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A study of bedside ultrasound in evaluating severe patients′ cardiac function |
Yuan Hui-qin, Liu Li-jun |
Intensive Care Unit, the Second Affiliated Hospital of Soochow University, Suzhou 215008, China |
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Abstract Objective To explore the reliability of bedside ultrasound in intensive care unit to evaluate the cardiac function, thus to provide evidence for the clinicians to diagnose and give treatment during the early stage of cardiac dysfunction. Methods This study was a prospective clinical analysis and 54 patients who needed PiCCO monitor from November 2016 to March 2017 in ICU of the Second Affiliated Hospital of Soochow University were assessed. Basic information of patients and the results of laboratory examination were collected. The parameters of the PiCCO included CO, SV, ELVW, SVRI and so on were measured via intermittent thermodilution. At the same time points, clinicians conducted transthoracic echocardiography to measure ejection fraction (EF), stroke volume (SV1), aortic valve velocity(AV) , velocity time integral(VTI). Take the value of invasive hemodynamic monitoring as the standard, then evaluate the correlation between SV1, AV, VTI measured by TTE and SV measured by PiCCO. Results Thirty-eight cases of the 54 patients obtained satisfactory two-dimensional and doppler spectrum images of the cardiac. The correlation coefficient between SV measured by TTE and SV measured by PiCCO was 0.839 (P<0.05). The correlation coefficient between AV, VTI measured by TTE and SV measured by PiCCO were 0.416 and 0.427, respectively (P<0.05). Bland-Altman analysis showed that stroke volume measured by M-mode echocardiography on the long-axis section of the left ventricle or by PiCCO could be substituted for each other except of relatively high cardiac output and low-resistance hemodynamics. Conclusion SV, AV and VTI measured by TTE may assess the left ventricular systolic function indirectly in the case of patients without left ventricular morphological abnormalities and localized wall motion abnormalities.
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Corresponding Authors:
Liu Li-jun, E-mail:lijunliusz@sina.com
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