medigraphic.com
ISSN 1029-3043 (Electronic)

2021, Number 1

<< Back Next >>

Medicentro 2021; 25 (1)

Use of the transthoracic echocardiography in emergency rooms

Palacio PH, Rey GKB, Esquijarosa ÁY, Pérez FP

Language: Spanish
References: 17
Page: 38-49
PDF size: 435.82 Kb.


ABSTRACT

Introduction: echocardiography has meant one of the most spectacular revolutions in the field of medical sciences in the last hundred years.
Objective: to describe some indications of the transthoracic echocardiography in critically ill patients as well as the therapeutic changes induced by its result.
Methods: a descriptive and cross-sectional study was carried out between November 1, 2018 and January 31, 2020 in the emergency services at “Joaquín Albarrán” Clinical and Surgical Teaching Hospital, Havana province, Cuba. The study universe consisted of patients (89 in total) who arrived at the emergency service with hemodynamic instability in the indicated period; all underwent a transthoracic echocardiography.
Results: 106 transthoracic echocardiograms were performed, and most of the patients had clinical diseases. It was possible to acquire useful images for the diagnosis in 100% of the patients. On average, 1.9 ± 1 acoustic windows were used per patient; 44 therapeutic modifications were made (41.5%) after performing the echocardiogram. The most important changes were related to fluid intake and the use of dobutamine.
Conclusions: the transthoracic echocardiography, in the emergency context, can offer key information that leads to important changes in therapy.


REFERENCES

  1. Neskovic A, Hagendorff A, Lancellotti P, Guarrancino F, Varga A, Cosyns B. Ecocardiografía de emergencia: Recomendaciones de la Asociación Europea de Imagen Cardiovascular. Eur Heart J-Cardiovasc Imaging. 2013;14:1-11.

  2. Vignon P. What is new in critical care echocardiography? Crit Care. 2018;22:40.

  3. Khalil MM, El-Shahid GS, Galal IH, El-Maraghy AA, Mahmoud HH. The utility of integrating basic echocardiography in routine respiratory intensive care practice. Egypt J Bronchol. 2018;12:433-47.

  4. Bernier Jean A, Albert M. The Diagnostic and therapeutic impact on point of care ultrasonography in the Intensive Care unit. J Intensive Care Med. 2017;31:197-203.

  5. Cook CH, Praba AC, Martin LC, Beery PR. Transthoracic echocardiography is not cost-effective in critically ill surgical patients. J Trauma. 2002 Mar.;52(2):280-4.

  6. Mayo PH, Beaulieu Y, Doelken P; America College of Chest Physicians. La Societe de Ranimation de Langue Francais Statement on competence in critical acre ultrasonography. Chest. 2009;135:1050-60.

  7. Calvo Ochagavia AR. Evaluación no invasiva de la función cardiovascular en el paciente críticamente enfermo mediante ecocardiografía [tesis]. España: Universidad Autónoma de Barcelona; 2017 [citado 11 abr. 2018]. Disponible en: https://ddd.uab.cat/pub/tesis/2017/hdl_10803_457512/aroc1de1.pdf

  8. Charron C, Repessé X, Bodson L, Siu-Ming A, Vieillard-Baron A. Ten good reasons why everybody can and should perform cardiac ultrasound in the ICU. Anaesthesiol Intensive Ther. 2014 Nov.-Dec.;46(5):319-22.

  9. Funcke S, Sander S, Goepfert M, Groesdonk H, Heringlake M, Hirsch J. Practice of hemodynamic monitoring and management in German, Austrian, and Swiss intensive care units: the multicenter cross-sectional ICU-Cardio Man Study. Ann Intensive Care. 2016;6:49.

  10. Stanko LK, Jacobsohn E, Tam JW, De Wet CJ, Avidan M. Transthoracic echocardiography: impact on diagnosis and management in tertiary intensive care units. Anaesth Intensive Care. 2005;33:492-6.

  11. Vieillard-Baron A, Charron C, Chergui K, Peyrouset O, Jardin F. Bedside echocardiographic evaluation of hemodynamics in sepsis: is a qualitative evaluation sufficient?. Intensive Care Med. 2006;32:1547-52.

  12. Ehrman RR, Sullivan AN, Favot MJ. Pathophysiology, echocardiographic evaluation, biomarker findings, and prognostic implications of septic cardiomyopathy: a review of the literature. Crit Care. 2018;22:112.

  13. Porter T, Shillcutt S, Adams M. Guidelines for the Use of Echocardiography as a Monitor for Therapeutic Intervention in Adults: A Report from the American Society of Echocardiography. J Am Soc Echocardiogr. 2015;28:40-56.

  14. Vieillard-Baron A, Slama M, Mayo P, Charron C, Amiel JB, Esterez C, et al. A pilot study on safety and clinical utility of a single-use 72-hour indwelling transesophageal echocardiography probe. Intensive Care Med. 2013;39:629-35.

  15. Orme RM, Oram MP, McKinstry. CE. Impact of echocardiography on patient management in the intensive care unit: an audit of district general hospital practice. Br J Anaesth. 2009;102(3):340-4.

  16. Monnet X, Marik PE, Teboul JL. Prediction of fluid responsiveness: an update. Ann Intensive Care. 2016 Nov. 17;6:111.

  17. John H, Sirounis D, Maizel J, Slama M. Echocardiography as a guide for fluid management. Crit Care. 2016;20:274.




2020     |     www.medigraphic.com