Prospective assessment of a score for assessing basic critical-care transthoracic echocardiography skills in ventilated critically ill patientsReport as inadecuate




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Annals of Intensive Care

, 4:12

First Online: 27 April 2014Received: 12 November 2013Accepted: 07 April 2014

Abstract

BackgroundWe studied a score for assessing basic transthoracic echocardiography TTE skills exhibited by residents who examined critically ill patients receiving mechanical ventilation.

MethodsWe conducted a prospective study in the 16 residents who worked in our medical-surgical ICU between 1 May 2008 and 1 November 2009. The residents received theoretical teaching two hours then performed supervised TTEs during their six-month rotation. Their basic TTE skills in mechanically ventilated patients were evaluated after one M1, three M3, and six M6 months by two experts, who used a scoring system devised for the study. After scoring, residents gave their hemodynamic diagnosis and suggested a treatment.

ResultsThe 4 residents with previous TTE skills obtained a significantly higher total score than did the 12 novices at M1 18 16 to 19 versus 13 10 to 15, respectively, P = 0.03. In the novices, the total score increased significantly during training M1, 13 10 to 14; M3, 15 12 to 16; and M6, 17 15 to 18; P < 0.001 and correlated significantly with the number of supervised TTEs r = 0.68, P < 0.0001. In the overall population, agreement with experts regarding the diagnosis and treatment was associated with a significantly higher total score 17 16 to 18 versus 13 12 to 16, P = 0.002. A total score ≥ 19-20 points had 100% specificity 95% confidence interval, 79 to 100% for full agreement with the experts regarding the diagnosis and treatment.

ConclusionsOur results validate the scoring system developed for our study of the assessment of basic critical-care TTE skills in residents.

KeywordsGoal-oriented bedside echocardiography Basic critical-care echocardiography skills Non-cardiologist intensivists Hemodynamic assessment Intensive care unit AbbreviationsCIconfidence interval

IQRinterquartile range

ROCreceiver-operating characteristics

TEEtransesophageal echocardiography

TTEtransthoracic echocardiography.

Electronic supplementary materialThe online version of this article doi:10.1186-2110-5820-4-12 contains supplementary material, which is available to authorized users.

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Author: Mathieu Jozwiak - Xavier Monnet - Raphaël Cinotti - Fréderic Bontemps - Jean Reignier - Guillaume Belliard

Source: https://link.springer.com/







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