiring quality and interpretable images using point-of-care echocardiography.

Data Sources: Detailed searches were performed using PubMed and Ovid Medline using medical subject headings and keywords on topics related to patient positioning, IV echo contrast, alternative subcostal views, right ventricular outflow tract (RVOT) hemodynamics, and point-of-care transesophageal echocardiography. Articles known to the authors were also selected based on expert opinion.

Bronchopleural Fistula in the Mechanically Ventilated Patient: A Concise Review.

Objective: To describe the physiology of air leak in bronchopleural fistula in mechanically ventilated patients and how understanding of its physiology drives management of positive-pressure ventilation. To provide guidance of lung isolation, mechanical ventilator, pleural catheter, and endobronchial strategies for the management of bronchopleural fistula on mechanical ventilation.

Data Sources: Online search of PubMed and manual review of articles (laboratory and patient studies) was performed.

Cardiogenic Auto-Triggering as a Consequence of Hemoperitoneum.

A 70-year-old woman presented with hemorrhagic shock secondary to hemoperitoneum following a paracentesis. On hospital day 3, she developed respiratory alkalosis and increased respiratory rates observed on the ventilator despite no spontaneous inspiratory effort. Converting to pressure support mode uncovered a cardiogenic oscillatory flow that had been auto-triggering the ventilator.