Volume Measurements In Patients Research Articles

Reproducibility Of Retinal Nerve Fiber Layer And Macular Volume Measurements In Patients Receiving Retinal Protection Pharmacotherapy

Background — High-quality monitoring of the glaucoma plays an important role in the early diagnosis and treatment of glaucoma, for which structural optical coherence tomography (OCT) is used. Technology that increases the repeatability and reproducibility of OCT may differ in different devices, thereby yielding different results. Objective — To assess the effect of the frequency of retinal protection pharmacotherapy courses on quantitative data regarding the macular volume and the thickness of the retinal nerve fiber layer (RNFL) measured by two instruments, SPECTRALIS and OPTOPOL, and also to evaluate the agreement between the data collected by these devices. Material and Methods — We monitored 17 patients (34 eyes) diagnosed with primary open-angle glaucoma in the advanced stage from 2019 to 2023. Group 1 including 9 patients (18 eyes) received a course of retinal protection pharmacotherapy with Retinalamin® at an interval of 3 months, while Group 2 comprising 8 patients (16 eyes) received similar treatment at an interval of 6 months. All observed patients underwent structural OCT on REVO NX (OPTOPOL Technology) and SPECTRALIS devices at the onset of the study, as well as after 3 and 6 months. Results — The agreement between the two devices in measuring RNFL thickness was estimated by the Lin’s concordance correlation coefficient (LCCC): in manual mode, LCCCstart=0.69 (95% CI: 0.51-0.81); while in automatic mode, LCCCstart=0.73 (95% CI: 0.57-0.84). The agreement between the macular volume measurements was as follows: in manual mode, LCCCstart=0.21 (95% CI: 0.21-0.29); while in automatic mode, LCCCstart=0.21 (95% CI: 0.21-0.29). Conclusion — The agreement between the SPECTRALIS and OPTOPOL devices in terms of RNFL thickness should be considered substantial, while in terms of macular volume, it should be classified as fair. As measured in the manual mode, the RNFL thickness in both groups receiving Retinalamin increased, which can be interpreted as a favorable effect of retinal protection pharmacotherapy.

Glenohumeral Joint Volume Measurement in Patients with Shoulder Instability: A 3D Volumetric Magnetic Resonance Arthrographic Study.

Background and Objectives: This study aimed to compare capsular volume in patients with shoulder instability to that in control subjects without instability using magnetic resonance (MR) arthrography. The objective was to develop a reliable screening method with which to assess shoulder volume. Materials and Methods: In 21 patients with atraumatic shoulder instability and 21 controls, thin-slice 3D volumetric MR arthrography sequences were obtained. MR arthrography images were uploaded to 3D reconstruction, and 3D images were generated. From the 3D reconstructed images, volumetric measurements of rotator interval (RI), anterior and posterior capsular (AC, PC) recesses, biceps tendon sheath (BS), axillary recess (AR), and total glenohumeral joint (TGJ) were performed. Individuals with any extra-articular contrast leakage were also recorded. Results: A retrospective study analyzed a patient group of 21 individuals with shoulder instability (mean age 29.52 ± 12.83 years) and a control group of 21 individuals without instability (mean age 35.71 ± 12.77 years). No statistically significant differences were identified between the groups with regard to age, gender, or side distribution. The mean total joint volume was significantly higher in the instability group (29.85 ± 6.40 cm3) compared to the control group (23.15 ± 3.48 cm3, p = 0.0001). Additionally, the mean volumes of the RI, AC, PC, BS, and AR were all significantly greater in the patient group compared to the control group. Conclusions: 3D volumetric MR arthrographic measurements of the shoulder joint capacity can provide valuable insights for clinical follow-up and guide surgical treatment decisions in cases of atraumatic shoulder instability.

A Novel Three-Point Localization Method for Bladder Volume Estimation.

