International consensus statement on training standards for advanced critical care echocardiography

Vieillard‐Baron, Antoine; Mayo, Paul H.; Vignon, Philippe; Cholley, Bernard; Slama, Michel; Pinsky, Michael R.; McLean, Anthony S.; Choi, Gordon; Beaulieu, Yanick; Arntfield, Robert; Koenig, Seth; Colreavy, Frances; Canivet, Jean-Luc; Backer, Daniel De

doi:10.1007/s00134-014-3228-5

Cited by 193 publications

(71 citation statements)

References 5 publications

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“…Circulatory shock occurs in one-third of patients admitted to the ICU [19], so being able to perform CCUS and measure CO is of importance. However, CO measurement by CCUS is considered an advanced level CCUS skill [20,21]. Whether trained novices (e.g., medical students or other less experienced physicians) are able to obtain reliable CO measurements has not yet been investigated.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of cardiac output measurements in critically ill patients by medical students

et al. 2020

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Background: Critical care ultrasonography (CCUS) is increasingly applied also in the intensive care unit (ICU) and performed by non-experts, including even medical students. There is limited data on the training efforts necessary for novices to attain images of sufficient quality. There is no data on medical students performing CCUS for the measurement of cardiac output (CO), a hemodynamic variable of importance for daily critical care. Objective: The aim of this study was to explore the agreement of cardiac output measurements as well as the quality of images obtained by medical students in critically ill patients compared to the measurements obtained by experts in these images. Methods: In a prospective observational cohort study, all acutely admitted adults with an expected ICU stay over 24 h were included. CCUS was performed by students within 24 h of admission. CCUS included the images required to measure the CO, i.e., the left ventricular outflow tract (LVOT) diameter and the velocity time integral (VTI) in the LVOT. Echocardiography experts were involved in the evaluation of the quality of images obtained and the quality of the CO measurements. Results: There was an opportunity for a CCUS attempt in 1155 of the 1212 eligible patients (95%) and in 1075 of the 1212 patients (89%) CCUS examination was performed by medical students. In 871 out of 1075 patients (81%) medical students measured CO. Experts measured CO in 783 patients (73%). In 760 patients (71%) CO was measured by both which allowed for comparison; bias of CO was 0.0 L min −1 with limits of agreement of − 2.6 L min −1 to 2.7 L min −1. The percentage error was 50%, reflecting poor agreement of the CO measurement by students compared with the experts CO measurement. Conclusions: Medical students seem capable of obtaining sufficient quality CCUS images for CO measurement in the majority of critically ill patients. Measurements of CO by medical students, however, had poor agreement with expert measurements. Experts remain indispensable for reliable CO measurements.

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Section: Introductionmentioning

confidence: 99%

Feasibility of cardiac output measurements in critically ill patients by medical students

et al. 2020

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“…The cardiopulmonary system is so complex and interrelated, that an integrated method (lung ultrasound assessment combined with echocardiography) is fundamental to the assessment of pulmonary involvement in acute and chronic cardiac failure [34] . Evidence of many diffuse comet tails in both hemithorax correlated with left ventricular dysfunction or valvular disease, and is suggestive of a cardiac pulmonary cause of pulmonary edema [35][36][37] . On the other hand, evidence of B-lines related to normal systolic and diastolic function suggests a noncardiogenic cause for congestion, although lung disease (e.g., pneumonia), acute respiratory distress syndrome, acute lung injury, or, particularly in a chronic setting, pulmonary fibrosis.…”

Section: Pulmonary Involvement In Cardiac Diseasesmentioning

confidence: 97%

Incremental value of thoracic ultrasound in intensive care units: Indications, uses, and applications

Liccardo

Martone

Trambaiolo

et al. 2016

WJR

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Emergency physicians are required to care for unstable patients with life-threatening conditions, and thus must make decisions that are both quick and precise about unclear clinical situations. There is increasing consensus in favor of using ultrasound as a real-time bedside clinical tool for clinicians in emergency settings alongside the irreplaceable use of historical and physical examinations. B-mode sonography is an old technology that was first proposed for medical applications more than 50 years ago. Its application in the diagnosis of thoracic diseases has always been considered limited, due to the presence of air in the lung and the presence of the bones of the thoracic cage, which prevent the progression of the ultrasound beam. However, the close relationship between air and water in the lungs causes a variety of artifacts on ultrasounds. At the bedside, thoracic ultrasound is based primarily on the analysis of these artifacts, with the aim of improving accuracy and safety in the diagnosis and therapy of the various varieties of pulmonary pathologic diseases which are predominantly "water-rich" or "air-rich". The indications, contraindications, advantages, disadvantages, and techniques of thoracic ultrasound and its related procedures are analyzed in the present review. Core tip: The close relationship between air and water in the lungs causes a variety of artifacts on ultrasounds. At the bedside, thoracic ultrasound is based primarily on the analysis of these artifacts, with the aim of improving accuracy and safety in the diagnosis and therapy of Liccardo B et al . Thoracic ultrasound in ICU the various varieties of pulmonary pathologic diseases which are predominantly "water-rich" or "air-rich". The indications, contraindications, advantages, disadvantages, and techniques of thoracic ultrasound and its related procedures are analyzed in the present review.

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“…An important aspect of the clinical application(s) of each new technological development is training at the bedside. After a statement published in Intensive Care Medicine in 2011 [ 19 ], the same group of experts published the results of a round table [ 20 ] held in Paris in 2013 during the ESICM congress. The 2014 international statement reports detailed training standards for advanced critical care echocardiography which should form the basis of future European certification in advanced critical care echocardiography.…”

Section: Ultrasonography In Critically Ill Patientsmentioning

confidence: 99%

Year in review in Intensive Care Medicine 2014: I. Cardiac dysfunction and cardiac arrest, ultrasound, neurocritical care, ICU-acquired weakness, nutrition, acute kidney injury, and miscellaneous

et al. 2015

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International consensus statement on training standards for advanced critical care echocardiography

Cited by 193 publications

References 5 publications

Feasibility of cardiac output measurements in critically ill patients by medical students

Feasibility of cardiac output measurements in critically ill patients by medical students

Incremental value of thoracic ultrasound in intensive care units: Indications, uses, and applications

Year in review in Intensive Care Medicine 2014: I. Cardiac dysfunction and cardiac arrest, ultrasound, neurocritical care, ICU-acquired weakness, nutrition, acute kidney injury, and miscellaneous

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