Utility of ultrasound in resuscitation
Keywords:
Ultrasonics, Cardiopulmonary resuscitation, Cardiac tamponade, Stroke volume, Ventricular dysfunction Right
Abstract
Ultrasound has become a diagnostic and therapeutic tool for critical situations. This article reviews the development of ultrasound with respect to critical events and its impact on reducing morbidity and mortality from abdominal and chest trauma, on the recognition of reversible causes of pulseless electrical activity, on decision-making in acute respiratory failure, and on predicting survival and reducing complications associated with invasive procedures. We revised how ultrasounds performed by non-experts with a minimum of training and focused on recognizing specific situations have a good degree of correlation with expert conducted ultrasounds. Some protocols of ultrasound in resuscitation described in the literature are reviewed and a description is made of the most relevant variables in critical situations, including left ventricular function, volume responsiveness, cardiac tamponade, right ventricular dilatation, and pulmonary evaluation.
References
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2. Armstrong WF, Schilt BF, Helper DJ, Dillo JC, Feigenbaum H. Diastolic collapse of the right ventricle with cardiac tamponade: an echocardiographic study. Circulation. 1982;65:1491-6.
3. Horowitz RS, Morganroth J, Parrotto C, Chen CC, Soffer J, Pauletto FJ. Immediate diagnosis of acute myocardial infarction by two dimensional echocardiography. Circulation. 1982;65:323-9.
4. Reichert CLA, Visser CA, Koolen JJ, vd Brink RB, van Wezel HB, Meyne NG, et al. Transesophageal echocardiography in hypotensive patients after cardiac operations. Comparison with hemodynamic parameters. J Thorac Cardiovasc Surg. 1992;104:321-6.
5. Vieillard-Baron A, Prin S, Chergui K, Dubourg O, Jardin F. Hemodynamic instability in sepsis: bedside assessment by Doppler echocardiography. Am J Respir Crit Care Med. 2003;168:1270-6.
6. Vignon P, Gueret P, Vedrinne JM, Lagrange P, Cornu E, Abrieu O, et al. Role of transesophageal echocardiography in the diagnosis and management of traumatic aortic disruption. Circulation. 1995;92:2959-68.
7. Gruessner R, Mentges B, Duber C, Ruckert K, Rothmund M. Sonography versus peritoneal lavage in blunt abdominal trauma. J Trauma. 1989;29:242-4.
8. Tso P, Rodriguez A, Cooper C, Militello P, Mirvis S, Badellino MM, et al. Sonography in blunt abdominal trauma: a preliminary progress report. J Trauma. 1992;33:39-44.
9. Rozycki GS, Ochsner MG, Schmidt JA, Frankel HL, Davis TP, Wang D, et al. A prospective study of surgeon performed ultrasound as the primary adjuvant modality for injured patient assessment. J Trauma. 1995;39:492-8.
10. Scalea TM, Rodriguez A, Chiu WC, Brenneman FD, Fallon WF Jr, Kato K, et al. Focused assessment with sonography for trauma (FAST): results from an international consensus conference. J Trauma. 1999;46:466-72.
11. Dulchavsky SA, Schawarz KL, Kirkpatrick AW, Billica RD, Williams DR, Diebel LN, et al. Prospective evaluation of thoracic ultrasound in the detection of pneumothorax. J Trauma. 2001;50:201-5.
12. Sisley AC, Rozycki GS, Ballard RB, Namias N, Salomone JP, Feliciano DV. Rapid detection of traumatic effusion using surgeon performed ultrasonography. J Trauma. 1998;44:291-6.
13. Vargas F, Gruson D, Valentino R, Bui HN, Salmi LR, Gilleron V, et al. Transesophageal pulsed Doppler echocardiography of pulmonary venous flow to assess left ventricular filling pressure in ventilated patients with acute respiratory distress syndrome. J Crit Care. 2004;19:187-97.
14. Vieillard-Baron A, Prin S, Chergui K, Dubourg O, Jardin F. Echo-Doppler demonstration of acute cor pulmonale in the medical intensive care unit. Am J Respir Crit Care Med. 2002;166:1310-9.
