Abstract:
INTRODUCTION:This prospective study aimed to assess whether use of the subxiphoid acoustic window in transthoracic echocardiography (TTE) can be an accurate alternative in the absence of an apical view to assess hemodynamic parameters. METHODS:This prospective study took place in a teaching hospital medical ICU. Over a 4-month period, TTE was performed in patients admitted for more than 24 hours. Two operators rated the quality of parasternal, apical, and subxiphoid acoustic windows as Excellent, Good, Acceptable, Poor, or No image. In the subpopulation presenting adequate (rated as acceptable or higher) apical and subxiphoid views, we compared the left ventricular ejection fraction (LVEF), the ratio between right and left ventricular end-diastolic areas (RVEDA/LVEDA), the ratio between early and late mitral inflow on pulsed Doppler (E/A ratio), the aortic velocity time integral (Ao VTI), and the ratio between early mitral inflow and displacement of the mitral annulus on tissue Doppler imaging (E/Ea ratio). RESULTS:An adequate apical view was obtained in 80%, and an adequate subxiphoid view was obtained in 63% of the 107 patients included. Only 5% of patients presented an adequate subxiphoid view without an adequate apical view. In the subpopulation of patients with adequate apical and subxiphoid windows (n = 65), LVEF, E/A, and RVEDA/LVEDA were comparable on both views, and were strongly correlated (r > 0.80) with acceptable biases and precision. However, the Ao VTI and the E/Ea ratio were lower on the subxiphoid view than on the apical view (18 ± 5 versus 16 ± 5 cm and 9.6 ± 4.6 versus 7.6 ± 4 cm, respectively, P = 0.001 for both). CONCLUSIONS:An adequate TTE subxiphoid window was obtained in fewer than two thirds of ICU patients. In addition to the classic indication for the subxiphoid window to study the vena cava and pericardium, this view can be used to study right and left ventricular morphology and function, but does not provide accurate hemodynamic Doppler information. ICU echocardiographers should therefore record both apical and subxiphoid views to assess comprehensively the cardiac function and hemodynamic status.
journal_name
Crit Carejournal_title
Critical care (London, England)authors
Maizel J,Salhi A,Tribouilloy C,Massy ZA,Choukroun G,Slama Mdoi
10.1186/cc12869subject
Has Abstractpub_date
2013-09-03 00:00:00pages
R186issue
5eissn
1364-8535issn
1466-609Xpii
cc12869journal_volume
17pub_type
杂志文章相关文献
CRITICAL CARE文献大全abstract:BACKGROUND:(1,3)-β-D-Glucan has been widely used in clinical practice for the diagnosis of invasive Candida infections. However, such serum biomarker showed potential to guide antimicrobial therapy in order to reduce the duration of empirical antifungal treatment in critically ill septic patients with suspected invasiv...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-020-03265-y
更新日期:2020-09-05 00:00:00
abstract:INTRODUCTION:It has been unclear if mechanical cardiopulmonary resuscitation (CPR) is a viable alternative to manual CPR. We aimed to compare resuscitation outcomes before and after switching from manual CPR to load-distributing band (LDB) CPR in a multi-center emergency department (ED) trial. METHODS:We conducted a p...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc11456
更新日期:2012-08-03 00:00:00
abstract:INTRODUCTION:The goal of personalised medicine in the intensive care unit (ICU) is to predict which diagnostic tests, monitoring interventions and treatments translate to improved outcomes given the variation between patients. Unfortunately, processes such as gene transcription and drug metabolism are dynamic in the cr...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc7140
更新日期:2008-01-01 00:00:00
abstract::Burns are a prevalent and burdensome critical care problem. The priorities of specialized facilities focus on stabilizing the patient, preventing infection, and optimizing functional recovery. Research on burns has generated sustained interest over the past few decades, and several important advancements have resulted...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-015-0961-2
更新日期:2015-06-12 00:00:00
abstract:INTRODUCTION:Between 1 and 31% of patients suffering out-of-hospital cardiac arrest (OHCA) survive to discharge from hospital. International studies have shown that the level of care provided by the admitting hospital determines survival for patients suffering from OHCA. These data may only be partially transferable to...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc11516
更新日期:2012-09-12 00:00:00
abstract:BACKGROUND:Despite quick implementation of reperfusion therapies, a few patients with high-risk, acute, massive, pulmonary embolism (PE) remain highly hemodynamically unstable. Others have absolute contraindication to receive reperfusion therapies. Venoarterial-extracorporeal membrane oxygenation (VA-ECMO) might lower ...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-017-1655-8
更新日期:2017-03-28 00:00:00
abstract::Central venous oxygen saturation (ScvO2) >70% or mixed venous oxygen saturation (SvO2) >65% is recommended for both septic and non-septic patients. Although it is the task of experts to suggest clear and simple guidelines, there is a risk of reducing critical care to these simple recommendations. This article reviews ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-014-0579-9
更新日期:2014-11-10 00:00:00
