Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Aug;18(3):206-211.
doi: 10.1177/1751143717700911. Epub 2017 Mar 28.

The impact of focused echocardiography using the Focused Intensive Care Echo protocol on the management of critically ill patients, and comparison with full echocardiographic studies by BSE-accredited sonographers

David P Hall  1 , Helen Jordan  2 , Shirjel Alam  3 , Michael A Gillies  2
Affiliations

The impact of focused echocardiography using the Focused Intensive Care Echo protocol on the management of critically ill patients, and comparison with full echocardiographic studies by BSE-accredited sonographers

David P Hall et al. J Intensive Care Soc. 2017 Aug.

Abstract

Introduction: Focused echocardiography is widely used to assist clinical decision-making in critically ill patients. In the UK, the Focused Intensive Care Echo protocol is recommended by the Intensive Care Society to ensure consistency of approach and guarantee training standards. Concerns remain about the reliability of information attained by non-expert clinicians in focused echocardiography, particularly when this is used to alter clinical management.

Methods: A prospective, observational evaluation of 60 consecutive patients undergoing Focused Intensive Care Echo studies in a single ICU.

Results: A complete Focused Intensive Care Echo study was possible in 43/60 scans (72%) and new diagnostic information obtained following 41/60 scans (68%), which lead to a change of clinical management in 28/60 (47%) of cases. In 24/60 (40%) of cases, a full transthoracic study was subsequently undertaken by a fully accredited sonographer. There were no cases where the results from the full study contradicted those from the limited Focused Intensive Care Echo study; additional diagnostic information was attained following 68% of full studies.

Conclusion: Focused echocardiography using the Focused Intensive Care Echo protocol is feasible and clinically useful in a high proportion of ICU patients. However, many still require additional expert echocardiographic assessment. Focused echocardiography delivered by non-experts is clinically useful in this setting but its limitations must be understood and access to expert assessment should be available.

Keywords: Focused Intensive Care Echo; Intensive care; cardiac output; echocardiography; haemodynamic monitoring.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Change in management as a direct result of echocardiographic findings.
Figure 2.
Figure 2.
Additional information provided by full BSE study.
See this image and copyright information in PMC

References

    1. Farkas JD, Anawati MK. Bedside ultrasonography evaluation of shock. Hospital Med Clin 2015; 4: 135–149.
    1. Breitkreutz R, Price S, Steiger HV, et al. Focused echocardiographic evaluation in life support and peri-resuscitation of emergency patients: a prospective trial. Resuscitation 2010; 81: 1527–1533. - PubMed
    1. Joseph MX, Disney PJS, Da Costa R, et al. Transthoracic echocardiography to identify or exclude cardiac cause of shock. Chest 2004; 126: 1592–1597. - PubMed
    1. Kanji HD, McCallum J, Sirounis D, et al. Limited echocardiography-guided therapy in subacute shock is associated with change in management and improved outcomes. J Crit Care 2014; 29: 700–705. - PubMed
    1. Manasia AR, Nagaraj HM, Kodali RB, et al. Feasibility and potential clinical utility of goal-directed transthoracic echocardiography performed by noncardiologist intensivists using a small hand-carried device (SonoHeart) in critically ill patients. J Cardiothorac Vasc Anesth 2005; 19: 155–159. - PubMed

LinkOut - more resources