Usefulness of a New Miniaturized Echocardiographic System in Outpatient Cardiology Consultations as an Extension of Physical Examination

Cardim, Nuno; Golfin, C Fernandez; Ferreira, Daniel; Aubele, Adalía; Toste, Júlia; Cobos, Miguel Ángel; Carmelo, Vanda; Nunes, Igor; Oliveira, António G.; Zamorano, José Luís

doi:10.1016/j.echo.2010.09.017

Cited by 116 publications

(92 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the advent of small ultraportable bedside ultrasound devices have heralded the age of the ''ultrasonic stethoscope,'' [1][2][3][4][5] realizing the widespread potential of ultrasound-assisted physical examination [6][7][8] requires the creation of an imaging protocol that can be successfully taught to all physicians within the confines of accredited medical education. Prior feasibility studies of teaching internal medical residents are characterized by heterogeneity in imaging protocols, nonrandomized enrollment of a small number of trainees, and training that is short-lived, 6,[9][10][11][12][13][14] making their results difficult to generalize.…”

Section: Discussionmentioning

confidence: 99%

Observations during development of an internal medicine residency training program in cardiovascular limited ultrasound examination

Kimura

Amundson

Phan

et al. 2012

Journal of Hospital Medicine

View full text Add to dashboard Cite

BACKGROUND: Despite the future potential of using ultrasound stethoscopes to augment the bedside cardiac physical, few data exist on a general cardiovascular imaging protocol that can be taught to physicians on a perpetual basis as a curriculum in graduate medical education. METHODS: During the past decade, we developed and integrated a cardiovascular limited ultrasound training program within the confines of an internal medicine residency. The evidence‐based rationale for the exam, the teaching methods, and curriculum are delineated, and subsequent observations regarding program requirements, proficiency, and academic outcomes are explored. Analysis of variance and linear regression assessed for relationships between academic scores, chief resident selection, and gender to proficiency in ultrasound. RESULTS: A brief, 5‐minute cardiovascular limited ultrasound exam (CLUE) was taught using both didactic and bedside methods, and practiced primarily within the cardiology consult, outpatient clinic, and intensive care rotations. Program costs were minimized by employing readily available institutional resources. After a 2‐year lead‐in training phase, the subsequent 4 years of senior resident performance (n = 41 residents) showed an 81% pass rate in CLUE competency. Resident ultrasound performance did not relate to academic scores (r = 0.05, P = 0.75), chief resident selection, nor gender. Observations regarding resident pitfalls in CLUE practice and increased participation in extracurricular research are described. CONCLUSIONS: We report our initial experience in developing and implementing a training program for bedside cardiovascular ultrasound examination that employed evidence‐based techniques, set proficiency goals, and assessed resident performance. It may be feasible to teach future internist–hospitalists the technique of bedside ultrasound during residency. Journal of Hospital Medicine 2012;. © 2012 Society of Hospital Medicine

show abstract

Section: Discussionmentioning

confidence: 99%

Observations during development of an internal medicine residency training program in cardiovascular limited ultrasound examination

Kimura

Amundson

Phan

et al. 2012

Journal of Hospital Medicine

View full text Add to dashboard Cite

show abstract

“…A lung ultrasound examination was performed during the first session of the week (at the same time as the peripheral blood sample preparation) using Vscan® (GE Healthcare, Japan), which is a hand-held ultrasound device with a wide-bandwidth phased-array probe (1.7-3.5 MHz) [11,12]. Bilateral scanning of the anterior and lateral chest walls was performed with the patient in a supine position.…”

