Impact of echocardiography on patient management in the intensive care unit: an audit of district general hospital practice.

Abstract:

BACKGROUND:Echocardiography has been shown to positively impact on the management of the critically ill patient. However, many published studies have a significant bias towards inclusion of cardiothoracic patients. We present an audit of the impact of echocardiography on the management of patients in a district general hospital intensive care unit (ICU). METHODS:We conducted a prospective audit of all echocardiograms, both transthoracic (TTE) and transoesophageal (TOE), performed on our ICU between October 1, 2005, and December 31, 2007. In addition to patient characteristics, we recorded the indication for the echocardiogram, and any change in management that occurred as a result of the study. RESULTS:Two hundred and fifty-eight echocardiograms were performed in 217 patients, of which 224 (86.8%) were performed by intensive care consultants. One hundred and eighty-seven studies (72.4%) were TTEs and 71 (27.8%) were TOEs. TTE provided diagnostic images in 91.3% of spontaneously breathing and 84.2% of mechanically ventilated patients. Management was changed directly as a result of information provided in 51.2% of studies. Changes included fluid administration, inotrope or drug therapy, and treatment limitation. CONCLUSIONS:Echocardiography may have a significant impact on the management of patients in the general ICU. We recommend that appropriate training in echocardiography should be incorporated into the intensive care curriculum in the UK.

journal_name

Br J Anaesth

authors

Orme RM,Oram MP,McKinstry CE

doi

10.1093/bja/aen378

subject

Has Abstract

pub_date

2009-03-01 00:00:00

pages

340-4

issue

3

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)34503-8

journal_volume

102

pub_type

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