Point-of-Care Transthoracic Echocardiography: A Growing Body of Evidence, an Educational Need

Perioperative Transthoracic Echocardiography—Thoughtful Design and Delivery of Standardized Imaging Protocols for Anesthesiology Teams

“…4 Their proposal represents an important step forward to address the required standards for this diagnostic modality in the perioperative period. 5 Although multiple national and international specialty societies have established training and accreditation pathways in echocardiography, there could be more focus on defining standards and categories across the spectrum of perioperative transthoracic echocardiography. [1][2][3][4][5][6] Subramaniam and colleagues have defined the category of basic echocardiography as relevant to all anesthesiologists due to its primary indication, namely for clinical diagnosis and rescue for perioperative hemodynamic instability.…”

“…5 Although multiple national and international specialty societies have established training and accreditation pathways in echocardiography, there could be more focus on defining standards and categories across the spectrum of perioperative transthoracic echocardiography. [1][2][3][4][5][6] Subramaniam and colleagues have defined the category of basic echocardiography as relevant to all anesthesiologists due to its primary indication, namely for clinical diagnosis and rescue for perioperative hemodynamic instability. 1;4. In their construct, the basic transthoracic exam has 5 views and 3 imaging windows utilizing both two-dimensional and color Doppler imaging..…”

“…4 This qualitative assessment can guide assessment of volume status, ventricular function, valvular function, pericardial tamponade, as well as lung and pleural function. [1][2][3][4][5][6] Since the basic exam does not include quantitative echocardiography and requires a total of 25 proctored exams, it is likely a reasonable goal for all anesthesiologists to achieve competence for this entry level of transthoracic echocardiography. 4 In contrast, Subramaniam and colleagues have defined advanced transthoracic echocardiography to include 13 imaging views and 3 imaging windows with utilization of twodimensional, color Doppler and spectral Doppler imaging.…”