Section: Methodsmentioning

confidence: 99%

Associations between fluid removal and number of B-lines, peak early mitral inflow wave velocity, and inferior vena cava dimensions in hemodialysis patients

et al. 2017

View full text Add to dashboard Cite

Background: The inferior vena cava (IVC) dimensions represent the right ventricular preload, whereas the peak early mitral inflow wave velocity (peak E-velocity) represents the left ventricular preload. On the other hand, B-lines represent extravascular lung water. The aim of this study was to evaluate possible acute changes in the IVC dimensions, peak E-velocity, and number of B-lines during hemodialysis therapy. Methods: A total of 55 consecutive patients receiving maintenance hemodialysis were enrolled in this study. We performed echo-graphic examinations at three time points (just after the start, during the middle, and just before the end of the hemodialysis therapy). We then investigated the changes in the IVC dimensions, peak E-velocity, and number of B-lines. Results: The peak E-velocity decreased from 80 ± 26 cm/s at the start of the therapy to 58 ± 22 cm/s during the middle and 51 ± 21 cm/s at the end of the therapy. The IVC dimensions also decreased from 15 ± 4 mm at the start of the therapy to 12 ± 3 mm during the middle and 11 ± 3 mm at the end of the therapy. The number of B-lines also decreased from 12 ± 5 at the start of the therapy to 9 ± 4 during the middle and 5 ± 3 at the end of the therapy. The changes in the peak E-velocity and IVC dimensions were significantly greater during the first half of the dialysis period than during the second half of the dialysis period (P < 0.0001 and P < 0.0001, respectively). On the other hand, the changes in the number of B-lines during these periods were significantly smaller during the first half of the dialysis period than during the second half of the dialysis period (P = 0.0016). Conclusions: We showed that the peak E-velocity and the IVC dimensions were reduced mainly during the first half of the dialysis period, while the number of B-lines showed a significant decrease mainly during the last half of the dialysis period. Even if the IVC dimensions are reduced sufficiently, caution is needed as lung congestion may still exist.

show abstract

“…Lung ultrasound was performed at the first session of the week, the same time of peripheral blood sample preparation, using Vscan® (GE Healthcare, Japan), a hand-held ultrasound device with a wide-bandwidth phased-array probe (1.7-3.5 MHz) [20,21]. Bilateral scanning of the anterior and lateral chest walls was performed with the patient in a supine position just after the start of the hemodialysis therapy.…”

Section: Methodsmentioning

confidence: 99%

Association between B-lines detected during lung ultrasound and various factors in hemodialysis patients

et al. 2017

View full text Add to dashboard Cite

Background: In recent years, the use of chest ultrasonography to detect lung water has received growing attention in clinical research. Estimation of the number of B-lines using lung ultrasound is now a standard method for the evaluation of pulmonary congestion. In the present study, we examined the relation between the number of B-lines and clinical parameters in hemodialysis patients. Methods: A total of 49 consecutive patients receiving maintenance hemodialysis were enrolled in this study. Lung ultrasound was performed using Vscan® (GE Healthcare, Japan). Bilateral scanning of the anterior and lateral chest walls was performed with the patient in a supine position just after the start of the hemodialysis therapy. The total number of B-lines was estimated. We investigated the relationships between the number of B-lines and other clinical parameters. Results: Patient heart rate and the serum log [NT-proBNP] level were positively correlated (P = 0.009 and 0.003, respectively), and body weight and the serum albumin and creatinine level were negatively correlated with the number of B-lines (P = 0.023, 0.001, and 0.011, respectively). Conclusions: The number of B-lines was positively correlated with the serum N-terminal pro-brain natriuretic peptide level. Lung ultrasound can quantify lung edema. Body weight and the serum albumin and creatinine level were negatively correlated with the number of B-lines. Careful attention to the presence of pulmonary edema is needed in patients with a low body weight and a low serum albumin and creatinine level.

show abstract

Usefulness of a New Miniaturized Echocardiographic System in Outpatient Cardiology Consultations as an Extension of Physical Examination

Cited by 116 publications

References 31 publications

Observations during development of an internal medicine residency training program in cardiovascular limited ultrasound examination

Observations during development of an internal medicine residency training program in cardiovascular limited ultrasound examination

Associations between fluid removal and number of B-lines, peak early mitral inflow wave velocity, and inferior vena cava dimensions in hemodialysis patients

Association between B-lines detected during lung ultrasound and various factors in hemodialysis patients

Contact Info

Product

Resources

About