Evidence map›Paper›PMID 39073505›Full record

ArticleAnnals of intensive care2024

Therapeutic impact of basic critical care echocardiography performed by residents after limited training.

Marine Goudelin, Bruno Evrard, Roxana Donisanu, Céline Gonzalez, Christophe Truffy, Marie Orabona, Antoine Galy, François-Xavier Lapébie, Yvan Jamilloux, Elodie Vandeix and 6 more

Abstract read
In one paragraph

Article in Annals of intensive care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Marine GoudelinMedical-Surgical Intensive Care Unit, Dupuytren University Hospital, 87000, Limoges, France.
Bruno EvrardMedical-Surgical Intensive Care Unit, Dupuytren University Hospital, 87000, Limoges, France.
Roxana DonisanuMedical-Surgical Intensive Care Unit, Dupuytren University Hospital, 87000, Limoges, France.
Céline GonzalezMedical-Surgical Intensive Care Unit, Dupuytren University Hospital, 87000, Limoges, France.
Christophe TruffyMedical-Surgical Intensive Care Unit, Dupuytren University Hospital, 87000, Limoges, France.
Marie OrabonaMedical-Surgical Intensive Care Unit, Dupuytren University Hospital, 87000, Limoges, France.
Antoine GalyMedical-Surgical Intensive Care Unit, Dupuytren University Hospital, 87000, Limoges, France.
François-Xavier LapébieMedical-Surgical Intensive Care Unit, Dupuytren University Hospital, 87000, Limoges, France.
Yvan JamillouxMedical-Surgical Intensive Care Unit, Dupuytren University Hospital, 87000, Limoges, France.
Elodie VandeixMedical-Surgical Intensive Care Unit, Dupuytren University Hospital, 87000, Limoges, France.
Dominique BelcourMedical-Surgical Intensive Care Unit, Dupuytren University Hospital, 87000, Limoges, France.
Charles HodlerMedical-Surgical Intensive Care Unit, Dupuytren University Hospital, 87000, Limoges, France.
Lucie RamirezMedical-Surgical Intensive Care Unit, Dupuytren University Hospital, 87000, Limoges, France.
Rémi GagnoudMedical-Surgical Intensive Care Unit, Dupuytren University Hospital, 87000, Limoges, France.
Catherine ChapellasMedical-Surgical Intensive Care Unit, Dupuytren University Hospital, 87000, Limoges, France.
Philippe VignonMedical-Surgical Intensive Care Unit, Dupuytren University Hospital, 87000, Limoges, France. philippe.vignon@unilim.fr.ORCID http://orcid.org/0000-0003-4551-5772

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe objective was to assess the agreement between therapeutic proposals derived from basic critical care echocardiography performed by novice operators in ultrasonography after a limited training (residents) and by experts considered as reference. Secondary objectives were to assess the agreement between operators' answers to simple clinical questions and the concordance between basic two-dimensional measurements.

methodsThis observational, prospective, single-center study was conducted over a 3-year period in a medical-surgical intensive care unit. Adult patients with acute circulatory and/or respiratory failure requiring a transthoracic echocardiography (TTE) examination were studied. In each patient, a TTE was performed by a resident novice in ultrasonography after a short training program and by an expert, independently but within 1 h and in random order. Each operator addressed standardized simple clinical questions and subsequently proposed a therapeutic strategy based on a predefined algorithm.

resultsResidents performed an average of 33 TTE studies in 244 patients (156 men; age: 63 years [52-74]; SAPS2: 45 [34-59]; 182 (75%) mechanically ventilated). Agreement between the therapeutic proposals of residents and experienced operators was good-to-excellent. The concordance was excellent for suggesting fluid loading, inotrope or vasopressor support (all Kappa values > 0.80). Inter-observer agreement was only moderate when considering the indication of negative fluid balance (Kappa: 0.65; 95% CI 0.50-0.80), since residents proposed diuretics in 23 patients (9.5%) while their counterparts had the same suggestion in 35 patients (14.4%). Overall agreement of responses to simple clinical questions was also good-to-excellent. Intraclass correlation coefficient exceeded 0.75 for measurement of ventricular and inferior vena cava size.

conclusionsA limited training program aiming at acquiring the basic level in critical care echocardiography enables ICU residents novice in ultrasonography to propose therapeutic interventions with a good-to-excellent agreement with experienced operators.

Indexed as

Intensive care unitPoint of care technologyTherapeutic usesTrainingTransthoracic echocardiographyUltrasound

Identifiers

PMID39073505
PMCPMC11286607

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.