The measurement of bladder volume is crucial for the diagnosis and treatment of urinary system diseases. Ultrasound imaging, with its non-invasive, radiation-free, and repeatable scanning capabilities, has become the preferred method for measuring residual urine volume. Nevertheless, it still faces some challenges, including complex imaging methods leading to longer measurement times and lower spatial resolution. Here, we propose a novel three-point localization method that does not require ultrasound imaging to calculate bladder volume. A corresponding triple-element ultrasound probe has been designed based on this method, enabling the ultrasound probe to transmit and receive ultrasound waves in three directions. Furthermore, we utilize the Hilbert Transform algorithm to extract the envelope of the ultrasound signal to enhance the efficiency of bladder volume measurements. The experiment indicates that bladder volume estimation can be completed within 5 s, with a relative error rate of less than 15%. These results demonstrate that this novel three-point localization method offers an effective approach for bladder volume measurement in patients with urological conditions.

Measurement of Upper Airway Volume in Children with Craniofacial Abnormalities.

Previous literature has established a high prevalence of upper airway obstruction in children with craniofacial abnormalities. This study aims to perform quantitative airway volume measurements in patients with craniofacial abnormalities and compare them to age and sex-matched controls. We performed a retrospective review of the records of all children with craniofacial abnormalities who underwent head-and-neck computed tomography (CT) imaging at a single tertiary-care center between 1/1/13 and 12/31/20 using the ICD-10 codes Q75.1, Q75.4, and Q87.0. These patients were then matched by age and sex to patients with isolated craniosynostosis (Q75.0). CT scans were imported into Dolphin Imaging software, and airway volumes were measured for the nasal cavity, nasopharynx, oropharynx, and hypopharynx. The primary outcome was the total airway volume, defined as the sum of these measurements. Thirty subjects with craniofacial syndromes were matched to 30 patients with isolated craniosynostosis (controls). In both groups, 18 subjects (60%) were male (p = 0.99). The average ages for syndromic patients and controls were 12.1 and 12.9 months, respectively (p = 0.84). On average, the total airway volumes of syndromic patients were 25% lower than those of controls (p = 0.02). Syndromic patients had 39% smaller nasal cavity volumes (p < 0.001) and 32% smaller nasopharyngeal volumes (p < 0.01). Significant volume differences were not observed for the oropharynx or hypopharynx. We present a unique technique to measure airway volumes in patients with craniofacial abnormalities. These findings will help practitioners to further understand the anatomy and pathophysiology of disturbed breathing in children with craniofacial syndromes. III Laryngoscope, 134:2915-2921, 2024.

Beyond Diameter: Enhancing Abdominal Aortic Aneurysm Surveillance with Volumetric Assessments after Endovascular Aneurysm Repair (EVAR).

This study aimed to investigate the relationship between maximum transverse diameter (MTD) and volume measurements in patients who underwent reoperations after endovascular aneurysm repair (EVAR), and their association with the occurrence of endoleaks. The study included 51 patients who underwent EVAR and subsequent re-operations caused by endoleaks type I-III. In some number of events, multiple re-operations were needed. MTD was measured using the Horos software, and segmentations of the AAA were performed using 3D Slicer. This study first evaluated post-operative computed tomography angiography (CTA) to measure MTD and volume. Then, similar measurements were made in the control scan for re-operation qualification. Negative remodeling (increase in MTD and/or volume) was observed in 40 cases using MTD, and 48 cases using volume measurements. The volume measurement showed lower missed negatives than MTD, indicating its effectiveness in screening for negative remodeling (p < 0.001). Combining both methods identified 51 negative remodeling cases and 8 positive changes, with a higher sensitivity compared to MTD alone. The volume of the sac did not predict specific endoleak types. Decreases in MTD were observed in smaller sacs, with smaller volume changes. Volume measurement is a valuable screening tool, and combining MTD and volume enhances sensitivity. However, sac volume does not predict endoleak type.

Serial blood volume measurements in patients with compensated chronic heart failure: How do volume profiles change over time?