15. National Institute for Clinical Excellence. Guideline on the use of ultrasound location devices for placing central venous catheters. London, 2002.
16. Neumar RW, Otto CW, Link MS, Kronick SL, Shuster M, Callaway CW, et al. Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122 Suppl 3:S729-67.
17. Matsushima K, Frankel HL. Beyond focused assessment with sonography for trauma: ultrasound creep in the trauma resuscitation area and, beyond. Curr Opin Crit Care. 2011;17:606-12.
18. Kirkpatrick AW, Sirois M, Laupland KB, Liu D, Rowan K, Ball CG, et al. Hand-held thoracic sonography for detecting post-traumatic pneumothoraces: the Extended Focused Assessment with Sonography for Trauma (EFAST). J Trauma. 2004;57:288-95.
19. Ball CG, Kirkpatrick AW, Feliciano DV. The occult pneumothorax: what have we learned? Can J Surg. 2009;52:E173-9.
20. Ball CG, Kirkpatrick AW, Laupland KB, Fox DI, Nicolaou S, Anderson IB, et al. Incidence, risk factors and outcomes for occult pneumothoraces in victims of major trauma. J Trauma. 2005;59:917-24.
21. Ma OJ, Mateer JR. Trauma ultrasound examination versus chest radiography in the detection of hemothorax. Ann Emerg Med. 1997;29:312-5.
22. Reardon R, Joing S. Hemothorax after a stab wound to the chest, with clear breath sounds and a normal radiograph. Acad Emerg Med. 2006;13:786.
23. Price S, Uddin S, Laupland KB, Quinn T. Echocardiography in cardiac arrest. Curr Opin Crit Care. 2010;16:211-5.
24. Perera P, Mailhot T, Riley D, Mandavia D. The RUSH Exam: rapid ultrasound in shock in the evaluation of the critically III. Emerg Med Clin North Am. 2010;28:29-56.
25. Arntfield RT, Millington SJ. Point of care cardiac ultrasound applications in the emergency department and intensive care unit-a review. Curr Cardiol Rev. 2012;8:98-108.
26. Martin D, Howell EE, Ziegelstein RC, Martire C, Whiting-O'Keefe QE, Shapiro EP, et al. Hand-carried ultrasound performed by hospitalist: does it improve the cardiac physical examination? Am J Med. 2009;122:35-41.
27. Breitkreutz R, Price S, Steiger HV, Seeger FH, Ilper H, Ackermann H, et al., Emergency Ultrasound Working Group of the Johann Wolfgang Goethe-University Hospital, Frankfurt am Main. Focused echocardiographic evaluation in life support and peri-resuscitation of emergency patients: a prospective trial. Resuscitation. 2010;81:1527-33. [ Links ]
28. Blyth L, Atkinson P, Gadd K, Lang E. Bedside focused echocardiography as predictor of survival in cardiac arrest patients: a systematic review. Acad Emerg Med. 2012;19:1119-26.
29. Cureton EL, Yeung LY, Kwan RO, Miraflor EJ, Sadjadi J, Price DD, et al. The heart of the matter: utility of ultrasound of cardiac activity during traumatic arrest. J Trauma Acute Care Surg. 2012;73.
30. Lichtenstein DA, Meziere GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest. 2008;134:117-25.
31. Zanobetti M, Poggioni C, Pini R. Can chest ultrasonography replace standard chest radiography for evaluation of acute dyspnea in the ED? Chest. 2011;139:1140-7.
32. McGee D, Gould MK. Preventing complications of central venous catheterization. N Engl J Med. 2003;348:1123-33.
33. Weekes A, Johnson DA, Keller SM, Efune B, Carey C, Rozario NL, et al. Central vascular catheter placement evaluation using saline flush and bedside echocardiography. Acad Emerg Med. 2014;21:65-72.
