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Transthoracic echocardiography for cardiopulmonary monitoring in intensive care

Published online by Cambridge University Press:  23 December 2004

M. B. Jensen ,
E. Sloth ,
K. M. Larsen  and
M. B. Schmidt
M. B. Jensen
Affiliation:
Aarhus University Hospital, Department of Anaesthesiology and Intensive Care, Skejby Sygehus, Denmark
E. Sloth
Affiliation:
Aarhus University Hospital, Department of Anaesthesiology and Intensive Care, Skejby Sygehus, Denmark
K. M. Larsen
Affiliation:
Aarhus University Hospital, Department of Anaesthesiology and Intensive Care, Skejby Sygehus, Denmark
M. B. Schmidt
Affiliation:
Aarhus University Hospital, Department of Anaesthesiology and Intensive Care, Skejby Sygehus, Denmark
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Abstract

Summary

Background and objective: To evaluate the feasibility of an abbreviated focus assessed transthoracic echocardiographic protocol, consisting of four standardized acoustic views for cardiopulmonary screening and monitoring.

Methods: The protocol was applied in 210 patients in a 20-bed multidisciplinary intensive care unit in a university hospital. When inconclusive, an additional transoesophageal echocardiographic examination was performed. Diagnosis, indication, acoustic window, position and value were recorded. Significant pathology, load, dimensions and contractility were assessed.

Results: Two-hundred-and-thirty-three transthoracic and four transoesophageal echoes were performed. The protocol provided usable images of the heart in 97% of the patients, 58% subcostal, 80% apical and 69% parasternal. Images through one window were obtainable in 23%, through two windows in 41% and through three windows in 34%. In 227 patients (97.4%) the focus assessed echo protocol contributed positively. In 24.5% of cases the information was decisive, in 37.3% supplemental and in 35.6% supportive.

Conclusions: By means of an abbreviated, focus assessed transthoracic echo protocol it is feasible to visualize the haemodynamic determinants for assessment and optimization. One or more useful images are obtainable in 97% of critically ill patients.

Keywords

ECHOCARDIOGRAPHY, transthoracic, transoesophagealCRITICAL CARE, monitoringHEART DISEASES, cardiac output low, heart failure, myocardial ischaemia
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 9 , September 2004 , pp. 700 - 707
Copyright
2004 European Society of Anaesthesiology

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