Among patients with chronic heart failure (HF) intravascular volume profiles vary significantly despite similar clinical compensation. However, little is known regarding changes in blood volume (BV) profiles over time. The objective of this analysis was to identify the extent and character of changes in volume profiles over time. A prospective analysis was undertaken in patients who were hospitalized and treated for fluid overload. Quantitative BV analyses were obtained in a compensated state at hospital discharge (baseline) and follow-up at 1, 3, and 6 mo. Data were available on 10 patients who remained stable without rehospitalization or medication change over a 6-mo period. Baseline BV profiles were highly variable at hospital discharge with an average deviation of +28% above normal in 6 patients and normal BV in 4 patients. Over the follow-up period, the median change in BV was -201 mL [-3% (-6, +3%)] from baseline with profiles remaining in the same volume category in 9 out of 10 patients. Crossover from normal BV to mild contraction (-13% of normal) occurred in one patient. Red blood cell mass demonstrated the largest change over 6 mo [median -275 (-410, +175) mL] with a deviation from normal of -14 (-20, +8) % (reflecting mild anemia). These findings suggest that BV profiles in clinically compensated patients with HF do not change substantially over a 6-mo period regardless of baseline expanded or normal BV. This lack of change in volume profiles particularly from an expanded BV has implications for long-term volume management, clinical outcomes, and also our understanding of volume homeostasis in HF.NEW & NOTEWORTHY The novel findings of this study demonstrate that blood volume profiles while highly variable in clinically compensated patients with HF on stable medical therapy do not change substantially over a 6-mo period regardless of baseline expanded or normal blood volumes. This lack of change in volume profiles particularly from an expanded blood volume has implications for long-term volume management and also for how we understand the pathophysiology of volume homeostasis in chronic HF.

Swarm intelligence empowered three-stage ensemble deep learning for arm volume measurement in patients with lymphedema

Arm lymphedema is mostly a side effect of the breast cancer surgery and radiation therapy, which may happen after the cancer treatment. Arm volume in patients with lymphedema must be accurately measured at the time of diagnosis to assess its severity and remeasured during the treatment to evaluate response to treatment. In this paper, a swarm intelligence three-stage hetero/homogeneous ensemble deep learning model (named THENDEL), embedded in a camera scanning tool, is presented as an automatic, noninvasive, inexpensive, reliable, and high-speed tool for lymphedema arm volume measurement, suitable for daily use in clinics. THENDEL is a three-stage ensemble deep learning model comprising different deep feature extractors (first heterogeneous stage), different regressors (second heterogeneous stage), and a homogeneous stage for multiple training of each feature extractor-regressor. Hyperparameters of THENDEL (i.e., weights of heterogeneous models) are automatically tuned in an offline procedure via a swarm intelligence algorithm based on grey wolf optimizer. The THENDEL model has been successfully developed to measure the volume of 730 arms from 365 women (age, 62.3 ± 9.6 years; body mass index, 25.4 ± 3.4 kg/m2; arm volume, 2187 ± 373 mL), including healthy and patients with lymphedema. To measure the volume of an arm, it is scanned by taking two images at the same time from orthogonal directions, and then, the arm volume is estimated by the THENDEL model. Experimental results demonstrate the reliability of the proposed method by obtaining 36.65 mL mean absolute error, 1.69 % mean percent error, and 0.992 correlation between the estimated and actual arm volumes.

Is Gastric Residual Volume Measurement Really Necessary to Achieve Targeted Calories?