34. British Thoracic Society. Pleural disease guideline 2010. A quick reference guide.
35. Tibbles CD, Porcaro W. Procedural applications of ultrasound. Emerg Med Clin North Am. 2004;22:797-815.
36. Seward JB, Douglas PS, Erbel R, Kerber RE, Kronzon I, Rakowski H, et al. Hand-carried cardiac ultrasound (HCU) device: recommendations regarding new, technology. A report from the echocardiography task force on new technology of the Nomenclature and Standards Committee of the American Society of Echocardiography. J Am Soc Echocardiogr. 2002;15:369-73.
37. Puyana JC, Rubiano AM, Hernando Ulloa J, Perdomo MA, editors. Ultrasonido en emergencias y trauma (USET). Bogotá: Distribuna Editorial; 2007.
38. Mayo PH, Beaulieu Y, Doelken P, Feller-Kopman D, Harrod C, Kaplan A, et al. American College of Chest Physicians/La Societé de Réanimation de Langue Francaise statement on competence in critical care ultrasonography. Chest. 2009;135:1050-60.
39. Expert Round Table on Ultrasound in ICU. International expert statement on training standards for critical care ultrasonography. Intensive Care Med. 2011;37:1077-83.
40. Niendorff D, Rassias AJ, Palac R, Beach ML, Costa S, Greenberg M. Rapid cardiac ultrasound of inpatients suffering PEA performed by nonexpert sonographers. Resuscitation. 2005;67:81-7.
41. Mj0lstad OC, Andersen GN, Dalen H, Graven T, Skjetne K, Kleinau JO. Feasibility and reliability of point of care pocket-size echocardiography performed by medical residents. Eur Heart J Cardiovasc Imaging. 2013;14:1195-202.
42. Labovitz AJ, Noble VE, Bierig M, Goldstein SA, Jones R, Kort S. Focused cardiac ultrasound in the emergent setting: a consensus statement of the American Society of Echocardiography and American College of Emergency Physicians. J Am Soc Echocardiogr. 2010;23:1225-30.
43. Jensen MB, Sloth E, Larsen KM, Schmidt MD. Transthoracic echocardiography for cardiopulmonary monitoring in intensive care. Eur J Anaesthesiol. 2004;21:700-7.
44. Cholley BP, Vieillard-Baron A, Mebazaa A. Echocardiography in the ICU: time for widespread use! Intensive Care Med. 2006;32:9-10.
45. Romero-Bermejo FJ, Ruiz-Bailen M, Guerrero-De-Mier M, Lopez-Alvaro J. Echocardiographic hemodynamic monitoring in the critically ill patient. Curr Cardiol Rev. 2011;7:146-56.
46. Barbier C, Loubieres Y, Schmit C, Hayon J, Ricome JL, Jardin F, et al. Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patients. Intensive Care Med. 2004;30:1740-6.
47. Vieillard B, Chergui K, Rabiller A, Peyrouset O, Page B, Beauchet A, et al. Superior vena caval collapsibility as a gauge of volume status in ventilated septic patients. Intensive Care Med. 2004;30:1734-9.
48. Muller L, Bobbia X, Toumi M, Louart G, Molinari N, Ragonnet B, et al. Respiratory variations of inferior vena cava diameter to predict fluid responsiveness in spontaneously breathing patients with acute circulatory failure: need for a cautious use. Crit Care. 2012;16:R188.
49. Rudski L, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23:685-713.
50. Slama M, Masson H, Teboul JL, Arnout ML, Susic D, Frohkich E, et al. Respiratory variations of aortic VTI: a new index of hypovolemia and fluid responsiveness. Am J Physiol Heart Circ Physiol. 2002;283:1729-33.
51. Shabetai R. Pericardial effusion: haemodynamic spectrum. Heart. 2004;90:255-6.
52. Mansencal N, Vileillard-Baron A, Beauchet A, Farcot JC, El Hajjam M, Dufaitre G, et al. Triage patients with suspected pulmonary embolism in the emergency department usinga portable ultrasound device. Echocardiography. 2008;25:451-6.
53. Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein DA, Mathis G, Kirkpatrick AW, et al. International Liaison Committee on Lung Ultrasound (ILC-LUS) for International Consensus Conference on Lung Ultrasound(ICC-LUS). International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012;38:577-91.
