Discover and read the best of Twitter Threads about #Doppler

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A straightforward, hands-on approach to Portal Vein Pulsed Wave Doppler.

Physiologic and pathologic waveforms

🧵0/7

#doppler #PWD #echofirst #POCUS #VexUs @ButterflyNetInc
1/ 7 PHYSIOLOGIC

Physiologic flow should be always antegrade and hepatopetal ( towards trasducer). Could be monophasic or gently ondulating,

In doppler it should be red (get the smallest angle posible).
To Remember:

Fugal: Away

Petal: Toward

Normal velocity: 16-40 cms
Read 12 tweets
Super easy explain of physiologic Hepatic Pulsed Wave Doppler waveform.

🧵1/
#doppler #radiology #pocus #vexus #hemodinamics #butterflyiq @ButterflyNetInc @hepocus
2/
After appropriate technique to get PWD of suprahepatic Veins.
Look for the 4 classic waves of the tetraphasic spectrum of the hepatic veins (a,S,v,D).
3/

Most of the flow in the hepatic veins is hepatofugal (towards heart).
Read 11 tweets
After yesterday's #POCUS quiz, it's time to reshare these cardiac tamponade infographics.
Courtesy of @ACEP_EUS
🔗acep.org/emultrasound/s…
Set of 3
See 🧵for the rest
#Nephpearls #MedEd #FOAMcc
Pulsus paradoxus #echofirst
Hepatic vein waveform changes
#POCUS #VExUS
Read 5 tweets
#POCUS Ocular

Este Sábado 4 de Diciembre el Dr. Patrick Caqui nos habló de #DVNO/#ONSD, Relación Globo Ocular/DVNO y Pupilometría

Abrimos 🆕 🧵 con algunos de los puntos más interesantes y comentarios extras.
¿Podrás mejorar tu desempeño en 👁️👁️‍🗨️?
A manera de introducción se mencionaron los temas a tratar. Utilidad indiscutible en el paciente neurocrítico.
Antes y durante de 1999 se estaba ocupando el modo B para la evaluación ocular, posteriormente se adicionó el Doppler Color y Pulsado y el Modo-M.
Los tiempos cambian.
En el 2020 el Dr. Patrick de #PedsICU 🇵🇪 público, en base a un caso clínico de amebiasis cerebral, un artículo acerca de monitoreo invasivo y no invasivo en pediatra.
Read 27 tweets
#Ecocardiografía y Cálculos Hemodinámicos

Este Sábado 16 de Octubre estuvo con nosotros la Dra. Eva Lemos para hablar de #POCUS, & #FoCUS específicamente.
¿Te lo perdiste?🚩

Estará en #YouTube y abrimos 🧵 con algunos de los puntos más interesantes y comentarios extras:
Las bases son #Fundamentales.

Nos dió un recordatorio simplificado del sustento físico que nunca sobra al hablar de POCUS (y siempre se hecha de falta si no se tienen las bases).
📘=🔊
Características del US, donde ocuparás varias palabras de las cuales debes estar familiarizado.
Y no podemos olvidarnos de la #interacción del haz del US y los tejidos.

🔇No toda emisión regresará al transductor y debes saber el por qué.
Read 25 tweets
#POCUS con USPed Latinoamérica🌎

En #SabadosdePOCUS Roberth González Cardiólogo Pediatra de 🇵🇪 nos habló de #Ecocardiografía en el Paciente #Critico en #Pediatria.

¿Quieres saber un poco de qué trato?

Abrimos 🧵 👩‍⚕️👨‍⚕️
Comentarios iniciales #PedsICU:

No vemos internamente la interacción cardiopulmonar. El #POCUS ha cambiado eso.
Dicha interacción regularmente había sido estudiada por separado.
La integración ❤️-🫁Pulmón debe ser siempre en contexto.

🔄🔃
Algo que le sirvió mucho al Dr. Roberth: la #Fisiología, su funcionamiento.

Ojo, este dato se ha mencionado mucho en nuestras sesiones. El #POCUS en verdad te ayuda a mejorar tus conocimientos básicos, cuando ves lo que tanto estudiaste.
Read 21 tweets
#Nephrology consult for worsening creatinine in the context of diuresis in a patient with #heartfailure
Documented weight 3 kg ⬇️ than the previous day. No accurate urine output. Pt feels OK (has some unrelated issue).
Question: over diuresis?
#POCUS #MedEd #VExUS see thread 👇
So, there is decreased LV systolic function and obviously diastolic dysfunction. Bi atrial enlargement. No significant pericardial effusion (there was trace on PLAX).
Next step in the hemodynamic circuit #POCUS assessment?
btw repeat weight was similar.
Next: IVC #POCUS assessment to assess right atrial pressure.
Here it is 👇
Big and plethoric (take it as 15 mmHg in a spontaneously breathing person - we get RVSP of ~41 mmHg based on the above tricuspid gradient)
Read 10 tweets
Stimulated by the enthusiasm of #MedEd student and #nephrology fellow, did a small experiment to see how well #POCUS -determined blood flow in the continuous renal replacement therapy (CRRT) circuit correlates with the actual no.
1/ First, got a color #Doppler img. of the tube 👇
2/ How do you calculate flow? It is the same principle that we use to determine flow rate in an arteriovenous fistula 👇 #POCUS Image
3/ 2nd step: measured the diameter of the tube (double-lined structure) - 0.42 cm Image
Read 4 tweets
#DarkNetflix Es la serie que conecta el pasado, presente y futuro en un circulo sin principio ni final.