abstract::The encouraging results of recent clinical trials on therapy of severe sepsis and septic shock are paralleled by ongoing studies on the epidemiology of sepsis and infection in intensive care unit patients all over the world. The development of network-based systems for assessing morbidity and mortality in intensive ca...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc2175
更新日期:2003-10-01 00:00:00
abstract::The early detection and treatment of sepsis are the most important factors in improving the outcome of patients with this condition. However, many patients admitted to hospital experience a long delay in the diagnosis of sepsis. Furthermore, it is not uncommon for febrile patients to be sent home from the Emergency De...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/s13054-014-0529-6
更新日期:2014-09-27 00:00:00
abstract::Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is an increasingly adopted life-saving mechanical circulatory support for a number of potentially reversible or treatable cardiac diseases. It is also started as a bridge-to-transplantation/ventricular assist device in the case of unrecoverable cardiac or ca...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-019-2541-3
更新日期:2019-07-30 00:00:00
abstract:INTRODUCTION:Blood transfusion in the perioperative period has frequently been associated with an excess of nosocomial infections. Whilst transfused whole blood induces specific host immune alteration that may predispose to nosocomial infections, the immunomodulating properties associated with leukodepleted blood remai...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-014-0541-x
更新日期:2014-10-01 00:00:00
abstract:INTRODUCTION:The accurate assessment of intravascular volume status for the therapy of severe hypovolemia and shock is difficult and critical to critically ill patients. Non-invasive evaluation of fluid responsiveness by the rapid infusion of a very limited amount of volume is an important clinical goal. This study aim...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc13891
更新日期:2014-05-27 00:00:00
abstract:BACKGROUND:Critical illness myopathy is an acquired skeletal muscle disorder with severe myosin loss and muscle weakness frequently seen in intensive care unit (ICU) patients. It is unknown if impaired excitation-contraction coupling contributes to the muscle weakness. METHODS:We used a unique ICU model where rats wer...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-016-1417-z
更新日期:2016-08-10 00:00:00
abstract:BACKGROUND:In patients intubated for mechanical ventilation, prolonged diaphragm inactivity could lead to weakness and poor outcome. Time to resume a minimal diaphragm activity may be related to sedation practice and patient severity. METHODS:Prospective observational study in critically ill patients. Diaphragm electr...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-020-03435-y
更新日期:2021-01-11 00:00:00
abstract:INTRODUCTION:Activation of the sympathetic nervous system has beneficial cardiovascular effects in sepsis, but there is also evidence that sympatholytics have beneficial actions in sepsis. We therefore determined the effect of selective β1-adrenoceptor blockade on cardiac and renal function and cytokine release in ovin...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-014-0610-1
更新日期:2014-11-21 00:00:00
abstract:INTRODUCTION:Inflammation and coagulation are closely linked, and both can be triggered by endotoxin. Thrombelastometry and impedance aggregometry are of diagnostic and predictive value in critically ill patients. In this observational study we investigated the correlation of endotoxin activity with thrombelasometric a...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc12892
更新日期:2013-09-11 00:00:00
abstract::Hypotension during intermittent hemodialysis is common, and has been attributed to acute volume shifts, shifts in osmolarity, electrolyte imbalance, temperature changes, altered vasoregulation, and sheer hypovolemia. Although hypovolemia may intuitively seem a likely cause for hypotension in intensive care patients, i...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-016-1307-4
更新日期:2016-06-09 00:00:00
abstract::Urgent cardiac ultrasound examination in the critical care setting is clinically useful. Application of goal-directed echocardiography in this setting is quite distinct from typical exploratory diagnostic comprehensive echocardiography, because the urgent critical care setting mandates a goal-directed approach. Goal-d...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-014-0681-z
更新日期:2014-12-01 00:00:00
abstract:INTRODUCTION:Delayed patient admission to the intensive care unit (ICU) due to lack of bed availability is a common problem, but the effect on patient outcome is not fully known. METHODS:A retrospective study was performed using departmental computerised records to determine the effect of delayed ICU admission and tem...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc11650
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Prior retrospective cross-sectional work has associated antimicrobials with a non-specific phrase: encephalopathy without seizures. The purpose of this study is to determine whether different classes of antimicrobials have differential associations with the daily risk of delirium after critical illness is ad...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-018-2262-z
更新日期:2018-12-12 00:00:00
abstract:BACKGROUND:Accurate prediction of delirium in the intensive care unit (ICU) may facilitate efficient use of early preventive strategies and stratification of ICU patients by delirium risk in clinical research, but the optimal delirium prediction model to use is unclear. We compared the predictive performance and user c...
