| Bedside echocardiographic evaluation of hemodynamics in sepsis: is a qualitative evaluation sufficient? | |
| | |
MedLine Citation:
|
PMID: 16855828 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: Transesophageal echocardiography (TEE) has proven its efficiency in assessing hemodynamics in patients by its ability to evaluate cardiac function and fluid responsiveness. Classically, it requires quantitative measurements, whereas in routine practice TEE is used in our unit especially as a qualitative procedure. We assessed the accuracy of this qualitative central hemodynamic evaluation obtained by TEE at the bedside. DESIGN AND SETTING: Prospective study conducted in a medical ICU between September 2004 and April 2005. All TEE examinations performed in consecutive patients hospitalized for septic shock and mechanically ventilated for an associated acute lung injury were eligible for evaluation. Intensivists trained in echocardiography were asked to classify (a) respiratory changes in the superior vena cava (SVC), (b) left ventricular (LV) systolic function, (c) right ventricular (RV) end-diastolic size, and (d) shape and kinetics of the interventricular septum (IVS). A post-hoc quantitative evaluation was then performed by a trained investigator unaware of the patients' status. RESULTS: We evaluated 83 examinations in 30 patients. Qualitative evaluation was easily able to distinguish patients with significant or nonsignificant SVC respiratory changes, normal, moderately or markedly depressed LV systolic function, and nondilated or dilated right ventricle. Acute cor pulmonale was also well recognized. CONCLUSION: By its ability accurately to evaluate hemodynamic status qualitative TEE could be useful for intensivists in managing circulatory failure in septic shock, rendering the more time-consuming quantitative evaluation useless. |
| | |
Authors:
|
Antoine Vieillard-Baron; Cyril Charron; Karim Chergui; Olivier Peyrouset; François Jardin |
Related Documents
:
|
15487278 - Spontaneous coronary dissection during postpartum: etiology and controversies in manage... 311648 - Arterial counterpulsation in severe refractory heart failure complicating acute myocard... 19681838 - Extracorporeal life support as ultimate strategy for refractory severe cardiogenic shoc... 8426338 - Automated external defibrillators: defining optimum levels of accuracy based on the cli... 22424018 - Relationship of female sex to outcomes after myocardial infarction with persistent tota... 12891208 - Quantitative clinical assessment of chronic anterior myocardial infarction with delayed... |
Publication Detail:
|
Type: Journal Article Date: 2006-07-20 |
Journal Detail:
|
Title: Intensive care medicine Volume: 32 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 2006 Oct |
Date Detail:
|
Created Date: 2006-10-02 Completed Date: 2007-03-16 Revised Date: 2007-10-10 |
Medline Journal Info:
|
Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
|
Languages: eng Pagination: 1547-52 Citation Subset: IM |
Affiliation:
|
University Hospital Ambroise Paré, Assistance Publique Hôpitaux de Paris, Medical Intensive Care Unit, 9 avenue Charles de Gaulle, 92104 Boulogne Cedex, France. antoine.vieillard-baron@apr.aphp.fr |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Analysis of Variance Diastole Echocardiography, Transesophageal* Female Heart Ventricles / ultrasonography Humans Male Point-of-Care Systems Prospective Studies Severity of Illness Index Shock, Septic / ultrasonography* Systole Vena Cava, Inferior / ultrasonography Vena Cava, Superior / ultrasonography |
| Comments/Corrections | |
Comment In:
|
Intensive Care Med. 2007 Jun;33(6):1106; author reply 1107
[PMID:
17404706
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Airway obstruction secondary to thoracic aortic aneurysm leak. A case report.
Next Document: Fragmentation of Golgi apparatus of nigral neurons with alpha-synuclein-positive inclusions in patie...