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

Graven T, Wahba A, Hammer AM, Sagen O, Olsen Ø, Skjetne K, Kleinau JO, Dalen H - Scand. Cardiovasc. J. (2015)

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Levanger Hospital, Nord-Trøndelag Health Trust , Levanger , Norway.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

Echocardiography with pericardial effusion. A: parasternal long axis view. B: apical four-chamber view. C: subcostal view. Double arrows indicate the measure points of pericardial effusion. LV, left ventricle; RV, right ventricle; LA, left atrium; RA, right atrium.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4389761&req=5

Figure 1: Echocardiography with pericardial effusion. A: parasternal long axis view. B: apical four-chamber view. C: subcostal view. Double arrows indicate the measure points of pericardial effusion. LV, left ventricle; RV, right ventricle; LA, left atrium; RA, right atrium.

Mentions: The assessment of the pericardial cavity for PE was done by two-dimensional (2D) views. With the patient placed in a left lateral decubitus position, parasternal long and short axis and apical four-chamber views were obtained, and with the patient in a supine position a subcostal 2D four-chamber view was obtained. PE was defined to be present when a hypoechoic space was visualized between the epicardium and the pericardium. As there is no standardized measurement for the quantification of PE by 2D echocardiography, the PE, if present, was quantified as the average of measurements of the largest end-diastolic distance between epicardium and pericardium at four points (alongside the left ventricle, at the apex, the right ventricle and the right atrium) (Figure 1). The amount of PE was classified as 1) not present, 2) insignificant if the maximum dimension of each measurement was < 5 mm, 3) moderate (5–14 mm) and 4) large if maximum dimension of at least one measurement was ≥ 15 mm.


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

Graven T, Wahba A, Hammer AM, Sagen O, Olsen Ø, Skjetne K, Kleinau JO, Dalen H - Scand. Cardiovasc. J. (2015)

Echocardiography with pericardial effusion. A: parasternal long axis view. B: apical four-chamber view. C: subcostal view. Double arrows indicate the measure points of pericardial effusion. LV, left ventricle; RV, right ventricle; LA, left atrium; RA, right atrium.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4389761&req=5

Figure 1: Echocardiography with pericardial effusion. A: parasternal long axis view. B: apical four-chamber view. C: subcostal view. Double arrows indicate the measure points of pericardial effusion. LV, left ventricle; RV, right ventricle; LA, left atrium; RA, right atrium.
Mentions: The assessment of the pericardial cavity for PE was done by two-dimensional (2D) views. With the patient placed in a left lateral decubitus position, parasternal long and short axis and apical four-chamber views were obtained, and with the patient in a supine position a subcostal 2D four-chamber view was obtained. PE was defined to be present when a hypoechoic space was visualized between the epicardium and the pericardium. As there is no standardized measurement for the quantification of PE by 2D echocardiography, the PE, if present, was quantified as the average of measurements of the largest end-diastolic distance between epicardium and pericardium at four points (alongside the left ventricle, at the apex, the right ventricle and the right atrium) (Figure 1). The amount of PE was classified as 1) not present, 2) insignificant if the maximum dimension of each measurement was < 5 mm, 3) moderate (5–14 mm) and 4) large if maximum dimension of at least one measurement was ≥ 15 mm.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Levanger Hospital, Nord-Trøndelag Health Trust , Levanger , Norway.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus