Accuracy of cardiac function and volume status estimates using the bedside echocardiographic assessment in trauma/critical care

Mark Gunst, Vafa Ghaemmaghami, Jason Sperry, Melissa Robinson, Terence OKeeffe, Randall Friese, Heidi Frankel

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Background:: Critically ill patients often require invasive monitoring to evaluate and optimize cardiac function and preload. With questionable outcomes associated with pulmonary artery catheters (PACs), some have evaluated the role of less invasive monitors. We hypothesized that the Bedside Echocardiographic Assessment in Trauma (BEAT) examination would generate cardiac index (CI) and central venous pressure (CVP) estimates that correlate with that of a PAC. Methods:: BEAT was performed on all SICU patients with a PAC in place. Prospective data included stroke volume and the inferior vena cava (IVC) diameter. The CI was calculated and correlated with that from the PAC. Each CI was then categorized as low, normal, or high. The IVC diameter was used to estimate the CVP. The association between the BEAT and PAC estimates of CI and CVP was evaluated using χ. Results:: Eighty-five BEAT examinations were performed, 57% on trauma and 37% on general surgery patients. Fifty-nine percent of the CI examinations and 97% of the IVC examinations contained quality images. Of these, the overall correlation coefficient was 0.70 (p < 0.0001). When CI was categorized, there was a significant association between the BEAT and PAC (p = 0.021). There was a significant association between the CVP estimate from the BEAT examination and the PAC (p = 0.031). Conclusion:: Our data show a significant correlation between the CI and CVP estimates obtained from the BEAT examination and that from a PAC. BEAT provides a noninvasive method of evaluating cardiac function and volume status. Bedside echocardiography is teachable and should become a part of future critical care curricula.

Original languageEnglish (US)
Pages (from-to)509-516
Number of pages8
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume65
Issue number3
DOIs
StatePublished - Sep 1 2008
Externally publishedYes

Fingerprint

Cardiac Volume
Critical Care
Pulmonary Artery
Central Venous Pressure
Catheters
Wounds and Injuries
Inferior Vena Cava
Cardiac Catheters
Critical Illness
Curriculum
Stroke Volume
Echocardiography

Keywords

  • Echocardiography
  • ICU
  • Monitoring
  • PAC
  • Trauma

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Accuracy of cardiac function and volume status estimates using the bedside echocardiographic assessment in trauma/critical care. / Gunst, Mark; Ghaemmaghami, Vafa; Sperry, Jason; Robinson, Melissa; OKeeffe, Terence; Friese, Randall; Frankel, Heidi.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 65, No. 3, 01.09.2008, p. 509-516.

Research output: Contribution to journalArticle

Gunst, Mark ; Ghaemmaghami, Vafa ; Sperry, Jason ; Robinson, Melissa ; OKeeffe, Terence ; Friese, Randall ; Frankel, Heidi. / Accuracy of cardiac function and volume status estimates using the bedside echocardiographic assessment in trauma/critical care. In: Journal of Trauma - Injury, Infection and Critical Care. 2008 ; Vol. 65, No. 3. pp. 509-516.
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