Background Pulmonary hypertension (PHT) is very frequent in ICUs. Estimation of systolic pulmonary artery pressure (PASP) by using tricuspid regurgitation velocity (TRV) is impossible in 25% of patients. However, it may be possible to estimate PHT in these patients by obtaining subxiphoid imaging of short axis (SX‐SAX) and measuring pulmonary artery diameter (PAD) and right ventricular outflow tract (RVOT) acceleration time (AT). We first aimed to compare the values of AT and PAD measured at the parasternal short axis view (PSAX) and SX‐SAX and then to compare AT measurements obtained in the RVOT and pulmonary artery (PA) in ICU patients. Methods This prospective observational study was conducted in a 7‐bed ICU of a tertiary academic teaching hospital. Measurements of TRV, PAD, and AT in parasternal and subxiphoid SAX were obtained. AT was measured in RVOT and PA locations. We measured other echocardiographic signs of PHT to assess the probability of PHT in addition to TRV measurements. Results The study consisted of 61 patients. TRV was measured in 85% of the patients, and SX‐SAX was visualized in 78%. The probability of PHT was high (49%) in this study population. There were agreement and no proportional bias between the measurements of PAD and AT at both SX‐SAX and PSAX. Measurements of AT in the RVOT and PA were similar, as well. Conclusion These results suggested that measurements of AT in the PSAX and SX‐SAX and RVOT and PA were similar in the ICU patients.
Introduction: The detection of cardiac systolic dysfunction is very important for well management of pulmonary critical care patients (PCCPs). However, there is a poor correlation between echocardiographic cardiac systolic function (CSF) parameters and it is not easy to obtain these parameters in PCCPs. Therefore, this cross-sectional observational study was planned for the detection of a more easily obtainable echocardiographic CSF parameter that is well correlated with other CSF parameters in PCCPs. Materials and Methods: Total 88 PCCPs were included. Demographic and clinical information and laboratory tests of all patients were recorded. The CSF parameters of the heart were obtained by transthoracic echocardiography with appropriate technique. LVOT-VTI (Left ventricular outflow tract velocity time integral), CO (cardiac output), EPSS (e point septal separation), Left ventricular EF (ejection fraction) and TAPSE (Tricuspid Annular Plane Systolic Excursion) as an indicator of CSF were tried to obtain from all pateints. We also calculated sensitivity, specificity, positive and negative predictive values of LVOT-VTI<20 parameter to diagnose heart failure. Results: The mean age of the patients was 73±12, 40% were female, 38% were intubated and 52% had COPD. LVOTVTI, EF, CO, EPSS parameters were obtained in 54(61%), 24(27%), 48(54%), 48(54%) patients, respectively. Decreased LVOT-VTI (<20 cm) was well correlated with decreased EF (<45%) (p=0.001, r=0.77), decreased CO (<5 L/dk) (p=0.03, r=0.64) and decreased TAPSE (<17 mm) (p=0.001, r=0.71). Also, there was good agreement between the EF and LVOTVTI measurements (Kappa:0.78, p:0.001). Sensitivity, specificity, positive and negative predictive values of LVOTVTI<20 for heart failure were 58, 78, 84, 49 repectively. Conclusion: LVOT-VTI is more easily obtainable and well correlated parameter which can be used as an indicator of CSF in PCCPs.
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