No importando ¿Dónde? sino ¿Cuándo?

Las preguntas que se originen seran contestada a lo largo de este hilo

[HiLo] Image
La historia se desarrolla en un pueblo llamado #Winden, donde funciona una planta nuclear.

Muy cerca a la planta existe una cueva que contiene un agujero de gusano que conecta el pasado con el presente. ImageImageImage
En el pueblo habitan 4 familias

Los #Nielsen.
Los #Kahnwald.
Los #Tiedemann.
Los #Doppler. ImageImageImageImage
Read 269 tweets
Time for another #VExUS #POCUS case: A pt with known severe CHF presents with abdominal pain and receives fluids (~1L). Later develops AKI, hyper K.
NOTE: has trace edema; no c/o weight gain
Here is what #echofirst and venous #Doppler show. #MedEd #thread 👇
1/ Apical 4 chamber
2/ Note the smoke (spontaneous echo contrast) on the left. Also, LA is huge. Another one 👇
3/ PLAX view #POCUS
Note left pleural effusion (fluid posterior to descending aorta)
Read 10 tweets
Another #VExUS #POCUS case: Pt with advanced kidney disease and volume overload. Note progressive decongestion with ultrafiltration. IVC was >2cm all through. Mild TR. Great way to monitor the efficacy of decongestive therapy #IMPOCUS #MedEd (Normal-abnormal flashcards in thread)
Normal -> abnormal hepatic vein #Doppler #POCUS with increasing congestion. Note D-wave is the only one below the baseline in severe congestion.
Normal -> abnormal portal vein waveform #Doppler #POCUS with increasing congestion. Note the to and fro motion with severe congestion as seen in our patient at presentation.
Read 4 tweets
Hey #weather research scientists! We are looking for your expertise! Are you interested in wind/temp profile at night? Are you using or wishing to use doppler on wheel? We could have something to propose to you! #severeweather #aeroecology #DOW 1/n
I'm a research scientist in #forest #ecology at the @cflscf (@NRCan). With a high-expertise team, we are looking at the dispersal patterns of the most important pests in eastern North American conifer forests: the #sprucebudworm. 2/
@cflscf @NRCan #Sprucebudworm #outbreaks occur every ca 30-40 years and can last 5 to 15 years. The last major outbreak (1969-92) covered 55 M ha (yes MILLIONS !) and resulted in tremendous losses in the forest sector. (below: area defoliated in 1975). 3/
Read 24 tweets
Hypertrophic Obstructive Cardiomyopathy #HOCM🚧

#Symptoms
Profound exertional dyspnea

#Imaging
▪️SAM/LVOT obstruction #whyCMR
▪️Classic #Doppler🗡#echofirst

#Hemodynamics
▪️Brockenbrough-Braunwald-Morrow sign, explained

#Treatment
▪️Alcohol🍷septal ablation #RadialFirst
Question:
Why wouldn’t more filling time⏱ prior to post PVC beat lead to less obstruction, less gradient, & ↑ arterial pressure?

After all, doesn’t ↑LV volume in #HCM ↓gradient and improve symptoms?

Cornerstone tx is hydration/💊s that ↑ diastolic filling time ...
Read 6 tweets
🚨MUERTE CEREBRAL☠️🧠 y Doppler Transcraneal (1)
👉Deben cumplirse varios criterios
👉Acelera los tiempos de espera para protocolo de trasplante

#FOAMed #FOAMcc #MedCritUni #ICU #USG #Doppler #CriticalCare ImageImageImage
🚨MUERTE CEREBRAL☠️🧠 y Doppler Transcraneal (2)
👉Descartar condiciones clínicas que puedan simular MC
👉Ex neurológico compatible
#FOAMed #FOAMcc #MedCritUni #ICU #USG #Doppler #CriticalCare ImageImage
🚨MUERTE CEREBRAL☠️🧠 y Doppler Transcraneal (3)
👉Test de apnea: con cuidado en retenedores crónicos de CO2
#FOAMed #FOAMcc #MedCritUni #ICU #USG #Doppler #CriticalCare ImageImage
Read 9 tweets

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