Contrast echocardiography improves the diagnostic yield of transthoracic studies performed in the intensive care setting by novice sonographers

Amgad N. Makaryus, Michael E. Zubrow, Linda D. Gillam, Nickolaos Michelakis, Lawrence Phillips, Safi Ahmed, David Friedman, Cristina Sison, Smadar Kort, David Rosman, Judy R. Mangion

Research output: Contribution to journalConference article

15 Citations (Scopus)

Abstract

Background: Bedside portable echocardiography in the intensive care department (ICU) is technically difficult, but crucial for directing patient care. Prior studies have shown contrast echocardiography (CE) in the ICU clarifies left ventricular wall motion when performed by experienced sonographers (ESO). However, in most hospitals, ESO are unavailable around the clock, and less experienced cardiovascular fellows or trainees may be asked to perform these examinations. Methods: Transthoracic echocardiograms were retrospectively evaluated by level III trained echocardiographers for 213 patients in the ICU. Most were performed to assess left ventricular function (65% or 139 of 213) and were scanned by cardiology fellows (70% or 149 of 213) with less than 3 months echocardiography experience. Contrast agent was used in 29% (62 of 213) of all patients. Results: The conversion of suboptimal or diagnostically inadequate apical 4- and 2-chamber views to diagnostically adequate with contrast was statistically significant when performed by both cardiology fellows and ESO (Fischer exact test, P < .0002). Conclusions: CE is effective in improving the diagnostic yield of transthoracic echocardiographic ICU studies performed by both novice sonographers and ESO. Using cardiology fellows to perform CE in this setting can be appropriate, particularly in after-hour situations, when ESO are not always available and the clinical question is left ventricular function. Results also suggest cardiology fellows can easily learn CE.

Original languageEnglish (US)
Pages (from-to)475-480
Number of pages6
JournalJournal of the American Society of Echocardiography
Volume18
Issue number5
DOIs
StatePublished - May 1 2005
Externally publishedYes
EventSixteenth Annual Scientific Sessions - Boston, MA, United States
Duration: Jun 15 2005Jun 18 2005

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Critical Care
Echocardiography
Cardiology
Left Ventricular Function
Contrast Media
Patient Care

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Makaryus, Amgad N. ; Zubrow, Michael E. ; Gillam, Linda D. ; Michelakis, Nickolaos ; Phillips, Lawrence ; Ahmed, Safi ; Friedman, David ; Sison, Cristina ; Kort, Smadar ; Rosman, David ; Mangion, Judy R. / Contrast echocardiography improves the diagnostic yield of transthoracic studies performed in the intensive care setting by novice sonographers. In: Journal of the American Society of Echocardiography. 2005 ; Vol. 18, No. 5. pp. 475-480.
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abstract = "Background: Bedside portable echocardiography in the intensive care department (ICU) is technically difficult, but crucial for directing patient care. Prior studies have shown contrast echocardiography (CE) in the ICU clarifies left ventricular wall motion when performed by experienced sonographers (ESO). However, in most hospitals, ESO are unavailable around the clock, and less experienced cardiovascular fellows or trainees may be asked to perform these examinations. Methods: Transthoracic echocardiograms were retrospectively evaluated by level III trained echocardiographers for 213 patients in the ICU. Most were performed to assess left ventricular function (65{\%} or 139 of 213) and were scanned by cardiology fellows (70{\%} or 149 of 213) with less than 3 months echocardiography experience. Contrast agent was used in 29{\%} (62 of 213) of all patients. Results: The conversion of suboptimal or diagnostically inadequate apical 4- and 2-chamber views to diagnostically adequate with contrast was statistically significant when performed by both cardiology fellows and ESO (Fischer exact test, P < .0002). Conclusions: CE is effective in improving the diagnostic yield of transthoracic echocardiographic ICU studies performed by both novice sonographers and ESO. Using cardiology fellows to perform CE in this setting can be appropriate, particularly in after-hour situations, when ESO are not always available and the clinical question is left ventricular function. Results also suggest cardiology fellows can easily learn CE.",
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Contrast echocardiography improves the diagnostic yield of transthoracic studies performed in the intensive care setting by novice sonographers. / Makaryus, Amgad N.; Zubrow, Michael E.; Gillam, Linda D.; Michelakis, Nickolaos; Phillips, Lawrence; Ahmed, Safi; Friedman, David; Sison, Cristina; Kort, Smadar; Rosman, David; Mangion, Judy R.

In: Journal of the American Society of Echocardiography, Vol. 18, No. 5, 01.05.2005, p. 475-480.

Research output: Contribution to journalConference article

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T1 - Contrast echocardiography improves the diagnostic yield of transthoracic studies performed in the intensive care setting by novice sonographers

AU - Makaryus, Amgad N.

AU - Zubrow, Michael E.

AU - Gillam, Linda D.

AU - Michelakis, Nickolaos

AU - Phillips, Lawrence

AU - Ahmed, Safi

AU - Friedman, David

AU - Sison, Cristina

AU - Kort, Smadar

AU - Rosman, David

AU - Mangion, Judy R.

PY - 2005/5/1

Y1 - 2005/5/1

N2 - Background: Bedside portable echocardiography in the intensive care department (ICU) is technically difficult, but crucial for directing patient care. Prior studies have shown contrast echocardiography (CE) in the ICU clarifies left ventricular wall motion when performed by experienced sonographers (ESO). However, in most hospitals, ESO are unavailable around the clock, and less experienced cardiovascular fellows or trainees may be asked to perform these examinations. Methods: Transthoracic echocardiograms were retrospectively evaluated by level III trained echocardiographers for 213 patients in the ICU. Most were performed to assess left ventricular function (65% or 139 of 213) and were scanned by cardiology fellows (70% or 149 of 213) with less than 3 months echocardiography experience. Contrast agent was used in 29% (62 of 213) of all patients. Results: The conversion of suboptimal or diagnostically inadequate apical 4- and 2-chamber views to diagnostically adequate with contrast was statistically significant when performed by both cardiology fellows and ESO (Fischer exact test, P < .0002). Conclusions: CE is effective in improving the diagnostic yield of transthoracic echocardiographic ICU studies performed by both novice sonographers and ESO. Using cardiology fellows to perform CE in this setting can be appropriate, particularly in after-hour situations, when ESO are not always available and the clinical question is left ventricular function. Results also suggest cardiology fellows can easily learn CE.

AB - Background: Bedside portable echocardiography in the intensive care department (ICU) is technically difficult, but crucial for directing patient care. Prior studies have shown contrast echocardiography (CE) in the ICU clarifies left ventricular wall motion when performed by experienced sonographers (ESO). However, in most hospitals, ESO are unavailable around the clock, and less experienced cardiovascular fellows or trainees may be asked to perform these examinations. Methods: Transthoracic echocardiograms were retrospectively evaluated by level III trained echocardiographers for 213 patients in the ICU. Most were performed to assess left ventricular function (65% or 139 of 213) and were scanned by cardiology fellows (70% or 149 of 213) with less than 3 months echocardiography experience. Contrast agent was used in 29% (62 of 213) of all patients. Results: The conversion of suboptimal or diagnostically inadequate apical 4- and 2-chamber views to diagnostically adequate with contrast was statistically significant when performed by both cardiology fellows and ESO (Fischer exact test, P < .0002). Conclusions: CE is effective in improving the diagnostic yield of transthoracic echocardiographic ICU studies performed by both novice sonographers and ESO. Using cardiology fellows to perform CE in this setting can be appropriate, particularly in after-hour situations, when ESO are not always available and the clinical question is left ventricular function. Results also suggest cardiology fellows can easily learn CE.

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