54. Lichtenstein D. Lung ultrasound in the critically ill. Curr Opin Crit Care. 2014;20:315-22.
2. Armstrong WF, Schilt BF, Helper DJ, Dillo JC, Feigenbaum H. Diastolic collapse of the right ventricle with cardiac tamponade: an echocardiographic study. Circulation. 1982;65:1491-6.
3. Horowitz RS, Morganroth J, Parrotto C, Chen CC, Soffer J, Pauletto FJ. Immediate diagnosis of acute myocardial infarction by two dimensional echocardiography. Circulation. 1982;65:323-9.
4. Reichert CLA, Visser CA, Koolen JJ, vd Brink RB, van Wezel HB, Meyne NG, et al. Transesophageal echocardiography in hypotensive patients after cardiac operations. Comparison with hemodynamic parameters. J Thorac Cardiovasc Surg. 1992;104:321-6.
5. Vieillard-Baron A, Prin S, Chergui K, Dubourg O, Jardin F. Hemodynamic instability in sepsis: bedside assessment by Doppler echocardiography. Am J Respir Crit Care Med. 2003;168:1270-6.
6. Vignon P, Gueret P, Vedrinne JM, Lagrange P, Cornu E, Abrieu O, et al. Role of transesophageal echocardiography in the diagnosis and management of traumatic aortic disruption. Circulation. 1995;92:2959-68.
7. Gruessner R, Mentges B, Duber C, Ruckert K, Rothmund M. Sonography versus peritoneal lavage in blunt abdominal trauma. J Trauma. 1989;29:242-4.
8. Tso P, Rodriguez A, Cooper C, Militello P, Mirvis S, Badellino MM, et al. Sonography in blunt abdominal trauma: a preliminary progress report. J Trauma. 1992;33:39-44.
9. Rozycki GS, Ochsner MG, Schmidt JA, Frankel HL, Davis TP, Wang D, et al. A prospective study of surgeon performed ultrasound as the primary adjuvant modality for injured patient assessment. J Trauma. 1995;39:492-8.
10. Scalea TM, Rodriguez A, Chiu WC, Brenneman FD, Fallon WF Jr, Kato K, et al. Focused assessment with sonography for trauma (FAST): results from an international consensus conference. J Trauma. 1999;46:466-72.
11. Dulchavsky SA, Schawarz KL, Kirkpatrick AW, Billica RD, Williams DR, Diebel LN, et al. Prospective evaluation of thoracic ultrasound in the detection of pneumothorax. J Trauma. 2001;50:201-5.
12. Sisley AC, Rozycki GS, Ballard RB, Namias N, Salomone JP, Feliciano DV. Rapid detection of traumatic effusion using surgeon performed ultrasonography. J Trauma. 1998;44:291-6.
13. Vargas F, Gruson D, Valentino R, Bui HN, Salmi LR, Gilleron V, et al. Transesophageal pulsed Doppler echocardiography of pulmonary venous flow to assess left ventricular filling pressure in ventilated patients with acute respiratory distress syndrome. J Crit Care. 2004;19:187-97.
14. Vieillard-Baron A, Prin S, Chergui K, Dubourg O, Jardin F. Echo-Doppler demonstration of acute cor pulmonale in the medical intensive care unit. Am J Respir Crit Care Med. 2002;166:1310-9.
15. National Institute for Clinical Excellence. Guideline on the use of ultrasound location devices for placing central venous catheters. London, 2002.
16. Neumar RW, Otto CW, Link MS, Kronick SL, Shuster M, Callaway CW, et al. Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122 Suppl 3:S729-67.
17. Matsushima K, Frankel HL. Beyond focused assessment with sonography for trauma: ultrasound creep in the trauma resuscitation area and, beyond. Curr Opin Crit Care. 2011;17:606-12.
18. Kirkpatrick AW, Sirois M, Laupland KB, Liu D, Rowan K, Ball CG, et al. Hand-held thoracic sonography for detecting post-traumatic pneumothoraces: the Extended Focused Assessment with Sonography for Trauma (EFAST). J Trauma. 2004;57:288-95.
