Initial clinical trial of substernal epicardial echocardiography: SEEing a new window to the postoperative heart

“…In the early postoperative phase after cardiac surgery, the image quality of echocardiography is frequently suboptimal ( 17 , 18 ). In addition to image quality the lack of standardized measures regarding the assessment of PE and PLE is challenging when comparing separate examinations.…”

Section: Discussionmentioning

confidence: 99%

Focused ultrasound of the pleural cavities and the pericardium by nurses after cardiac surgery

Graven

Wahba

Hammer

et al. 2015

Scandinavian Cardiovascular Journal

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Objectives. We aimed to study the feasibility and reliability of focused ultrasound (US) examinations to quantify pericardial (PE)- and pleural effusion (PLE) by a pocket-size imaging device (PSID) performed by nurses in patients early after cardiac surgery. Design. After a 3-month training period, with cardiologists as supervisors, two nurses examined 59 patients (20 women) with US using a PSID at a median of 5 days after cardiac surgery. The amount of PE and PLE was classified in four categories by US (both) and chest x-ray (PLE only). Echocardiography, including US of the pleural cavities, by experienced cardiologists was used as reference. Results. Focused US by the nurses was more sensitive than x-ray to detect PLE. The correlations of the quantification of PE and PLE by the nurses and reference was r (95% confidence interval) 0.76 (0.46–0.89) and 0.81 (0.73–0.89), both p < 0.001. PE and PLE were drained in one and six (eight cavities) patients, all classified as large amount by the nurses. Conclusions. Cardiac nurses were able to obtain reliable measurements and quantification of both PE and PLE bedside by focused US and outperform the commonly used chest x-ray regarding PLE after cardiac surgery.

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“…Images obtained with SEE were compared with those obtained by TEE. Right ventricle and anterior structures were better visualized by SEE and the limitations of examination relate to posterior structures including the distal and descending aorta [77,81,82]. The examination can be repeated as frequently as needed in order to better monitor the response.…”

Section: Role Of Substernal Epicardial Echocardiography Imaging Technmentioning

confidence: 99%

Recognition of diastolic heart failure in the postoperative heart

Alsaddique¹

2008

European Journal of Cardio-Thoracic Surgery

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Diastolic dysfunction is assuming more importance as it is increasingly evident that it can be solely responsible for heart failure. Although many comprehensive studies pertinent to diastolic dysfunction and diastolic heart failure have been recently published, there is a paucity of information on diastolic dysfunction appearing in the postoperative cardiac surgical patient. We sought to look into current literature searching for criteria that could be applied to help diagnose it in this group of patients in the intensive care setting where cardiac surgical patients are usually managed in the immediate postoperative period. Because of the almost similar clinical features it is important to make the distinction between diastolic or systolic heart failure.

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Initial clinical trial of substernal epicardial echocardiography: SEEing a new window to the postoperative heart

Cited by 10 publications

References 4 publications

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Focused ultrasound of the pleural cavities and the pericardium by nurses after cardiac surgery

Recognition of diastolic heart failure in the postoperative heart

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