| Routine transthoracic echocardiography in a general Intensive Care Unit: an 18 month survey in 704 patients. | |
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MedLine Citation:
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PMID: 19393476 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The authors analyzed 704 transthoracic echocardiographic (TTE) examinations, performed routinely to all admitted patients to a general 16-bed Intensive Care Unit (ICU) during an 18-month period. Data acquisition and prevalence of abnormalities of cardiac structures and function were assessed, as well as the new, previously unknown severe diagnoses. A TTE was performed within the first 24 h of admission on 704 consecutive patients, with a mean age of 61.5+/-17.5 years, ICU stay of 10.6+/-17.1 days, APACHE II 22.6+/-8.9, and SAPS II 52.7+/-20.4. In four patients, TTE could not be performed. Left ventricular (LV) dimensions were quantified in 689 (97.8%) patients, and LV function in 670 (95.2%) patients. Cardiac output (CO) was determined in 610 (86.7%), and mitral E/A in 399 (85.9% of patients in sinus rhythm). Echocardiographic abnormalities were detected in 234 (33%) patients, the most common being left atrial (LA) enlargement (n=163), and LV dysfunction (n=132). Patients with these alterations were older (66+/-16.5 vs 58.1+/-17.4, p<0.001), presented a higher APACHE II score (24.4+/-8.7 vs 21.1+/-8.9, p<0.001), and had a higher mortality rate (40.1% vs 25.4%, p<0.001). Severe, previously unknown echocardiographic diagnoses were detected in 53 (7.5%) patients; the most frequent condition was severe LV dysfunction. Through a multivariate logistic regression analysis, it was determined that mortality was affected by tricuspid regurgitation (p=0.016, CI 1.007-1.016) and ICU stay (p<0.001, CI 1-1.019). We conclude that TTE can detect most cardiac structures in a general ICU. One-third of the patients studied presented cardiac structural or functional alterations and 7.5% severe previously unknown diagnoses. |
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Authors:
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Paulo Alexandre Marcelino; Susan Marques Marum; Ana Paula Matos Fernandes; Nuno Germano; Mario G Lopes |
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Publication Detail:
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Type: Journal Article Date: 2008-11-20 |
Journal Detail:
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Title: European journal of internal medicine Volume: 20 ISSN: 1879-0828 ISO Abbreviation: Eur. J. Intern. Med. Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-04-27 Completed Date: 2009-07-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9003220 Medline TA: Eur J Intern Med Country: Netherlands |
Other Details:
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Languages: eng Pagination: e37-42 Citation Subset: IM |
Affiliation:
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Intensive Care Unit, Hospital Curry Cabral, Lisbon, Portugal. p.marcelino@netcabo.pt |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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APACHE Adolescent Adult Aged Aged, 80 and over Cardiomegaly / mortality, ultrasonography Critical Illness / mortality Echocardiography / statistics & numerical data* Female Health Care Surveys* Heart Diseases / mortality*, ultrasonography* Humans Intensive Care Units / statistics & numerical data* Length of Stay / statistics & numerical data Male Middle Aged Mitral Valve Insufficiency / mortality, ultrasonography Ventricular Dysfunction, Left / mortality, ultrasonography Young Adult |
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