19. Ball CG, Kirkpatrick AW, Feliciano DV. The occult pneumothorax: what have we learned? Can J Surg. 2009;52:E173-9.
20. Ball CG, Kirkpatrick AW, Laupland KB, Fox DI, Nicolaou S, Anderson IB, et al. Incidence, risk factors and outcomes for occult pneumothoraces in victims of major trauma. J Trauma. 2005;59:917-24.
21. Ma OJ, Mateer JR. Trauma ultrasound examination versus chest radiography in the detection of hemothorax. Ann Emerg Med. 1997;29:312-5.
22. Reardon R, Joing S. Hemothorax after a stab wound to the chest, with clear breath sounds and a normal radiograph. Acad Emerg Med. 2006;13:786.
23. Price S, Uddin S, Laupland KB, Quinn T. Echocardiography in cardiac arrest. Curr Opin Crit Care. 2010;16:211-5.
24. Perera P, Mailhot T, Riley D, Mandavia D. The RUSH Exam: rapid ultrasound in shock in the evaluation of the critically III. Emerg Med Clin North Am. 2010;28:29-56.
25. Arntfield RT, Millington SJ. Point of care cardiac ultrasound applications in the emergency department and intensive care unit-a review. Curr Cardiol Rev. 2012;8:98-108.
26. Martin D, Howell EE, Ziegelstein RC, Martire C, Whiting-O'Keefe QE, Shapiro EP, et al. Hand-carried ultrasound performed by hospitalist: does it improve the cardiac physical examination? Am J Med. 2009;122:35-41.
27. Breitkreutz R, Price S, Steiger HV, Seeger FH, Ilper H, Ackermann H, et al., Emergency Ultrasound Working Group of the Johann Wolfgang Goethe-University Hospital, Frankfurt am Main. Focused echocardiographic evaluation in life support and peri-resuscitation of emergency patients: a prospective trial. Resuscitation. 2010;81:1527-33. [ Links ]
28. Blyth L, Atkinson P, Gadd K, Lang E. Bedside focused echocardiography as predictor of survival in cardiac arrest patients: a systematic review. Acad Emerg Med. 2012;19:1119-26.
29. Cureton EL, Yeung LY, Kwan RO, Miraflor EJ, Sadjadi J, Price DD, et al. The heart of the matter: utility of ultrasound of cardiac activity during traumatic arrest. J Trauma Acute Care Surg. 2012;73.
30. Lichtenstein DA, Meziere GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest. 2008;134:117-25.
31. Zanobetti M, Poggioni C, Pini R. Can chest ultrasonography replace standard chest radiography for evaluation of acute dyspnea in the ED? Chest. 2011;139:1140-7.
32. McGee D, Gould MK. Preventing complications of central venous catheterization. N Engl J Med. 2003;348:1123-33.
33. Weekes A, Johnson DA, Keller SM, Efune B, Carey C, Rozario NL, et al. Central vascular catheter placement evaluation using saline flush and bedside echocardiography. Acad Emerg Med. 2014;21:65-72.
34. British Thoracic Society. Pleural disease guideline 2010. A quick reference guide.
35. Tibbles CD, Porcaro W. Procedural applications of ultrasound. Emerg Med Clin North Am. 2004;22:797-815.
36. Seward JB, Douglas PS, Erbel R, Kerber RE, Kronzon I, Rakowski H, et al. Hand-carried cardiac ultrasound (HCU) device: recommendations regarding new, technology. A report from the echocardiography task force on new technology of the Nomenclature and Standards Committee of the American Society of Echocardiography. J Am Soc Echocardiogr. 2002;15:369-73.
37. Puyana JC, Rubiano AM, Hernando Ulloa J, Perdomo MA, editors. Ultrasonido en emergencias y trauma (USET). Bogotá: Distribuna Editorial; 2007.
38. Mayo PH, Beaulieu Y, Doelken P, Feller-Kopman D, Harrod C, Kaplan A, et al. American College of Chest Physicians/La Societé de Réanimation de Langue Francaise statement on competence in critical care ultrasonography. Chest. 2009;135:1050-60.