Objective: Malnutrition, energy protein, and inadequate or excessive intake of other nutrients have measurable effects on tissues, body function, and clinical outcomes of patients. We aimed to determine the time to reach target calories, nutritional failures, and complications during feeding in measured and unmeasured gastric residual volume patients under ventilation in the intensive care unit. Methods: The study was completed with 62 patients under mechanical ventilatory support in the intensive care unit. According to the consultation order, patients were divided into 2 groups. Gastric residual volume was measured in the control group (gastric residual volume, n=31) and not in the other (non-gastric residual volume, n=31). Nutrition nurses continuously monitored all enteral-fed patients, and the results were recorded. Results: The feeding pause of the gastric residual volume group was longer than that of the non-gastric residual volume group (P &lt; .001). The time to reach target calories was higher in the gastric residual volume group than in the non-gastric residual volume group (P=.010). The rate of vomiting as a complication was 9.7% (3 patients) in the gastric residual volume group and 6.5% in the non-gastric residual volume group, although the difference was not significant (P=.641). The observation rate of abdominal distension was 6.5% (2 patients) in the gastric residual volume group and the non-gastric residual volume group (P=.999). The positive end-expiratory pressure (PEEP) values were higher in patients who vomited, but the difference was not significant (P=.203). In patients with abdominal distension, PEEP values were higher than in patients without distension, but the difference was not significant (P=.282). Conclusion: In conclusion, gastric residual volume measurement in patients with mechanical ventilatory support prolonged nutritional breaks and extended the time required to reach target calories compared with patients without gastric residual volume measurement

Splenic Size and Volume Measurements in Patients with Chronic Lymphocytic Leukemia

To determine which methods of assessment of splenic size most accurately represent the actual spleen volume in patients with Chronic Lymphocytic Leukemia (CLL). The Abdominal Computed Tomography images of 48 patients with CLL enrolled on a phase 2 clinical trial at two time-points before and after 2-months of continuous acalabrutinib treatment were analyzed. Linear one-dimensional measurements of the spleen were taken in different planes. Two-dimensional and three-dimensional measurements were calculated from the linear measurements using mathematical formulae. The spleen volume was determined by manual segmentation as the ground truth. Data derived were analyzed using Pearson correlation and statistical significance was set at p < 0.05. Among the single-dimensional measurements, the strongest correlation with the segmented splenic volume was the sagittal long axis diameter (LAD) (r=0.89, p < 0.05), followed closely by Coronal LAD (r=0.87, p < 0.05) and cephalocaudal length (iwCLL) (r=0.84, p < 0.05). For the two-dimensional indices, the sum of LAD and short axis diameter (SAD) of the spleen in axial plane showed good correlation with the splenic volume (r=0.77, p < 0.05). Among the three-dimensional indices, the splenic index (0.523 x axial LAD x axial SAD x coronal height) and a formula for volume (30+0.58 x axial LAD x axial SAD x coronal height) had the strongest correlation (both r=0.92, p < 0.05) with the spleen volume. The three-dimensional formulae showed the strongest correlation with volumetric reference spleen measurement. Among unidimensional measurements, the sagittal LAD had the best correlation with the actual splenic volume. The two-dimensional calculation methods were less reliable.

AI-based medical e-diagnosis for fast and automatic ventricular volume measurement in patients with normal pressure hydrocephalus

Based on CT and MRI images acquired from normal pressure hydrocephalus (NPH) patients, using machine learning methods, we aim to establish a multimodal and high-performance automatic ventricle segmentation method to achieve an efficient and accurate automatic measurement of the ventricular volume. First, we extract the brain CT and MRI images of 143 definite NPH patients. Second, we manually label the ventricular volume (VV) and intracranial volume (ICV). Then, we use the machine learning method to extract features and establish automatic ventricle segmentation model. Finally, we verify the reliability of the model and achieved automatic measurement of VV and ICV. In CT images, the Dice similarity coefficient (DSC), intraclass correlation coefficient (ICC), Pearson correlation, and Bland–Altman analysis of the automatic and manual segmentation result of the VV were 0.95, 0.99, 0.99, and 4.2 ± 2.6, respectively. The results of ICV were 0.96, 0.99, 0.99, and 6.0 ± 3.8, respectively. The whole process takes 3.4 ± 0.3 s. In MRI images, the DSC, ICC, Pearson correlation, and Bland–Altman analysis of the automatic and manual segmentation result of the VV were 0.94, 0.99, 0.99, and 2.0 ± 0.6, respectively. The results of ICV were 0.93, 0.99, 0.99, and 7.9 ± 3.8, respectively. The whole process took 1.9 ± 0.1 s. We have established a multimodal and high-performance automatic ventricle segmentation method to achieve efficient and accurate automatic measurement of the ventricular volume of NPH patients. This can help clinicians quickly and accurately understand the situation of NPH patient's ventricles.

