| Title |
Can we improve transthoracic echocardiography training in non-cardiologist residents? Experience of two training programs in the intensive care unit
|
|---|---|
| Published in |
Annals of Intensive Care, May 2016
|
| DOI | 10.1186/s13613-016-0150-8 |
| Pubmed ID | |
| Authors |
Vincent Labbé, Stéphane Ederhy, Blandine Pasquet, Romain Miguel-Montanes, Cédric Rafat, David Hajage, Stéphane Gaudry, Didier Dreyfuss, Ariel Cohen, Muriel Fartoukh, Jean-Damien Ricard |
| Abstract |
To evaluate the diagnostic performances of two training programs for residents with no prior ultrasound experience to reach competences in extended basic critical care transthoracic echocardiography (CCE) including Doppler capabilities. This is a prospective observational study in two intensive care units of teaching hospitals. Group I (five residents) completed a short training program (4-h theory; 3-h practical); group II (six residents) completed a longer training program (6-h theory; 12-h practical). The residents and an expert examined all patients who required a transthoracic echocardiography. Their agreement studied by Cohen's κ coefficient, concordance coefficient correlation (CCC) and Bland-Altman plots was used as an indicator of program effectiveness. Group I performed 136 CCEs (mean/resident 27; range 22-32; 65 in ventilated patients) in 115 patients (62 men; 64 ± 18 years; Simplified Acute Physiologic Score [SAPS] II 37 ± 18). Group II performed 158 CCEs (mean/resident 26; range 21-31; 65 in ventilated patients) in 108 patients (64 men; 58 ± 17 years; SAPS II 42 ± 22). Both groups adequately assessed left ventricular (LV) systolic function (κ 0.75, 95 % confidence interval [CI] 0.64-0.86; κ 0.77, 95 % CI 0.66-0.88, respectively) and pericardial effusion (κ 0.83, 95 % CI 0.67-0.99; κ 0.76, 95 % CI 0.60-0.93, respectively). Group II appraised severe right ventricular dilatation and significant left-sided valve disease with good to very good agreement (κ 0.80, 95 % CI 0.56-0.96; κ 0.79, 95 % CI 0.66-0.93, respectively). Regarding left ventricular ejection fraction, E/A ratio, E/e' ratio and aortic peak velocity assessed by group II, CCCs were all >0.70 and the bias (mean difference) ±SD on Bland-Altman analysis was 1.3 ± 8.8 %, 0 ± 0.3, 0.4 ± 2.2 and 0.1 ± 0.4 m/s, respectively. Detection of paradoxical septum (κ 0.65, 95 % CI 0.37-0.93), of heterogeneous LV contraction (κ 0.49, 95 % CI 0.33-0.65) and of respiratory variation of the inferior vena cava (κ 0.27, 95 % CI 0.09-0.45), as well as stroke volume measurement (CCC 0.65, 95 % CI 0.54-0.74; bias ± SD -1.4 ± 4.7 cm), was appraised by group II with moderate agreement requiring probably more comprehensive training. Although a training program blending 6-h theory and 12-h practical may be adapted to achieve some essential competences, it seems to be insufficiently to perform a complete extended basic critical care transthoracic echocardiography including Doppler capabilities. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Belgium | 1 | 33% |
| Spain | 1 | 33% |
| Unknown | 1 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 33% |
| Members of the public | 1 | 33% |
| Practitioners (doctors, other healthcare professionals) | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 30 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 30 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 5 | 17% |
| Librarian | 3 | 10% |
| Other | 3 | 10% |
| Student > Postgraduate | 3 | 10% |
| Student > Bachelor | 2 | 7% |
| Other | 7 | 23% |
| Unknown | 7 | 23% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 13 | 43% |
| Biochemistry, Genetics and Molecular Biology | 2 | 7% |
| Business, Management and Accounting | 1 | 3% |
| Computer Science | 1 | 3% |
| Nursing and Health Professions | 1 | 3% |
| Other | 4 | 13% |
| Unknown | 8 | 27% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 May 2016.
All research outputs
#13,469,948
of 22,870,727 outputs
Outputs from Annals of Intensive Care
#707
of 1,044 outputs
Outputs of similar age
#167,525
of 326,819 outputs
Outputs of similar age from Annals of Intensive Care
#10
of 29 outputs
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