Can ICU Fellows Perform Transthoracic Echocardiography with Minimal Training?
Author Information
Author(s): Almaani M, Alnabi M Alabdrab, Bainbridge D, Taneja R
Primary Institution: University of Western Ontario
Hypothesis
Can ICU fellows, with minimal focused training in TTE, reliably acquire good-quality images in critically ill patients?
Conclusion
ICU fellows can acquire images comparable in quality to certified echocardiographers, but struggle to obtain images of the LV or RV in over 25% of patients.
Supporting Evidence
- Nine patients were diagnosed with cardiogenic shock, eight with distributive shock, and two with hypovolemic shock.
- A total of 169 images were analyzed.
- The ICC for interobserver agreement was good at 0.8.
- ICU fellows had a composite image score of 12.3 ± 0.7 compared to 11 ± 0.6 for certified echocardiographers.
Takeaway
Doctors in training can take pictures of the heart using a special tool, but sometimes they can't get good pictures of all parts of the heart.
Methodology
19 adult patients were enrolled, and TTE was performed by ICU fellows after minimal training, with images graded by blinded reviewers.
Limitations
ICU fellows could not acquire images of the LV or RV in 26% of patients.
Participant Demographics
Adult patients requiring echocardiography and hemodynamically unstable.
Statistical Information
P-Value
0.08
Statistical Significance
p=0.08
Digital Object Identifier (DOI)
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