Prognostic role of spleen volume measurement using computed tomography in patients with compensated chronic liver disease from hepatitis B viral infection

To determine the prognostic value of CT-based splenic volume measurement in patients with compensated chronic liver disease (cCLD) from chronic hepatitis B (CHB). A total of 584 patients having multiphasic liver CT scans between January and December 2011 were retrospectively reviewed. Spleen volume was measured using a semi-automated three-dimensional volumetric software program. Electronic medical records and national registry data were reviewed to determine the diagnosis of hepatocellular carcinoma (HCC), hepatic decompensation, or death. The cumulative incidence (CI) of the development of decompensation, HCC occurrence, and overall survival (OS) were estimated by the Kaplan-Meier method. The Cox proportional hazard regression model was used to evaluate prognostic factors. The optimal cutoff spleen volume to predict each outcome was obtained using a minimal p value approach method. After a median follow-up of 92months, 114 patients developed HCC with a 7-year CI of 17.2%. A larger spleen volume was a significant predictor of HCC occurrence (HR = 2.13, p= 0.009). Decompensation occurred in 30 patients with a 7-year CI of 5.0%, and a larger spleen volume was also significantly associated with the development of decompensation (HR = 4.66, p= 0.005). Twenty-three patients died, and their estimated 7-year OS was 96.4%. A larger spleen volume also significantly affected OS (HR = 6.15, p= 0.007). The optimal cutoff spleen volume was set at 532mL for HCC occurrence, 656.9mL for the development of decompensation, and 741.1mL for OS. A larger spleen volume was significantly associated with HCC occurrence, development of decompensation, and poor OS in patients with cCLD from CHB. • Spleen volume could be easily acquired from routine multiphasic liver CT scan using a semi-automated 3D volumetric software program with excellent inter-observer agreement. • A larger spleen volume was significantly associated with a higher rate of hepatocellular carcinoma occurrence, the development of decompensation, and poor overall survival in patients with compensated chronic liver disease from chronic hepatitis B.

Portable infrared imaging for longitudinal limb volume monitoring in patients with lymphatic filariasis.

BackgroundThe Global Programme to Eliminate Lymphatic Filariasis (LF) emphasizes hygiene, exercise, and other measures to reduce morbidity and disability related to LF. We recently reported that a portable, three-dimensional, infrared imaging system (3DIS) provides accurate limb volume measurements in patients with filarial lymphedema. To assess the practical utility of repeated 3DIS measurements for longitudinal lymphedema management, we examined intraday and day-to-day leg volume changes in adults with filarial lymphedema in southern Sri Lanka.Methodology and principal findingsWe assessed 41 participants with lower extremity lymphedema (stages 1–6) in their homes in the mornings (6:00–9:00 AM) and afternoons (2:00–6:00 PM) of three days within one calendar week. Two examiners performed replicate 3DIS volume measurements at each visit. Median coefficient of variation among replicate volume measurements was 1.7% (IQR 1.1% - 2.3%) for left legs and 2.2% (IQR 1.6% - 2.8%) for right legs. Median intraday volume increase was 3.0%. Range among daily volume measurements tended to be lower for afternoon measurements (median 2.25%, IQR 1.4%– 5.4%) than for morning measurements (median 3.0%, IQR 1.4% - 8.4%).Conclusions and significanceLimb volume measurements by 3DIS are accurate and reproducible, and this technique is feasible for use in patients’ homes. We have developed practical suggestions for optimal outcomes with 3DIS. Duplicate measurements should be performed and repeat assessments should be done at approximately the same time of day to minimize bias. Duplicate measures that vary by more than 8% should prompt review of scanning technique with a repeat measurement. With proper training and attention to technique, 3DIS can be a valuable tool for healthcare workers who work with lymphedema patients.

