Ultrasound for the detection of intraperitoneal fluid: The role of Trendelenburg positioning
A prospective, observational study was performed to evaluate the role of Trendelenburg positioning in improving the sensitivity of the single-view ultrasound examination. Hemodynamically stable patients undergoing diagnostic peritoneal lavage (DPL) were assigned to one of two groups: supine or 5° of...
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| Veröffentlicht in: | The American journal of emergency medicine 1999-03, Vol.17 (2), p.117-120 |
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| creator | Abrams, Barbara J Sukumvanich, Paniti Seibel, Roger Moscati, Ronald Jehle, Dietrich |
| description | A prospective, observational study was performed to evaluate the role of Trendelenburg positioning in improving the sensitivity of the single-view ultrasound examination. Hemodynamically stable patients undergoing diagnostic peritoneal lavage (DPL) were assigned to one of two groups: supine or 5° of Trendelenburg positioning. Baseline right intercostal oblique images of Morison's pouch were obtained followed by additional images for each 100 cc of lavage fluid instilled into the peritoneal cavity. The initial volume of fluid required to identify an anechoic stripe was recorded for each patient. Patients were excluded if they had (1) a positive DPL for hemoperitoneum (defined as 10 cc of gross blood or >100,000 red blood cells/μL), (2) positive baseline ultrasound study, (3) hemodynamic instability, or (4) lack of documentation (ie, baseline/subsequent hard copy images were not obtained or inadequately demonstrated anechoic stripe). The mean quantity of fluid for visualization of the anechoic stripe was 443.8 cc in the Trendelenburg group (n = 8) and 668.2 cc in the supine group (n = 11). These means were statistically different (
P < .05,
t test). The median amount of fluid needed for visualization of the anechoic stripe was 400 cc and 700 cc for the Trendelenburg and supine groups, respectively. |
| doi_str_mv | 10.1016/S0735-6757(99)90040-2 |
| format | Article |
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P < .05,
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P < .05,
t test). The median amount of fluid needed for visualization of the anechoic stripe was 400 cc and 700 cc for the Trendelenburg and supine groups, respectively.</description><subject>Abdominal Injuries - diagnostic imaging</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Digestive system. Abdomen</subject><subject>Female</subject><subject>Head-Down Tilt - physiology</subject><subject>hemoperitoneum</subject><subject>Hemoperitoneum - diagnostic imaging</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Prospective Studies</subject><subject>Sensitivity and Specificity</subject><subject>Supine Position - physiology</subject><subject>Ultrasonic investigative techniques</subject><subject>Ultrasonography</subject><subject>Wounds, Nonpenetrating - diagnostic imaging</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0E1rFTEUgOEgir2t_gRlFiJ1MfUkmSSTbkSKH4WCC687IeTjTI3MTa7JjOC_d6b3ot11lUWecxJeQl5QuKBA5duvoLhopRLqXOs3GqCDlj0iGyo4a3uq6GOy-UdOyGmtPwEo7UT3lJwsG4BxkBvy_ds4FVvznEIz5NJMP7AJOKGfYk5NHpqYlvs9ljjlhHZshnGO4bLZLq7kEVeyLZgCjpjcXG6bfa5xHY7p9hl5Mtix4vPjeUa2Hz9srz63N18-XV-9v2k91zC1DDigczwMTDllqUSpehAg2SCodFr2ynZcW6Epc74XCmg_OEtFsA4Y42fk9WHtvuRfM9bJ7GL1OI42YZ6rkVpK3nG5QHGAvuRaCw5mX-LOlj-GglmrmruqZk1mtDZ3Vc36wMvjA7PbYbg3dci4gFdHYKu341Bs8rH-d4pJ6MXC3h0YLjF-Ryym-ojJY4hlKW5Cjg_85C9StZPw</recordid><startdate>19990301</startdate><enddate>19990301</enddate><creator>Abrams, Barbara J</creator><creator>Sukumvanich, Paniti</creator><creator>Seibel, Roger</creator><creator>Moscati, Ronald</creator><creator>Jehle, Dietrich</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19990301</creationdate><title>Ultrasound for the detection of intraperitoneal fluid: The role of Trendelenburg positioning</title><author>Abrams, Barbara J ; Sukumvanich, Paniti ; Seibel, Roger ; Moscati, Ronald ; Jehle, Dietrich</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-2030ebb3df27b7a16e67805062f516b9687a439a5912bc857018fba15dab0223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Abdominal Injuries - diagnostic imaging</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Digestive system. Abdomen</topic><topic>Female</topic><topic>Head-Down Tilt - physiology</topic><topic>hemoperitoneum</topic><topic>Hemoperitoneum - diagnostic imaging</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Prospective Studies</topic><topic>Sensitivity and Specificity</topic><topic>Supine Position - physiology</topic><topic>Ultrasonic investigative techniques</topic><topic>Ultrasonography</topic><topic>Wounds, Nonpenetrating - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abrams, Barbara J</creatorcontrib><creatorcontrib>Sukumvanich, Paniti</creatorcontrib><creatorcontrib>Seibel, Roger</creatorcontrib><creatorcontrib>Moscati, Ronald</creatorcontrib><creatorcontrib>Jehle, Dietrich</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abrams, Barbara J</au><au>Sukumvanich, Paniti</au><au>Seibel, Roger</au><au>Moscati, Ronald</au><au>Jehle, Dietrich</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ultrasound for the detection of intraperitoneal fluid: The role of Trendelenburg positioning</atitle><jtitle>The American journal of emergency medicine</jtitle><addtitle>Am J Emerg Med</addtitle><date>1999-03-01</date><risdate>1999</risdate><volume>17</volume><issue>2</issue><spage>117</spage><epage>120</epage><pages>117-120</pages><issn>0735-6757</issn><eissn>1532-8171</eissn><coden>AJEMEN</coden><abstract>A prospective, observational study was performed to evaluate the role of Trendelenburg positioning in improving the sensitivity of the single-view ultrasound examination. Hemodynamically stable patients undergoing diagnostic peritoneal lavage (DPL) were assigned to one of two groups: supine or 5° of Trendelenburg positioning. Baseline right intercostal oblique images of Morison's pouch were obtained followed by additional images for each 100 cc of lavage fluid instilled into the peritoneal cavity. The initial volume of fluid required to identify an anechoic stripe was recorded for each patient. Patients were excluded if they had (1) a positive DPL for hemoperitoneum (defined as 10 cc of gross blood or >100,000 red blood cells/μL), (2) positive baseline ultrasound study, (3) hemodynamic instability, or (4) lack of documentation (ie, baseline/subsequent hard copy images were not obtained or inadequately demonstrated anechoic stripe). The mean quantity of fluid for visualization of the anechoic stripe was 443.8 cc in the Trendelenburg group (n = 8) and 668.2 cc in the supine group (n = 11). These means were statistically different (
P < .05,
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| subjects | Abdominal Injuries - diagnostic imaging Adult Biological and medical sciences Digestive system. Abdomen Female Head-Down Tilt - physiology hemoperitoneum Hemoperitoneum - diagnostic imaging Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Prospective Studies Sensitivity and Specificity Supine Position - physiology Ultrasonic investigative techniques Ultrasonography Wounds, Nonpenetrating - diagnostic imaging |
| title | Ultrasound for the detection of intraperitoneal fluid: The role of Trendelenburg positioning |
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