39. Expert Round Table on Ultrasound in ICU. International expert statement on training standards for critical care ultrasonography. Intensive Care Med. 2011;37:1077-83.
40. Niendorff D, Rassias AJ, Palac R, Beach ML, Costa S, Greenberg M. Rapid cardiac ultrasound of inpatients suffering PEA performed by nonexpert sonographers. Resuscitation. 2005;67:81-7.
41. Mj0lstad OC, Andersen GN, Dalen H, Graven T, Skjetne K, Kleinau JO. Feasibility and reliability of point of care pocket-size echocardiography performed by medical residents. Eur Heart J Cardiovasc Imaging. 2013;14:1195-202.
42. Labovitz AJ, Noble VE, Bierig M, Goldstein SA, Jones R, Kort S. Focused cardiac ultrasound in the emergent setting: a consensus statement of the American Society of Echocardiography and American College of Emergency Physicians. J Am Soc Echocardiogr. 2010;23:1225-30.
43. Jensen MB, Sloth E, Larsen KM, Schmidt MD. Transthoracic echocardiography for cardiopulmonary monitoring in intensive care. Eur J Anaesthesiol. 2004;21:700-7.
44. Cholley BP, Vieillard-Baron A, Mebazaa A. Echocardiography in the ICU: time for widespread use! Intensive Care Med. 2006;32:9-10.
45. Romero-Bermejo FJ, Ruiz-Bailen M, Guerrero-De-Mier M, Lopez-Alvaro J. Echocardiographic hemodynamic monitoring in the critically ill patient. Curr Cardiol Rev. 2011;7:146-56.
46. Barbier C, Loubieres Y, Schmit C, Hayon J, Ricome JL, Jardin F, et al. Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patients. Intensive Care Med. 2004;30:1740-6.
47. Vieillard B, Chergui K, Rabiller A, Peyrouset O, Page B, Beauchet A, et al. Superior vena caval collapsibility as a gauge of volume status in ventilated septic patients. Intensive Care Med. 2004;30:1734-9.
48. Muller L, Bobbia X, Toumi M, Louart G, Molinari N, Ragonnet B, et al. Respiratory variations of inferior vena cava diameter to predict fluid responsiveness in spontaneously breathing patients with acute circulatory failure: need for a cautious use. Crit Care. 2012;16:R188.
49. Rudski L, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23:685-713.
50. Slama M, Masson H, Teboul JL, Arnout ML, Susic D, Frohkich E, et al. Respiratory variations of aortic VTI: a new index of hypovolemia and fluid responsiveness. Am J Physiol Heart Circ Physiol. 2002;283:1729-33.
51. Shabetai R. Pericardial effusion: haemodynamic spectrum. Heart. 2004;90:255-6.
52. Mansencal N, Vileillard-Baron A, Beauchet A, Farcot JC, El Hajjam M, Dufaitre G, et al. Triage patients with suspected pulmonary embolism in the emergency department usinga portable ultrasound device. Echocardiography. 2008;25:451-6.
53. Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein DA, Mathis G, Kirkpatrick AW, et al. International Liaison Committee on Lung Ultrasound (ILC-LUS) for International Consensus Conference on Lung Ultrasound(ICC-LUS). International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012;38:577-91.
54. Lichtenstein D. Lung ultrasound in the critically ill. Curr Opin Crit Care. 2014;20:315-22.
How to Cite
1.
Pérez-Coronado JD, Franco-Gruntorad GA. Utility of ultrasound in resuscitation. Colomb. J. Anesthesiol. [Internet]. 2015 Oct. 1 [cited 2024 Apr. 26];43(4):321–330. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/355
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2015-10-01
How to Cite
1.
Pérez-Coronado JD, Franco-Gruntorad GA. Utility of ultrasound in resuscitation. Colomb. J. Anesthesiol. [Internet]. 2015 Oct. 1 [cited 2024 Apr. 26];43(4):321–330. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/355
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