Pocket-sized ultrasound examination of fluid imbalance in patients with heart failure: A pilot and feasibility study of heart failure nurses without prior experience of ultrasonography

Gustafsson, Mikael; Alehagen, Urban; Johansson, Peter

doi:10.1177/1474515114559435

Cited by 25 publications

(68 citation statements)

References 29 publications

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“…Studies comparing nurses with an expert have shown similar results. In another study by Gustafsson et al 15 four nurses in a heart failure clinic without prior ultrasound experience received 4 h training before they performed scans on 104 patients. The prospective study by Dalen,Gundersen 14 which investigated the IRR between two nurses specialized in cardiovascular nursing and a cardiologist found good agreement.…”

Section: Discussionmentioning

confidence: 99%

“…15 It may be critical to choose the correct moment for measurements, as previous studies have cautioned against measurements of the IVC for dry weight assessment at treatment cessation, as they may be incorrect due to plasma refilling. This study shows that for this individual, after this period, their scans were reliable.…”

Section: Discussionmentioning

confidence: 99%

“…Their nurses performed better in achieving adequate images of the IVC in the longitudinal orientation, which correlates with the results of our study, where all 100% of the LV scans were rated as adequate by both expert raters, whereas 87% of TV scans were rated as adequate. In another study by Gustafsson et al 15 four nurses in a heart failure clinic without prior ultrasound experience received 4 h training before they performed scans on 104 patients. During this study, the nurses performed ultrasound scans not only on the IVC, but also on the chest, back and abdomen to investigate pleural effusions and comet tail artefacts to assess for pulmonary congestion.…”

Section: Discussionmentioning

confidence: 99%

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Can a renal nurse assess fluid status using ultrasound on the inferior vena cava? A cross‐sectional interrater study

Steinwandel

Gibson

Towell

et al. 2017

Hemodialysis International

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Can a renal nurse assess fluid status using ultrasound on the inferior vena cava? A cross‐sectional interrater study

Steinwandel

Gibson

Towell

et al. 2017

Hemodialysis International

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show abstract

“…Relevant literature concerning renal nurses’ use of US to measure the IVC in haemodialysis patients was examined. No articles on renal nurses using US to measure the IVC were found, however several papers have concluded that nurses can successfully use ultrasound in a variety of other clinical settings (Baumann et al ; Schoch & Smith ; Sharp et al ; Dalen et al ; Gustafsson et al ).…”

Section: Use Of Ultrasound By Nursesmentioning

confidence: 99%

“…use ultrasound in a variety of other clinical settings(Baumann et al 2008;Schoch & Smith 2012;Sharp et al 2013;Dalen et al 2014;Gustafsson et al 2014).…”

mentioning

confidence: 99%

Use of ultrasound by registered nurses—a systematic literature review

Steinwandel

Gibson

Rippey

et al. 2017

Journal of Renal Care

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Ultrasound of the inferior vena cava has the potential to assist in defining the ultrafiltration goal for that particular dialysis session, thus reducing the risk of intradialytic hypotension. Additionally, it has potential to change current renal nursing practice when added to clinical nursing assessment methods. Further studies are required to validate this assessment tool carried out by a renal nurse compared with a skilled ultrasonographer.

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What are the minimum requirements to establish proficiency in lung ultrasound training for quantifying B‐lines?

et al. 2020

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Aims The goal of this study was to determine the number of scans needed for novice learners to attain proficiency in B-line quantification compared with expert interpretation. Methods and results This was a prospective, multicentre observational study of novice learners, physicians and non-physicians from three academic institutions. Learners received a 2 h lung ultrasound (LUS) training session on B-line assessment, including lecture, video review to practice counting and hands-on patient scanning. Learners quantified B-lines using an eight-zone scanning protocol in patients with suspected acute heart failure. Ultrasound (US) machine settings were standardized to a depth of 18 cm and clip length of 6 s, and tissue harmonics and multibeam former were deactivated. For quantification, the intercostal space with the greatest number of B-lines within each zone was used for scoring. Each zone was given a score of 0-20 based on the maximum number of B-lines counted during one respiratory cycle. The B-line score was determined by multiplying the percentage of the intercostal space filled with B-lines by 20. We compared learner B-line counts with a blinded expert reviewer (five US fellowship-trained faculty with > 5 years of clinical experience) for each lung zone scanned; proficiency was defined as an intraclass correlation of > 0.7. Learning curves for each learner were constructed using cumulative sum method for statistical analysis. The Wilcoxon rank-sum test was used to compare the number of scans required to reach proficiency between different learner types. Twenty-nine learners (21 research associates, 5 residents and 3 non-US-trained emergency medicine faculty) scanned 2629 lung zones with acute pulmonary oedema. After a mean of 10.8 (standard deviation 14.0) LUS zones scanned, learners reached the predefined proficiency standard. The number of scanned zones required to reach proficiency was not significantly different between physicians and non-physicians (P = 0.26), learners with no prior US experience vs. > 25 prior patient scans (P = 0.64) and no prior vs. some prior LUS experience (P = 0.59). The overall intraclass correlation for agreement between learners and experts was 0.74 and 0.80 between experts. Conclusions Our results show that after a short, structured training, novice learners are able to achieve proficiency for quantifying B-lines on LUS after scanning 11 zones. These findings support the use of LUS for B-line quantification by non-physicians in clinical and research applications.

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Pocket-sized ultrasound examination of fluid imbalance in patients with heart failure: A pilot and feasibility study of heart failure nurses without prior experience of ultrasonography

Cited by 25 publications

References 29 publications

Can a renal nurse assess fluid status using ultrasound on the inferior vena cava? A cross‐sectional interrater study

Can a renal nurse assess fluid status using ultrasound on the inferior vena cava? A cross‐sectional interrater study

Use of ultrasound by registered nurses—a systematic literature review

What are the minimum requirements to establish proficiency in lung ultrasound training for quantifying B‐lines?

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