Projection-based respiratory-resolved left ventricular volume measurements in patients using free-breathing double golden-angle 3D radial acquisition

ObjectiveTo refine a new technique to measure respiratory-resolved left ventricular end-diastolic volume (LVEDV) in mid-inspiration and mid-expiration using a respiratory self-gating technique and demonstrate clinical feasibility in patients.Materials and methodsTen consecutive patients were imaged at 1.5 T during 10 min of free breathing using a 3D golden-angle radial trajectory. Two respiratory self-gating signals were extracted and compared: from the k-space center of all acquired spokes, and from a superior–inferior projection spoke repeated every 64 ms. Data were binned into end-diastole and two respiratory phases of 15% respiratory cycle duration in mid-inspiration and mid-expiration. LVED volume and septal–lateral diameter were measured from manual segmentation of the endocardial border.ResultsRespiratory-induced variation in LVED size expressed as mid-inspiration relative to mid-expiration was, for volume, 1 ± 8% with k-space-based self-gating and 8 ± 2% with projection-based self-gating (P = 0.04), and for septal–lateral diameter, 2 ± 2% with k-space-based self-gating and 10 ± 1% with projection-based self-gating (P = 0.002).DiscussionMeasuring respiratory variation in LVED size was possible in clinical patients with projection-based respiratory self-gating, and the measured respiratory variation was consistent with previous studies on healthy volunteers. Projection-based self-gating detected a higher variation in LVED volume and diameter during respiration, compared to k-space-based self-gating.

Risk prediction of posttraummatic enophthalmos development on the basis of orbital volume calculations using multislice computed tomography data

Purpose. To elaborate a method of orbital volume measurement in patients with midface trauma at pre- and postoperative stages on the basis of multislice computed tomography (MSCT); to investigate the capabilities of orbital volume measurement to acquire additional diagnostic information and to estimate the risk of postoperative enophthalmos development.&#x0D; Materials and methods. A total of 71 patients (100%) with midface trauma were examined at the Sechenov University clinic. At pre- and postoperative stages, all patients (n = 71, 100%) were examined using MSCT (Toshiba Aquilion One 640) with 0.5 mm slice thickness in bone and soft tissue regimen. To measure orbital volume, MSCT data were processed using Vitrea workstation: bone borders of the right and left orbit were marked before and after surgical treatment on every axial slice, and orbital volumes were presented in ml.&#x0D; Results. Preoperative MSCT data management revealed increased orbital volume due to orbital trauma in 64 patients (90%), the difference between healthy and traumatized orbit was between 2 ml and 14 ml. In these patients, reconstructive surgical procedure was performed. In 7 patients (10%) with mild midface trauma, the difference between orbital volumes was less than 2 ml, this was considered as a positive prognostic factor, and these patients were not subjects to surgical treatment. After surgery, in 55 patients (77%) the orbital volume restored, the difference between orbital volumes was less than 2 ml. In 9 cases (13%), the difference in orbital volume was more than 2 ml, considered as adverse prognostic factor which means that there still was a risk of postoperative enophthalmos development. In this patient group, additional diagnostic examination was necessary, and patients required planning of residual enophthalmos surgical correction with MSCT control during the post-op period.&#x0D; Conclusion. Postprocessing of the MSCT data gave the possibility to calculate pre-and postoperative orbital volume changes and present it in mathematical units (ml) in 3D mode. As the result the additional information can be acquired in order to identify the risk of postoperative enophthalmos.

