Document Detail


Routine transthoracic echocardiography in a general Intensive Care Unit: an 18 month survey in 704 patients.
MedLine Citation:
PMID:  19393476     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Paulo Alexandre Marcelino; Susan Marques Marum; Ana Paula Matos Fernandes; Nuno Germano; Mario G Lopes
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Publication Detail:
Type:  Journal Article     Date:  2008-11-20
Journal Detail:
Title:  European journal of internal medicine     Volume:  20     ISSN:  1879-0828     ISO Abbreviation:  Eur. J. Intern. Med.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-27     Completed Date:  2009-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9003220     Medline TA:  Eur J Intern Med     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  e37-42     Citation Subset:  IM    
Affiliation:
Intensive Care Unit, Hospital Curry Cabral, Lisbon, Portugal. p.marcelino@netcabo.pt
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MeSH Terms
Descriptor/Qualifier:
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

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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