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01-04-2004 | Brief Report

Hand-held echocardiography with doppler capability for the assessment of critically-ill patients: is it reliable?

Authors: Philippe Vignon, Mickaël B. J. Frank, Jérôme Lesage, Frédérique Mücke, Bruno François, Sandrine Normand, Michel Bonnivard, Marc Clavel, Hervé Gastinne

Published in: Intensive Care Medicine | Issue 4/2004

Abstract

Objective

To evaluate the diagnostic capability of a hand-carried ultrasound device (HCU) in critically ill patients when using conventional transthoracic echocardiography (TTE) as a reference.

Design

Prospective, descriptive study.

Setting

Medical-surgical intensive care unit of a teaching hospital.

Patients

All patients requiring a TTE study were eligible.

Interventions

Each patient underwent an echocardiographic examination using a full-feature echocardiographic platform (Sonos 5500, Philips Medical Systems, Andover, MA) and a small battery-operated device (SonoHeart Elite, SonoSite, Bothell, WA). The operators (level III training in echocardiography) were randomized (HCU vs. TTE) and they independently interpreted the echocardiograms at the patient bedside.

Results

During a 2-month period, 55 consecutive patients (age: 61±16 years, simplified acute physiology score 46±15, body mass index 26±7) were studied, 40 of them being mechanically ventilated (73%). The number of acoustic windows was comparable using HCU and TTE (2.3±0.8 vs. 2.4±0.8: P=0.24). The overall diagnostic accuracy of HCU was lower compared with conventional TTE (137/171 vs. 158/171 clinical questions solved: P=0.002), reaching 80% and 92%, respectively. Despite its spectral Doppler capability, HCU missed diagnoses that were adequately identified by TTE: elevated left ventricular pressure (n=2), relevant valvulopathy (n=2) and moderate (n=4) or severe (n=2) pulmonary hypertension. Acute management was altered by HCU and TTE findings in 27 patients (49%) and 28 patients (51%), respectively.

Conclusions

In this study, HCU had a lower diagnostic accuracy compared with conventional TTE, despite its spectral Doppler capability. Further studies are needed to validate these evolving diagnostic tools in critical care settings.

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Title: Hand-held echocardiography with doppler capability for the assessment of critically-ill patients: is it reliable?
Authors: Philippe Vignon
Mickaël B. J. Frank
Jérôme Lesage
Frédérique Mücke
Bruno François
Sandrine Normand
Michel Bonnivard
Marc Clavel
Hervé Gastinne
Publication date: 01-04-2004
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 4/2004
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-003-2128-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Hand-held echocardiography with doppler capability for the assessment of critically-ill patients: is it reliable?

Abstract

Objective

Design

Setting

Patients

Interventions

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design

Setting

Patients

Interventions

Results

Conclusions

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