journal_title:Critical care (London, England)
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1186/s13054-018-2037-6
更新日期:2018-05-05 00:00:00
abstract::Critical care medicine in China has made great advances in recent decades. This has led to an unavoidable issue: end-of-life ethics. With advances in medical technology and therapeutics allowing the seemingly limitless maintenance of life, the exact time of death of an individual patient is often determined by the dec...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc13140
更新日期:2013-12-04 00:00:00
abstract::Sepsis is characterized by a dysregulated immune response to infection leading to life-threatening organ dysfunction. Sepsis-induced liver injury is recognized as a powerful independent predictor of mortality in the intensive care unit. During systemic infections, the liver regulates immune defenses via bacterial clea...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-020-03327-1
更新日期:2020-10-19 00:00:00
abstract:INTRODUCTION:Although less invasive than pulmonary artery catheters (PACs), arterial pulse pressure analysis techniques for estimating cardiac output (CO) have not been simultaneously compared to PAC bolus thermodilution CO (COtd) or continuous CO (CCO) devices. METHODS:We compared the accuracy, bias and trending abil...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc9335
更新日期:2010-01-01 00:00:00
abstract:INTRODUCTION:There has been dramatic improvement in survival for patients with HIV/AIDS; however, some studies on patients with HIV/AIDS and serious illness have reported continued low rates of intensive care. The purpose of this study was to examine patterns of care and outcomes for patients with severe sepsis and HIV...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc3811
更新日期:2005-01-01 00:00:00
abstract:INTRODUCTION:Procalcitonin (PCT) and C-reactive protein (CRP) are established markers of infection in the general population. In contrast, several studies reported falsely increased PCT levels in patients receiving T-cell antibodies. We evaluated the validity of these markers in patients scheduled for hemopoietic stem ...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc7749
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:Dextrose may be used during cardiac arrest resuscitation to prevent or reverse hypoglycemia. However, the incidence of dextrose administration during cardiac arrest and the association of dextrose administration with survival and other outcomes are unknown. METHODS:We used the Get With The Guidelines®-Res...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-015-0867-z
更新日期:2015-04-10 00:00:00
abstract:BACKGROUND:Improving timeliness of pathogen identification is crucial to allow early adaptation of antibiotic therapy and improve prognosis in patients with pneumonia. We evaluated the relevance of a new syndromic rapid multiplex PCR test (rm-PCR) on respiratory samples to guide empirical antimicrobial therapy in adult...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-020-03114-y
更新日期:2020-07-14 00:00:00
abstract:INTRODUCTION:The pathophysiology of postoperative delirium remains poorly understood. The purpose of this study was to examine the relationship between serum cortisol level and occurrence of early postoperative delirium in patients undergoing coronary artery bypass graft (CABG) surgery. METHODS:A total of 243 patients...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc9393
更新日期:2010-01-01 00:00:00
abstract:INTRODUCTION:Enteral nutrition (EN) with eicosapentaenoic acid (EPA)/γ-linolenic acid (GLA) is recommended for mechanically ventilated patients with severe lung injury. EPA/GLA has anti-inflammatory benefits, as evidenced by its association with reduction in pulmonary inflammation, improvement in oxygenation and improv...
journal_title:Critical care (London, England)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/cc10267
更新日期:2011-06-09 00:00:00