Feasibility in the echocardiographic estimation of parameters of the right ventricle in prone position

Abstract

Background: Echocardiographic cardiac parameters in the prone position are usually obtained with an esophageal probe. The feasibility of obtaining them by means of a transthoracic approach is unknown. Objective: Estimating the feasibility to obtain parameters of the right ventricle by transthoracic echocardiography in prone position on the subject. Methods: Pilot design of consecutive case series without cardiopulmonary disease. Demographic, vital signs and echocardiographic variables were defined in the ventral initial, prone and ventral final decubitus positions. The data are shown with averages and standard deviations, and frequencies and percentages according to the variable. The differences between the positions were calculated with ANOVA of repeated samples and adjustment of Bonferroni test. Intra-subject variability was obtained by the Bland-Altman procedure and its 95% confidence interval. Results: We studied 50 subjects, 44 (88%) males, age 30 ± 6 years and body mass index 25.65 ± 2.71 kg/m 2 . Tricuspid annular plane systolic excursion (TAPSE) and S'-wave were measured 100% of the time. The vital signs and echocardiographic variables according to the position had differences in:

Transthoracic echocardiography during prone position ventilation: Lessons from the COVID‐19 pandemic

“…There are anecdotic reports of TTE 12 and a more extensive experience in transesophageal echocardiography during prone position ventilation, 13 but there is no standardization in the technique for image acquisition and measurements. Santos et al showed an adequate correlation of the RV measurements in prone compared with the supine position in 50 individuals; however, in this study, the evaluation was in healthy patients, not mechanically ventilated, 14 and the performance of critical care echocardiography in patients under IMV has unique challenges because the positive pressure caused by the pulmonary insuflation limits the acoustic window.…”

Echocardiography in Prone Positioned Critically Ill Patients: A Wealth of Information from a Single View

“…Noteworthily, Santos et al [ 16 ] focused their approach on RV function analysis in a group of spontaneous breathing healthy patients. They concluded that TTE in prone position is a useful tool to evaluate RV function; specifically, they observed that TAPSE and S’TDI were the parameters with the most superimposable results between supine and prone position.…”