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The Utility of Bedside Ultrasound in the Detection of a Ruptured Globe in a Porcine Model

BACKGROUND: Recent case reports have shown that ultrasonography can be used to diagnose ocular pathology in an emergency setting. Ultrasound may be especially useful when periorbital edema and pain interfere with the examination of the post-traumatic eye. OBJECTIVE: This study evaluated the ability...

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Autores principales: Chandra, Amit, Mastrovitch, Todd, Ladner, Heidi, Ting, Vincent, Radeos, Michael S., Samudre, Sandeep
Formato: Texto
Lenguaje:English
Publicado: Department of Emergency Medicine, University of California, Irvine School of Medicine 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791730/
https://www.ncbi.nlm.nih.gov/pubmed/20046246
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author Chandra, Amit
Mastrovitch, Todd
Ladner, Heidi
Ting, Vincent
Radeos, Michael S.
Samudre, Sandeep
author_facet Chandra, Amit
Mastrovitch, Todd
Ladner, Heidi
Ting, Vincent
Radeos, Michael S.
Samudre, Sandeep
author_sort Chandra, Amit
collection PubMed
description BACKGROUND: Recent case reports have shown that ultrasonography can be used to diagnose ocular pathology in an emergency setting. Ultrasound may be especially useful when periorbital edema and pain interfere with the examination of the post-traumatic eye. OBJECTIVE: This study evaluated the ability of emergency physicians to detect a ruptured globe in an ex-vivo porcine model. METHODS: Following a brief training lecture, 15 emergency medicine residents and 4 emergency medicine attending physicians used ultrasonography to evaluate 18 porcine eyes, randomized as normal, ruptured, or completely devoid of vitreous humor. The consequences of ultrasound applanation with this method were evaluated by measuring intraocular pressure changes with and without a 1mm clear plastic shield. RESULTS: Our study participants were able to identify abnormal eyes with a sensitivity of 79% (95% CI 73% to 84%) and a specificity of 51% (95% CI 41% to 61%). Intraocular pressure increased 5% with ultrasound applanation, though with a 1mm thick plastic shield there was no measurable change. CONCLUSIONS: Ultrasound imaging may be a future modality to be used by trained emergency physicians to expedite the identification of a rupture globe, but it is unlikely to replace more definitive imaging techniques. The use of a clear plastic barrier in this porcine model prevents an increase in intra-ocular pressure without affecting image quality, and should be used in any future studies on this method.
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spelling pubmed-27917302009-12-31 The Utility of Bedside Ultrasound in the Detection of a Ruptured Globe in a Porcine Model Chandra, Amit Mastrovitch, Todd Ladner, Heidi Ting, Vincent Radeos, Michael S. Samudre, Sandeep West J Emerg Med Trauma/Critical Care BACKGROUND: Recent case reports have shown that ultrasonography can be used to diagnose ocular pathology in an emergency setting. Ultrasound may be especially useful when periorbital edema and pain interfere with the examination of the post-traumatic eye. OBJECTIVE: This study evaluated the ability of emergency physicians to detect a ruptured globe in an ex-vivo porcine model. METHODS: Following a brief training lecture, 15 emergency medicine residents and 4 emergency medicine attending physicians used ultrasonography to evaluate 18 porcine eyes, randomized as normal, ruptured, or completely devoid of vitreous humor. The consequences of ultrasound applanation with this method were evaluated by measuring intraocular pressure changes with and without a 1mm clear plastic shield. RESULTS: Our study participants were able to identify abnormal eyes with a sensitivity of 79% (95% CI 73% to 84%) and a specificity of 51% (95% CI 41% to 61%). Intraocular pressure increased 5% with ultrasound applanation, though with a 1mm thick plastic shield there was no measurable change. CONCLUSIONS: Ultrasound imaging may be a future modality to be used by trained emergency physicians to expedite the identification of a rupture globe, but it is unlikely to replace more definitive imaging techniques. The use of a clear plastic barrier in this porcine model prevents an increase in intra-ocular pressure without affecting image quality, and should be used in any future studies on this method. Department of Emergency Medicine, University of California, Irvine School of Medicine 2009-11 /pmc/articles/PMC2791730/ /pubmed/20046246 Text en Copyright © 2009 the authors. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Trauma/Critical Care
Chandra, Amit
Mastrovitch, Todd
Ladner, Heidi
Ting, Vincent
Radeos, Michael S.
Samudre, Sandeep
The Utility of Bedside Ultrasound in the Detection of a Ruptured Globe in a Porcine Model
title The Utility of Bedside Ultrasound in the Detection of a Ruptured Globe in a Porcine Model
title_full The Utility of Bedside Ultrasound in the Detection of a Ruptured Globe in a Porcine Model
title_fullStr The Utility of Bedside Ultrasound in the Detection of a Ruptured Globe in a Porcine Model
title_full_unstemmed The Utility of Bedside Ultrasound in the Detection of a Ruptured Globe in a Porcine Model
title_short The Utility of Bedside Ultrasound in the Detection of a Ruptured Globe in a Porcine Model
title_sort utility of bedside ultrasound in the detection of a ruptured globe in a porcine model
topic Trauma/Critical Care
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791730/
https://www.ncbi.nlm.nih.gov/pubmed/20046246
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