| Basic critical care echocardiography: Validation of a curriculum dedicated to noncardiologist residents. | |
| | |
MedLine Citation:
|
PMID: 21221001 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
OBJECTIVE:: To assess the efficacy of a limited, tailored training program for noncardiologist residents without experience in ultrasound to reach competence in basic critical care echocardiography. DESIGN:: Prospective descriptive clinical study. SETTING:: Medical-surgical intensive care unit of a teaching hospital. PATIENTS:: 201 patients (125 men; age: 61 ± 16 yrs; Simplified Acute Physiologic Score II: 37 ± 17; 145 ventilated patients) who required a transthoracic echocardiography were studied. INTERVENTION AND MEASUREMENTS:: The curriculum consisted of a 12-hr learning program blending didactics, interactive clinical cases, and tutored hands-on sessions. After completion of this tailored training program, all eligible patients subsequently underwent a transthoracic echocardiography performed in random order by a recently trained resident and an experienced intensivist with expertise in critical care echocardiography who was used as a reference. The agreement between responses to clinical questions provided by the two investigators who independently interpreted the transthoracic echocardiography study at bedside was used as an indicator of effectiveness of the tested curriculum. MAIN RESULTS:: Residents performed a mean of 33 transthoracic echocardiograms during the study period (range: 29-38). Experienced intensivists had significantly fewer unaddressed clinical questions than did residents (57 [5.7%] vs. 111 [11.0%] of 1,005 clinical questions: p < .0001). When compared to residents, the experienced intensivists performed shorter transthoracic echocardiography examinations (3.0 ± 1.0 min vs. 7.0 ± 2.5 min: p < .0001) with more acoustic windows (888 vs. 828 of 1,005 potential windows: p < .0001). Residents adequately assess global left ventricle systolic function (κ: 0.84; 95% confidence interval: 0.76-0.92). They accurately identified dilated left ventricle (κ: 0.90; 95% confidence interval: 0.80-1.0), dilated right ventricle (κ: 0.76; 95% confidence interval: 0.64-0.89), dilated inferior vena cava (κ: 0.79; 95% confidence interval: 0.63-0.94), and pericardial effusion (κ: 0.79; 95% confidence interval: 0.58-0.99) and diagnosed two cases of tamponade. CONCLUSIONS:: A 12-hr training program blending didactics, interactive clinical cases, and tutored hands-on sessions dedicated to noncardiologist residents without experience in ultrasound appears well suited for reaching competence in basic critical care echocardiography. |
| | |
Authors:
|
Philippe Vignon; Frédérique Mücke; Frédéric Bellec; Benoît Marin; Jérôme Croce; Tania Brouqui; Cédric Palobart; Patrick Senges; Christophe Truffy; Alexandra Wachmann; Anthony Dugard; Jean-Bernard Amiel |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-1-7 |
Journal Detail:
|
Title: Critical care medicine Volume: - ISSN: 1530-0293 ISO Abbreviation: - Publication Date: 2011 Jan |
Date Detail:
|
Created Date: 2011-1-11 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
From the Medical-Surgical Intensive Care Unit (PV, FM, FB, JC, TB, CP, PS, CT, AW, AD, JA), Dupuytren Teaching Hospital, Limoges; Clinical Investigation Center (PV, JA), CIC-P INSERM 0801, Dupuytren Teaching Hospital, Limoges; University of Limoges (PV), Limoges; and Department of Biostatistics (BM), Dupuytren Teaching Hospital, Limoges, France. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Antibiotic dosing during sustained low-efficiency dialysis: Special considerations in adult critical...
Next Document: Accuracy and reliability of a subcutaneous continuous glucose-monitoring system in critically ill pa...