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.
RCT Entities:
OBJECTIVE: To evaluate the diagnostic capability of a hand-carried ultrasound device (HCU) in critically illpatients 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.
Authors: Charles J Bruce; Samantha C Montgomery; Kent R Bailey; Jamil Tajik; James B Seward Journal: Am J Cardiol Date: 2002-12-01 Impact factor: 2.778
Authors: M D Cheitlin; J S Alpert; W F Armstrong; G P Aurigemma; G A Beller; F Z Bierman; T W Davidson; J L Davis; P S Douglas; L D Gillam Journal: Circulation Date: 1997-03-18 Impact factor: 29.690
Authors: K T Spencer; A S Anderson; A Bhargava; A C Bales; M Sorrentino; K Furlong; R M Lang Journal: J Am Coll Cardiol Date: 2001-06-15 Impact factor: 24.094
Authors: Eleni C Vourvouri; Don Poldermans; Johan De Sutter; Fabiola B Sozzi; Paolo Izzo; Jos R T C Roelandt Journal: J Am Soc Echocardiogr Date: 2002-01 Impact factor: 5.251
Authors: Jean-Bernard Amiel; Ana Grümann; Gwenaëlle Lhéritier; Marc Clavel; Bruno François; Nicolas Pichon; Anthony Dugard; Benoît Marin; Philippe Vignon Journal: Crit Care Date: 2012-02-15 Impact factor: 9.097
Authors: Julien Maizel; Ahmed Salhi; Christophe Tribouilloy; Ziad A Massy; Gabriel Choukroun; Michel Slama Journal: Crit Care Date: 2013-09-03 Impact factor: 9.097
Authors: Julio Pontet; Christian Yic; José L Díaz-Gómez; Pablo Rodriguez; Igor Sviridenko; Diego Méndez; Sylvia Noveri; Ana Soca; Mario Cancela Journal: Ultrasound J Date: 2019-09-30
Authors: Matthieu Biais; Cédric Carrié; François Delaunay; Nicolas Morel; Philippe Revel; Gérard Janvier Journal: Crit Care Date: 2012-05-14 Impact factor: 9.097
Authors: Jeane M Tsutsui; Raquel R Maciel; Joicely M Costa; Jose L Andrade; Jose F Ramires; Wilson Mathias Journal: Cardiovasc Ultrasound Date: 2004-11-17 Impact factor: 2.062
Authors: Sam Jenkins; Mohamed G Shiha; Eron Yones; James Wardley; Alisdair Ryding; Chris Sawh; Marcus Flather; Paul Morris; Andrew J Swift; Vassilios S Vassiliou; Pankaj Garg Journal: J Echocardiogr Date: 2021-08-02
Authors: Sam Jenkins; Samer Alabed; Andrew Swift; Gabriel Marques; Alisdair Ryding; Chris Sawh; James Wardley; Benoy Nalin Shah; Peter Swoboda; Roxy Senior; Robin Nijveldt; Vassilios S Vassiliou; Pankaj Garg Journal: Heart Date: 2021-08-06 Impact factor: 5.994