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• W2077780385 abstract "Study Objectives: Point-of-care ultrasonography for the detection of abdominal aortic aneurysm is one of life-saving applications of ultrasonography in the emergency department (ED). Unfortunately, full visualization of the aorta using the standard midline approach is often inadequate. We evaluated whether the addition of a lateral right upper quadrant approach could improve visualization of the abdominal aorta. Methods: This was a prospective observational pilot study. We enrolled patients > 50 years old undergoing abdominal CT scan for any indication in the ED. Ultrasonographies were performed by residents, physician assistants, and research assistants trained in aortic ultrasonography and images were reviewed by an ultrasonography fellowship-trained expert reviewer. The standard midline transverse proximal, mid, and distal aortic images as well as additional images of the aorta from the lateral right upper quadrant were obtained. Visualization of the aorta was determined to be adequate if > 2/3 of the entire abdominal aorta was visualized and inadequate if <2/3 was visualized. Results: We enrolled 60 patients. One patient was unable to complete the ultrasonography and was excluded from analysis. The mean age of the patients was 69 (range 51-100) with 65% female and 35% male. Subjects had a mean BMI = 26 (range 16.5-42.9), abdominal circumference of 106cm (range 60-173), and 66% had oral intake in the last 6 hours. Using logistic regression, abdominal circumference was the only independent predictor of inadequate visualization from the midline view with a p=0.004. Mean time to perform midline view was 4.8 minutes, and lateral view was 3.9 minutes. Visualization of the aorta using the midline approach was adequate in 28/59 (47%) of the patients and 36/59 (61%) of the lateral approach. Of the 31 patients with inadequate midline view, 17 of those had an adequate lateral view. Adding the lateral view to the standard midline view increased adequate visualization from 47 to 76%. Four subjects were ultimately diagnosed with abdominal aortic aneurysm on CT. Of those, 2 were visualized in both midline and lateral views, 1 was in the excluded patient, and 1 did not have adequate ultrasonography images for review. Conclusion: Addition of a lateral right upper quadrant view to the standard midline approach improves adequate visualization of the abdominal aorta by 29%. It may be helpful to add an additional lateral view of the aorta when the traditional midline view is inadequate especially when performed by less experienced sonographers. Further study is required to determine if the lateral view is equivalent for detecting abdominal aortic aneurysm." @default.
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• W2077780385 date "2012-10-01" @default.
• W2077780385 modified "2023-09-23" @default.
• W2077780385 title "40 Addition of a Lateral View Improves Visualization of the Abdominal Aorta With Bedside Ultrasonography" @default.
• W2077780385 doi "https://doi.org/10.1016/j.annemergmed.2012.06.067" @default.
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