Impact of goal directed basic echocardiography on diagnostic and therapeutic management in an ICU of cardiac surgery

O. Moreno, A. Ochagavía, A. Artigas, S. Barbadillo, R. Tomás, M. D. Bosque, C. Fortia, F. Baigorri

Research output: Contribution to journalArticleResearch

Abstract

© 2019 Elsevier España, S.L.U. y SEMICYUC Objective: Few studies have evaluated the impact in diagnosis and therapeutic management of basic transthoracic echocardiography in postoperated cardiac surgery. The aim of our study was to evaluate the impact of basic transthoracic echocardiography in the management of this kind of patients. Design: Over an 18-month period, we prospectively studied all patients admitted to a university hospital Intensive Care Unit following heart surgery. We evaluated clinically all of them to establish a diagnosis and an initial treatment. We performed basic transthoracic echocardiography for a diagnosis evaluation that was compared with clinical diagnosis. If they differed, we assessed to change treatment and evaluate the therapeutic response. We performed a descriptive analysis. Results: We included 136 patients and performed 203 echocardiographies. Transthoracic echocardiography differed of initial diagnosis in 101 (49.8%) echocardiographies. In 56 of these echocardiographies (55.44%), we could give an alternative diagnosis with a change in the treatment in 30 patients (53,6%). We found clinical improvement in 26 patients (86.76%) in the following 30-60 minutes. Conclusions: Basic transthoracic echocardiography is useful in diagnostic and therapeutic management of postoperative cardiac surgery patients. We could not confirm the clinical diagnosis in half of the performed echocardiographies. In most patients in whom we observe a change in the diagnosis due to echocardiography, we observed a clinical improvement after changing the treatment.
Original languageEnglish
JournalMedicina Intensiva
DOIs
Publication statusPublished - 1 Jan 2019

Keywords

  • Basic transthoracic echocardiography
  • Critically ill patients
  • Heart surgery
  • Impact on diagnosis and treatment

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