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Critical Care Echocardiography as a Routine Procedure for the Detection and Early Treatment of Cardiac Pathologies
Transthoracic and transesophageal echocardiography are important investigations in the intensive care unit (ICU) to diagnose acute cardiac pathologies and assess the haemodynamic status. Recommendations for critical care echocardiography (CCE) have been published recently, but these still lack an ev...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7555963/ https://www.ncbi.nlm.nih.gov/pubmed/32899659 http://dx.doi.org/10.3390/diagnostics10090671 |
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author | Schmidt, Stefan Dieks, Jana-Katharina Quintel, Michael Moerer, Onnen |
author_facet | Schmidt, Stefan Dieks, Jana-Katharina Quintel, Michael Moerer, Onnen |
author_sort | Schmidt, Stefan |
collection | PubMed |
description | Transthoracic and transesophageal echocardiography are important investigations in the intensive care unit (ICU) to diagnose acute cardiac pathologies and assess the haemodynamic status. Recommendations for critical care echocardiography (CCE) have been published recently, but these still lack an evidence-based foundation. It is not known if performing transthoracic echocardiography (TTE) on a routine basis instead of only when required in acute cases is feasible or clinically useful. In this single-centre prospective observational study, we routinely performed TTE on 111 consecutive non-cardiological, non-cardiothoracic surgical ICU patients in two surgical ICUs in a tertiary care facility. Significant cardiac pathologies were detected in 82 (76.6%) and critical cardiac pathologies in 33 (30.8%) of the 107 patients. The most common critical cardiac pathologies were sPAP > 50 mmHg (19.63%), tricuspid annular plane systolic excursion ≤ 13 mm (9.4%), grade III diastolic dysfunction (8.4%), severe tricuspid valve insufficiency (5.6%) and left ventricular ejection fraction (LV-EF) ˂ 30% (4.7%). Some of the most commonly found cardiac pathologies are not well emphasised in current recommendations and training programs. We observed a progression of the cardiac pathologies previously described in 41 of the patients (91.1%). Patients with echocardiographic abnormalities had a significant survival disadvantage in the ICU. By performing CCE routinely, we observed the range and prevalence of cardiac pathologies that can be detected by echocardiography in critically ill patients. We recommend routine transthoracic CCE in ICU patients for early detection of cardiac pathologies and to help inform early intervention regimens, since cardiac conditions carry a significant survival disadvantage for the ICU patient. |
format | Online Article Text |
id | pubmed-7555963 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-75559632020-10-19 Critical Care Echocardiography as a Routine Procedure for the Detection and Early Treatment of Cardiac Pathologies Schmidt, Stefan Dieks, Jana-Katharina Quintel, Michael Moerer, Onnen Diagnostics (Basel) Article Transthoracic and transesophageal echocardiography are important investigations in the intensive care unit (ICU) to diagnose acute cardiac pathologies and assess the haemodynamic status. Recommendations for critical care echocardiography (CCE) have been published recently, but these still lack an evidence-based foundation. It is not known if performing transthoracic echocardiography (TTE) on a routine basis instead of only when required in acute cases is feasible or clinically useful. In this single-centre prospective observational study, we routinely performed TTE on 111 consecutive non-cardiological, non-cardiothoracic surgical ICU patients in two surgical ICUs in a tertiary care facility. Significant cardiac pathologies were detected in 82 (76.6%) and critical cardiac pathologies in 33 (30.8%) of the 107 patients. The most common critical cardiac pathologies were sPAP > 50 mmHg (19.63%), tricuspid annular plane systolic excursion ≤ 13 mm (9.4%), grade III diastolic dysfunction (8.4%), severe tricuspid valve insufficiency (5.6%) and left ventricular ejection fraction (LV-EF) ˂ 30% (4.7%). Some of the most commonly found cardiac pathologies are not well emphasised in current recommendations and training programs. We observed a progression of the cardiac pathologies previously described in 41 of the patients (91.1%). Patients with echocardiographic abnormalities had a significant survival disadvantage in the ICU. By performing CCE routinely, we observed the range and prevalence of cardiac pathologies that can be detected by echocardiography in critically ill patients. We recommend routine transthoracic CCE in ICU patients for early detection of cardiac pathologies and to help inform early intervention regimens, since cardiac conditions carry a significant survival disadvantage for the ICU patient. MDPI 2020-09-04 /pmc/articles/PMC7555963/ /pubmed/32899659 http://dx.doi.org/10.3390/diagnostics10090671 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Schmidt, Stefan Dieks, Jana-Katharina Quintel, Michael Moerer, Onnen Critical Care Echocardiography as a Routine Procedure for the Detection and Early Treatment of Cardiac Pathologies |
title | Critical Care Echocardiography as a Routine Procedure for the Detection and Early Treatment of Cardiac Pathologies |
title_full | Critical Care Echocardiography as a Routine Procedure for the Detection and Early Treatment of Cardiac Pathologies |
title_fullStr | Critical Care Echocardiography as a Routine Procedure for the Detection and Early Treatment of Cardiac Pathologies |
title_full_unstemmed | Critical Care Echocardiography as a Routine Procedure for the Detection and Early Treatment of Cardiac Pathologies |
title_short | Critical Care Echocardiography as a Routine Procedure for the Detection and Early Treatment of Cardiac Pathologies |
title_sort | critical care echocardiography as a routine procedure for the detection and early treatment of cardiac pathologies |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7555963/ https://www.ncbi.nlm.nih.gov/pubmed/32899659 http://dx.doi.org/10.3390/diagnostics10090671 |
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