| Focused rapid echocardiographic evaluation versus vascular cather-based assessment of cardiac output and function in critically ill trauma patients. | |
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MedLine Citation:
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PMID: 22673240 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: : Focused rapid echocardiographic evaluation (FREE) is a comprehensive transthoracic echocardiogram tailored for the intensive care unit. It assesses both the cardiac index (CI) and left ventricular ejection fraction (EF). FREE and vascular catheter-derived CI was compared, and the ability of CI to detect moderate to severe dysfunction (EF <40%) was determined. METHODS: : FREE quality assurance database was reviewed to identify patients who had a hemodynamic catheter. RESULTS: : Of 507 FREEs, 115 patients were identified, 25 pulmonary artery catheters (PACs) and 90 FloTrac Vigileo (FT/V) arterial catheters. There were 27 patients with an EF <40%. In 86%, the CI was determined by FREE, and it changed care in 59%. The CI correlation for FREE versus PAC was r = 0.88 and versus FT/V was r = 0.63 (p < 0.05). The PAC-FREE bias was -0.07 (95% confidence interval -0.89 to 0.74) and the FT/V-FREE bias was -0.13 (95% confidence interval -1.4 to 1.1). FREE-PAC categorized patients the same way 87% and FREE-FT/V 76%; in patients with EF <40%, this changed to 90% and 63%, respectively. Using a threshold value (CI ≤2.5), the PAC detected dysfunction in 62.5% and the F/VT in 6%, p < 0.05. CONCLUSIONS: : There was excellent agreement between FREE and PAC but less with FT/V, especially in patients with and EF <40%. FREE can be used to validate catheter-derived data and provide important additional information. Further studies are needed to determine its impact on patient outcome. LEVEL OF EVIDENCE: : III, diagnostic study. |
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Authors:
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Sarah B Murthi; John R Hess; Aaron Hess; Lynn G Stansbury; Thomas M Scalea |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The journal of trauma and acute care surgery Volume: 72 ISSN: 2163-0763 ISO Abbreviation: J Trauma Acute Care Surg Publication Date: 2012 May |
Date Detail:
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Created Date: 2012-06-07 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101570622 Medline TA: J Trauma Acute Care Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1158-64 Citation Subset: AIM; IM |
Affiliation:
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Baltimore, Maryland From the Division of Trauma and Surgical Critical Care (S.B.M., L.G.S., T.M.S.), Department of Surgery, R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland; Departments of Medicine and Pathology (J.R.H.), University of Maryland School of Medicine, Baltimore, Maryland; and Department of Epidemiology (A.H.), University of Maryland School of Medicine, Baltimore, Maryland. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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