Chest
Original ResearchChest UltrasonographyAssessment of Left Ventricular Function by Intensivists Using Hand-Held Echocardiography
Section snippets
Study Population
This study was performed in the medical ICU of Hennepin County Medical Center, an urban teaching hospital affiliated with the University of Minnesota. The study population included 44 patients who had a formal TTE ordered by their primary physician because of one or more of the following indications: hypotension (n = 19); dyspnea-hypoxemia (n = 17); unexplained tachycardia (n = 4); increased troponin levels (n = 3); and abnormal ECG (n = 3).
Training and Interpretation of Focused TTE by Intensivists
Prior to beginning the study, intensivists involved in
Results
The 44 patients included 28 men (64%) and 16 women (36%) with a mean (± SD) age of 60 ± 16 years. The most common primary diagnoses were sepsis (n = 10), pulmonary edema (n = 6), pneumonia (n = 6), and seizure (n = 5); the remaining 13 patients had other miscellaneous conditions. Eighteen of the 44 patients (41%) were intubated, and 8 patients (18%) required therapy with vasopressors. The time required to complete the limited TTE was ≤ 10 min in most cases.
We first assessed the ability of
Discussion
The goal of this prospective observational study was to determine whether intensivists who had undergone brief and focused training in echocardiography were able to assess LV function accurately using a miniaturized ultrasound unit. Using a near-simultaneous comprehensive TTE as the “gold standard,” intensivists were able to differentiate normal and abnormal LV function correctly in 86% of cases; in 82% of cases the intensivists correctly classified LV function as normal, mildly to moderately
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The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
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