Why the study?
The study evaluated non-invasive critical care echocardiography with a novel web graph visualization to quantify hemodynamic parameters as an alternative to thermodilution techniques.
Does non-invasive critical care echocardiography (CCE) provide feasible and accurate hemodynamic profiling compared to thermodilution techniques in ICU patients?
Does non-invasive critical care echocardiography (CCE) provide feasible and accurate hemodynamic profiling compared to thermodilution techniques in ICU patients?
Answers are grounded in this paper and cite their sources.
Critical care echocardiography is a feasible alternative to thermodilution for hemodynamic profiling in ICU patients, particularly useful when thermodilution is unreliable, and can identify low cardiac index associated with higher mortality.
In this prospective observational study, non-invasive critical care echocardiography (CCE) was used to obtain quantitative hemodynamic parameters in 107 intensive care unit (ICU) patients; the parameters were then visualized in a novel web graph approach to increase the understanding and impact of CCE abnormalities, as an alternative to thermodilution techniques. Visualizing the CCE hemodynamic data in six-dimensional web graph plots was feasible in almost all ICU patients. In 23.1% of patients, significant tricuspid regurgitation prevented correlation between thermodilution techniques and echocardiographic hemodynamics. Two parameters of longitudinal right ventricular function (TAPSE and S’) did not correlate in ICU patients. Clinical surrogate parameters of hemodynamic compromise did not correlate with measured hemodynamics. 26.2% of the patients with mean arterial pressures above 60 mmHg had cardiac indices (CI) below 2.5 L min −1 ·m −2 . A CI below 2.2 L·min −1 ·m −2 was associated with a significant ICU survival disadvantage. CCE was feasible in addition or as an alternative to thermodilution techniques for the hemodynamic evaluation of ICU patients. Six-dimensional web graph plots visualized the hemodynamic states and were especially useful in conditions in which thermodilution methods were not reliable. Hemodynamic CCE identified patients with previously unknown low CI, which correlated with a higher ICU mortality.
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Schmidt et al. (2022) studied this question.
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