Point‐of‐care echocardiography – A road to future or a step backwards

Vaishnav, M.; Sedgwick, J.

doi:10.1002/ajum.12128

Cited by 7 publications

(6 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Alongside complete echocardiographic examination, focused echocardiography protocols are being proposed to quickly assess hemodynamics in a variety of acute clinical settings. In critical care, FICE, RUSH and FATE are quite well-known [ 27 ]. Indeed, point-of-care ultrasound protocols have the advantage of being fast and, when used properly, they can give valuable information that can impact patient care.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

View full text Add to dashboard Cite

In critically ill patients, standard transthoracic echocardiography (TTE) generally does not facilitate good image quality during mechanical ventilation. We propose a prone-TTE in prone positioned patients, which allows clinicians to obtain a complete apical four-chamber (A-4-C) view. A basic cardiac assessment can be performed in order to evaluate right ventricle function and left ventricle performance, even measuring objective parameters, i.e., tricuspid annular plane systolic excursion (TAPSE); pulmonary artery systolic pressure (PAP), from the tricuspid regurgitation peak Doppler velocity; RV end-diastolic diameter and its ratio to left ventricular end-diastolic diameter; the S’ wave peak velocity with tissue Doppler imaging; the ejection fraction (EF); the mitral annular plane systolic excursion (MAPSE); diastolic function evaluation by the mitral valve; and annular Doppler velocities. Furthermore, by tilting the probe, we can obtain the apical-five-chamber (A-5-C) view, which facilitates the analysis of blood flow at the level of the output tract of the left ventricle (LVOT) and then the estimation of stroke volume. Useful applications of this technique are hemodynamic assessment, titration of fluids, vasoactive drugs therapy, and evaluation of the impact of prone positioning on right ventricle performance and right pulmonary resistances. We believe that considerable information can be drawn from a single view and hope this may be helpful to emergency and critical care clinicians whenever invasive hemodynamic monitoring tools are not available or are simply inconvenient due to clinical reasons.

show abstract

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The emergence of point of care ultrasound (POCUS) as a reliable bedside clinical tool that influences decision making and diagnosis provides timely intervention in the emergency department. 8 Several studies have suggested that the utility of POCUS in the emergency setting be a similar ability to detect cardiac pathology accurately compared to the conventional TTE. 9,10 However, the common prerequisite would be an experienced or trained operator of POCUS and the accessibility of the POCUS at the center.…”

Section: Discussionmentioning

confidence: 99%

Unusual cause of heart failure in the young, the intracardiac mass: Diagnostic dilemmas solved by echocardiography

Siew

Othman

et al. 2021

Proceedings of Singapore Healthcare

View full text Add to dashboard Cite

Primary cardiac tumor remains exceedingly rare, accounting for 0.5 cases per million of the population annually. We report a case of cardiac tumor, which was initially misdiagnosed as heart failure secondary to acute coronary syndrome. The diagnosis was revised later after routine echocardiography in the ward. A 39-year-old gentleman who presented to the emergency department with cardiac failure and ischemic changes on the electrocardiogram was initially worked-up for acute coronary syndrome. However, echocardiography was performed later in the ward to evaluate the cardiac ejection fraction, revealing a massive left atrial mass measuring 6 cm × 4 cm. Severe mitral regurgitation was noted through the echocardiogram owing to the mass prolapse into the mitral annulus. The initial presentation of cardiac tumors can be ambiguous. Studies have shown that echocardiography as the noninvasive cardiac imaging approach remains the gold standard of diagnostic tool. Hence, echocardiography should be performed as a routine assessment of cardiac failure. Meanwhile, the incorporation of point of care ultrasound in the available center may assist the physician to diagnose accurately in the emergency department setting by excluding other potential differential diagnoses. Delay in diagnosis and initiation of treatment may result in progression to chronic heart failure and dangerous complication, i.e. hemodynamic sequelae and systemic embolism of the clot. In our experience, we managed to reach an accurate diagnosis, timely referral and appropriate intervention despite the lack of point of care ultrasound.

show abstract

“…shock that may be the cause of shock or hypotension [51]. TTE may be used to detect a possible cause of AHF and subsequently to initiate the appropriate treatment, and to optimize the previously initiated treatment.…”

Section: Cardiac Function Index (Cfi)mentioning

confidence: 99%

“…FATE is a protocol that enables a focused and systematic approach in critically ill patients, aiming to find a potentially reversible cause of haemodynamic instability, such as pulmonary embolism, cardiac tamponade, systolic heart failure, aortic dissection, hypovolaemic shock, obstructive shock, or distributive shock [ 49 , 50 ]. The FAST protocol is used to exclude tamponade in trauma patients when intra-abdominal or thoracic bleeding is suspected, whereas the RUSHed protocol is used to detect pathologies like tamponade, pneumo- and haemothorax, pulmonary embolism, aortic dissection, and cardiogenic shock that may be the cause of shock or hypotension [ 51 ]. TTE may be used to detect a possible cause of AHF and subsequently to initiate the appropriate treatment, and to optimize the previously initiated treatment.…”

Section: Echocardiographymentioning

confidence: 99%

Haemodynamic monitoring in acute heart failure – what you need to know

Jasińska-Gniadzik¹,

Szwed²,

Zawadka³

et al. 2022

pwki

View full text Add to dashboard Cite

Acute heart failure (AHF) is a sudden, life-threatening condition, defined as a gradual or rapid onset of symptoms and/or signs of HF. AHF requires urgent medical attention, being the most frequent cause of unplanned hospital admission in patients above 65 years of age. AHF is associated with a 4-12% in-hospital mortality rate and a 21-35% 1-year mortality rate post-discharge. Considering the serious prognosis in AHF patients, it is very important to understand the mechanisms and haemodynamic status in an individual AHF patient, thus preventing end-organ failure and death. Haemodynamic monitoring is a serial assessment of cardiovascular function, intended to detect physiologic abnormalities at the earliest stages, determine which interventions could be most effective, and provide the basis for initiating the most appropriate therapy and evaluate its effects. Over the past decades, haemodynamic monitoring techniques have evolved greatly. Nowadays, they range from very invasive to non-invasive, from intermittent to continuous, and in terms of the provided parameters. Invasive techniques contain pulmonary artery catheterization and transpulmonary thermodilution. Minimally invasive techniques include oesophageal Doppler and noncalibrated pulse wave analysis. Non-invasive techniques contain echocardiography, bioimpedance, and bioreactance techniques as well as non-invasive pulse contour methods. Each of these techniques has specific indications and limitations. In this article, we aimed to provide a pathophysiological explanation of the physical terms and parameters used for haemodynamic monitoring in AHF and to summarize the working principles, advantages, and disadvantages of the currently used methods of haemodynamic monitoring.

show abstract

Point‐of‐care echocardiography – A road to future or a step backwards

Cited by 7 publications

References 34 publications

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

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

Unusual cause of heart failure in the young, the intracardiac mass: Diagnostic dilemmas solved by echocardiography

Haemodynamic monitoring in acute heart failure – what you need to know

Contact Info

Product

Resources

About