Accuracy of Residual Urinary Volume Measurements in Patients with Neurogenic Bladder when using a Portable Ultrasound Bladder Scanner

Accuracy of Residual Urinary Volume Measurements in Patients with Neurogenic Bladder when using a Portable Ultrasound Bladder Scanner

The Bayesian risk estimate at onset (BREMSO) correlates with cognitive and physical disability in patients with early multiple sclerosis

BackgroundPrevention of long-term disability is the goal of therapeutic intervention in Relapsing Remitting MS (RRMS). The Bayesian Risk Estimate for MS at Onset (BREMSO) gives an individual risk score predicting disease evolution into Secondary Progressive MS (SPMS). We investigated whether BREMSO correlates with physical disability, cognitive dysfunction, and regional brain atrophy early in MS. MethodsOne hundred RRMS patients with at least two years of follow-up were enrolled. BREMSO score as well as Symbol Digit Modalities Test (SDMT) and Multiple Sclerosis Severity Score (MSSS), Timed 25-Foot Walk Test (T25-FW) and 9-Hole Peg Test (9-HPT), were assessed. Intracranial volume (ICV), subcortical gray matter structures and corpus callosum (CC) were automatically segmented on MRI images and their volumes measured. ResultsBREMSO score correlated negatively with SDMT at visit1 (β = −0.33, p = 0.019), visit2 (β = −0.34, p = 0.017) and visit3 (β = −0.34, p = 0.014), and positively with MSSS at visit1 (r = 0.38, p = 0.006), visit2 (r = 0.47, p < 0.0001) and visit3 (r = 0.42, p = 0.002), but not with T25-FW and 9-HPT. BREMSO negatively correlated with CC volume at baseline (p < 0.03). No correlations were found with ICV and subcortical gray matter. ConclusionsBREMSO score at onset correlated with physical disability (MSSS), cognitive function (SDMT) and CC volume measurements in patients with early MS.

Gastric residual volume measurement in the intensive care unit: an international survey reporting nursing practice

Gastric residual volume measurement is routinely used to evaluate the feeding tolerance and gastro-oesophageal reflux in patients receiving enteral feeding therapy in the intensive care unit. However, little supportive evidence for this intervention is available as the usefulness of gastric residual volume measurements in patients receiving enteral feeding therapy in the intensive care is controversial. The aim of this study was to assess the practice of intensive care unit nurses related to gastric residual volume measurement in patients receiving enteral nutrition. A survey was conducted among a sample of intensive care unit nurses (n = 832) from four hospitals in Turkey (n = 182) and attendees of the Annual Congress of the Flemish Society for Critical Care Nurses in Flanders, Belgium (n = 650). The survey instrument was developed by the researchers based on the related literature. A total of 480 nurses completed the questionnaire (response rate = 73%). Gastric residual volume is measured by 98·0% of respondents, with wide variations in the frequency of measuring. A 50-200 mL gastric residual volume is considered problematic by 45·5% (n = 183) of the participants, and only 18·4% (n = 81) reported their practice to be based on a current guideline. Strikingly, more experienced intensive care unit nurses appear to perform gastric residual volume measurements more commonly than their less experienced colleagues (p = 0·004), while the practice is more often reported to be performed in Belgium than in Turkey (p < 0·001). Gastric residual volume management could be improved by applying current evidence to daily nursing practice. Our results show that increased awareness of these guidelines by nurses is needed to reduce inefficient use of working time and resources, streamline clinical practices and improve patient outcomes. Current gastric residual volume measurement guidelines and up-to-date, relevant training should be provided to nurses.

The Accuracy of Portable Ultrasound Bladder Scanner Measurements of Postvoid Residual Volume in Women With Pelvic Organ Prolapse.

