Gastric ultrasound-guided noninvasive ventilation for altered hypertensive cardiogenic pulmonary edema: A case report
Background: Gastric ultrasound is mainly used in the preoperative evaluation of patients for aspiration risk assessment. This is accomplished by assessing the gastric antrum, which can be used to calculate the total gastric volume (TGV). We extrapolated this concept to our emergency department to ma...
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Elsevier
2025-06-01
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| author | Sasikumar Mahalingam Gunaseelan Rajendran Anitha Ramkumar Kumaresh Pillur Tamilarasu Aswin Kumaran Surendar Ravipragasam Tharun kumar Ganesan Shivakumar Somannavar Vijayalakshmi Padmanaban Vinay Yareshimi Nedurumalli Naga Vaishnavi Nirmala Subbamanda Dinesh |
| author_facet | Sasikumar Mahalingam Gunaseelan Rajendran Anitha Ramkumar Kumaresh Pillur Tamilarasu Aswin Kumaran Surendar Ravipragasam Tharun kumar Ganesan Shivakumar Somannavar Vijayalakshmi Padmanaban Vinay Yareshimi Nedurumalli Naga Vaishnavi Nirmala Subbamanda Dinesh |
| author_sort | Sasikumar Mahalingam |
| collection | DOAJ |
| description | Background: Gastric ultrasound is mainly used in the preoperative evaluation of patients for aspiration risk assessment. This is accomplished by assessing the gastric antrum, which can be used to calculate the total gastric volume (TGV). We extrapolated this concept to our emergency department to manage cardiogenic pulmonary edema. Case report: Here, we report a case of a 65-year-old man with comorbidities, namely, hypertension and coronary artery disease, who presented to the emergency department with acute cardiogenic pulmonary edema (ACPE) and had a drop in sensorium after a few minutes of hospital arrival, for whom we resorted to gastric ultrasound-guided noninvasive ventilation (G-NIV) under a sedation cover rather than intubation. We achieved excellent outcomes, and the patient was discharged healthy. Why should an emergency physician be aware of this?: Although noninvasive ventilation (NIV) is a class 1 indication for ACPE, its role may be limited in altered sensorium or irritable patients. Ideally, these patients should be intubated and mechanically ventilated. However, in resource-limited settings where ventilators are not available, G-NIVs can be used. However, another advantage of G-NIV is that intubation-related complications can be avoided, resulting in early discharge and less morbidity. |
| format | Article |
| id | doaj-art-2567bc2c623e45439b5feba32aef60c5 |
| institution | OA Journals |
| issn | 2773-2320 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
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| series | JEM Reports |
| spelling | doaj-art-2567bc2c623e45439b5feba32aef60c52025-08-20T02:36:58ZengElsevierJEM Reports2773-23202025-06-014210015710.1016/j.jemrpt.2025.100157Gastric ultrasound-guided noninvasive ventilation for altered hypertensive cardiogenic pulmonary edema: A case reportSasikumar Mahalingam0Gunaseelan Rajendran1Anitha Ramkumar2Kumaresh Pillur Tamilarasu3Aswin Kumaran4Surendar Ravipragasam5Tharun kumar Ganesan6Shivakumar Somannavar7Vijayalakshmi Padmanaban8Vinay Yareshimi9Nedurumalli Naga Vaishnavi10Nirmala Subbamanda Dinesh11Department of Emergency Medicine, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India; Corresponding author. Department of Emergency Medicine, Sri Lakshmi Narayana Institute of Medical Sciences, No 9, Vaigai Street, Vallalar Nagar, Nainarmandabam, Puducherry, 605004, India.Department of Emergency Medicine, Sri Manakula Vinayagar Medical College, Puducherry, IndiaDepartment of Emergency Medicine, Sri Manakula Vinayagar Medical College, Puducherry, IndiaDepartment of Emergency Medicine, Karpaga Vinayaga Institute of Medical Science and Research Center, TamilNadu, IndiaDepartment of Emergency Medicine, Indira Gandhi Medical College and Research Institute, Puducherry, IndiaDepartment of Emergency Medicine, Indira Gandhi Medical College and Research Institute, Puducherry, IndiaDepartment of Emergency Medicine, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, IndiaDepartment of Emergency Medicine, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, IndiaDepartment of Emergency Medicine, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, IndiaDepartment of Emergency Medicine, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, IndiaDepartment of Emergency Medicine, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, IndiaDepartment of Emergency Medicine, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, IndiaBackground: Gastric ultrasound is mainly used in the preoperative evaluation of patients for aspiration risk assessment. This is accomplished by assessing the gastric antrum, which can be used to calculate the total gastric volume (TGV). We extrapolated this concept to our emergency department to manage cardiogenic pulmonary edema. Case report: Here, we report a case of a 65-year-old man with comorbidities, namely, hypertension and coronary artery disease, who presented to the emergency department with acute cardiogenic pulmonary edema (ACPE) and had a drop in sensorium after a few minutes of hospital arrival, for whom we resorted to gastric ultrasound-guided noninvasive ventilation (G-NIV) under a sedation cover rather than intubation. We achieved excellent outcomes, and the patient was discharged healthy. Why should an emergency physician be aware of this?: Although noninvasive ventilation (NIV) is a class 1 indication for ACPE, its role may be limited in altered sensorium or irritable patients. Ideally, these patients should be intubated and mechanically ventilated. However, in resource-limited settings where ventilators are not available, G-NIVs can be used. However, another advantage of G-NIV is that intubation-related complications can be avoided, resulting in early discharge and less morbidity.http://www.sciencedirect.com/science/article/pii/S2773232025000215Gastric antrumUltrasoundPulmonary edemaPositive pressure noninvasive ventilationAspiration syndrome |
| spellingShingle | Sasikumar Mahalingam Gunaseelan Rajendran Anitha Ramkumar Kumaresh Pillur Tamilarasu Aswin Kumaran Surendar Ravipragasam Tharun kumar Ganesan Shivakumar Somannavar Vijayalakshmi Padmanaban Vinay Yareshimi Nedurumalli Naga Vaishnavi Nirmala Subbamanda Dinesh Gastric ultrasound-guided noninvasive ventilation for altered hypertensive cardiogenic pulmonary edema: A case report JEM Reports Gastric antrum Ultrasound Pulmonary edema Positive pressure noninvasive ventilation Aspiration syndrome |
| title | Gastric ultrasound-guided noninvasive ventilation for altered hypertensive cardiogenic pulmonary edema: A case report |
| title_full | Gastric ultrasound-guided noninvasive ventilation for altered hypertensive cardiogenic pulmonary edema: A case report |
| title_fullStr | Gastric ultrasound-guided noninvasive ventilation for altered hypertensive cardiogenic pulmonary edema: A case report |
| title_full_unstemmed | Gastric ultrasound-guided noninvasive ventilation for altered hypertensive cardiogenic pulmonary edema: A case report |
| title_short | Gastric ultrasound-guided noninvasive ventilation for altered hypertensive cardiogenic pulmonary edema: A case report |
| title_sort | gastric ultrasound guided noninvasive ventilation for altered hypertensive cardiogenic pulmonary edema a case report |
| topic | Gastric antrum Ultrasound Pulmonary edema Positive pressure noninvasive ventilation Aspiration syndrome |
| url | http://www.sciencedirect.com/science/article/pii/S2773232025000215 |
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