| Focused Assessment with Sonography for Trauma in weightlessness: a feasibility study. | |
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MedLine Citation:
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PMID: 12788418 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The Focused Assessment with Sonography for Trauma (FAST) examines for fluid in gravitationally dependent regions. There is no prior experience with this technique in weightlessness, such as on the International Space Station, where sonography is currently the only diagnostic imaging tool. STUDY DESIGN: A ground-based (1 g) porcine model for sonography was developed. We examined both the feasibility and the comparative performance of the FAST examination in parabolic flight. Sonographic detection and fluid behavior were evaluated in four animals during alternating weightlessness (0 g) and hypergravity (1.8 g) periods. During flight, boluses of fluid were incrementally introduced into the peritoneal cavity. Standardized sonographic windows were recorded. Postflight, the video recordings were divided into 169 20-second segments for subsequent interpretation by 12 blinded ultrasonography experts. Reviewers first decided whether a video segment was of sufficient diagnostic quality to analyze (determinate). Determinate segments were then analyzed as containing or not containing fluid. A probit regression model compared the probability of a positive fluid diagnosis to actual fluid levels (0 to 500 mL) under both 0-g and 1.8-g conditions. RESULTS: The in-flight sonographers found real-time scanning and interpretation technically similar to that of terrestrial conditions, as long as restraint was maintained. On blinded review, 80% of the recorded ultrasound segments were considered determinate. The best sensitivity for diagnosis in 0 g was found to be from the subhepatic space, with probability of a positive fluid diagnosis ranging from 9% (no fluid) to 51% (500 mL fluid). CONCLUSIONS: The FAST examination is technically feasible in weightlessness, and merits operational consideration for clinical contingencies in space. |
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Authors:
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Andrew W Kirkpatrick; Douglas R Hamilton; Savvas Nicolaou; Ashot E Sargsyan; Mark R Campbell; Alan Feiveson; Scott A Dulchavsky; Shannon Melton; George Beck; David L Dawson |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Validation Studies |
Journal Detail:
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Title: Journal of the American College of Surgeons Volume: 196 ISSN: 1072-7515 ISO Abbreviation: J. Am. Coll. Surg. Publication Date: 2003 Jun |
Date Detail:
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Created Date: 2003-06-05 Completed Date: 2003-06-20 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9431305 Medline TA: J Am Coll Surg Country: United States |
Other Details:
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Languages: eng Pagination: 833-44 Citation Subset: AIM; IM; S |
Affiliation:
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Foothills Medical Centre, Calgary, Alberta, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aerospace Medicine
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methods*,
standards,
trends Animals Disease Models, Animal* Feasibility Studies Female Forecasting Hypergravity* Regression Analysis Rheology Sensitivity and Specificity Single-Blind Method Swine Traumatology / methods, standards, trends Weightlessness* Weightlessness Simulation* Wounds and Injuries / ultrasonography* |
| Investigator | |
Investigator/Affiliation:
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S A Dulchavsky / Wayne St U Sch Med, Detroit, MI |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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