ObjectivesThe purpose of this study was to evaluate the accuracy of portable bladder scanner postvoid residual (PVR) volume measurements in patients with pelvic organ prolapse. A secondary goal was to determine whether covariates such as bladder volume and stage of prolapse affect bladder scanner accuracy.Study DesignComplex urodynamic studies were performed on 70 patients with stage II or greater prolapse. Complex urodynamic studies included measurement of maximum bladder capacity (MBC) as well as measurement of PVR by urethral catheterization before, and following, complex filling cystometry. For each catheterized PVR, a corresponding bladder scanner measurement was obtained; the primary outcome was the difference between these measurements. In addition, bladder scanner measurements of MBC were compared with MBC by urodynamic pump. Measurements were compared by paired t test. Linear regression was used to assess association between covariates and bladder scanner error.ResultsThere was no significant difference between catheter and bladder scanner PVR at the initial (mean difference, 5.94 mL; 95% confidence interval [CI], −3.8 to 15.7) or final (mean difference, 1.37 mL; 95% CI, −10.9 to 13.6) measurements. Maximum bladder capacity measurements by bladder scanner were significantly smaller than catheterized measurements (mean difference, −21.3 mL; 95% CI, −40.3 to −2.3). Stage III/IV prolapse was associated with increased bladder scanner error (P = 0.03).ConclusionsThe portable bladder scanner accurately measures PVR in patients with pelvic organ prolapse and could be considered as an alternative to catheterized assessment. However, stage III/IV prolapse is associated with increased bladder scanner error, which should be considered when determining appropriate candidates for bladder scanner PVR assessment.

Improved Precision of Automatic Brain Volume Measurements in Patients with Clinically Isolated Syndrome and Multiple Sclerosis Using Edema Correction.

The presence of edema will result in increased brain volume, which may obscure progressing brain atrophy. Similarly, treatment-induced edema reduction may appear as accelerated brain tissue loss (pseudoatrophy). The purpose of this study was to correlate brain tissue properties to brain volume, to investigate the possibilities for edema correction and the resulting improvement of the precision of automated brain volume measurements. A group of 38 patients with clinically isolated syndrome or newly diagnosed MS were imaged at inclusion and after 1, 2, and 4 years using an MR quantification sequence. Brain volume, relaxation rates (R1 and R2), and proton density were measured by automated software. The reduction of normalized brain volume with time after inclusion was 0.273%/year. The mean SDs were 0.508%, 0.526%, 0.454%, and 0.687% at baseline and 1, 2, and 4 years. Linear regression of the relative change of normalized brain volume and the relative change of R1, R2, and proton density showed slopes of -0.198 (P < .001), 0.156 (P = .04), and 0.488 (P < .001), respectively. After we applied the measured proton density as a correction factor, the mean SDs decreased to 24.2%, 4.8%, 33.3%, and 17.4%, respectively. The observed atrophy rate reduced from 0.273%/year to 0.238%/year. Correlations between volume and R1, R2, and proton density were observed in the brain, suggesting that a change of brain tissue properties can affect brain volume. Correction using these parameters decreased the variation of brain volume measurements and may have reduced the effect of pseudoatrophy.

Measurement of Myocardial Extracellular Volume Fraction From Iodine Density Images Using Single-Source, Dual-Energy Computed Tomography: A Feasibility Study.

The aims of this study were to develop and validate an iodine density method for the quantification of myocardial extracellular volume (ECV) fraction using single-source, dual-energy computed tomography. Extracellular volume measurements were carried out in 40 subjects (20 patients with heart failure, 20 control subjects) using single-source, dual-energy computed tomography. Subtraction-derived ECVs (subECVs) were computed by subtracting precontrast from delayed images. Iodine density-derived ECVs (iECVs) were calculated from iodine density images obtained from delayed images. Iodine density-derived ECVs were compared with reference subECVs. A strong correlation (r = 0.896, P < 0.0001) and a small bias (-0.06%) were determined between subECV and iECV with high interobserver concordances (0.915 and 0.906, respectively). Extracellular volume measurements in patients with heart failure were higher in both subECV and iECV compared with control subjects (34.6% [SD, 5.0%] vs 29.5% [SD, 3.6%], P = 0.001, for subECV; 34.9% [SD, 4.5%] vs 29.2% [SD, 2.6%], P < 0.0001, for iECV). Extracellular volume analysis using iodine density is a useful tool for the noninvasive quantification of ECV in myocardial diseases.