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Open Access 01-10-2003 | Research

Diagnostic ability of hand-held echocardiography in ventilated critically ill patients

Authors: Philippe Vignon, Catherine Chastagner, Bruno François, Jean-François Martaillé, Sandrine Normand, Michel Bonnivard, Hervé Gastinne

Published in: Critical Care | Issue 5/2003

Abstract

Study objectives

To compare the diagnostic capability of recently available hand-held echocardiography (HHE) and of conventional transthoracic echocardiography (TTE) used as a gold standard in critically ill patients under mechanical ventilation.

Design

A prospective and descriptive study.

Setting

The general intensive care unit of a teaching hospital.

Patients

All mechanically ventilated patients requiring a TTE study with a full-feature echocardiographic platform (Sonos 5500^®; Philips Medical Systems, Andover, MA, USA) also underwent an echocardiographic examination using a small battery-operated device (33 × 23 cm², 3.5 kg) (Optigo^®; Philips Medical Systems).

Interventions

Each examination was performed independently by two intensivists experienced in echocardiography and was interpreted online. For each patient, the TTE videotape was reviewed by a cardiologist experienced in echocardiography and the final interpretation was used as a reference diagnosis.

Results

During the study period, 106 TTE procedures were performed in 103 consecutive patients (age, 59 ± 18 years; Simplified Acute Physiology Score, 46 ± 14; body mass index, 26 ± 9 kg/m²; positive end-expiratory pressure, 8 ± 4 cmH₂O). The number of acoustic windows was comparable using HHE and TTE (233/318 versus 238/318, P = 0.72). HHE had a lower overall diagnostic capacity than TTE (199/251 versus 223/251 clinical questions solved, P = 0.005), mainly due to its lack of spectral Doppler capability. In contrast, diagnostic capacity based on two-dimensional imaging was comparable for both approaches (129/155 versus 135/155 clinical questions solved, P = 0.4). In addition, HHE and TTE had a similar therapeutic impact in 45 and 47 patients, respectively (44% versus 46%, P = 0.9).

Conclusions

HHE appears to have a narrower diagnostic field when compared with conventional TTE, but promises to accurately identify diagnoses based on two-dimensional imaging in ventilated critically ill patients.

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Title: Diagnostic ability of hand-held echocardiography in ventilated critically ill patients
Authors: Philippe Vignon
Catherine Chastagner
Bruno François
Jean-François Martaillé
Sandrine Normand
Michel Bonnivard
Hervé Gastinne
Publication date: 01-10-2003
Publisher: BioMed Central
Published in: Critical Care / Issue 5/2003
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc2360

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Diagnostic ability of hand-held echocardiography in ventilated critically ill patients

Abstract

Study objectives

Design

Setting

Patients

Interventions

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Study objectives

Design

Setting

Patients

Interventions

Results

Conclusions

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