The Open Critical Care Medicine Journal




(Discontinued)

ISSN: 1874-8287 ― Volume 7, 2014

Hemodynamic Comparison Between Right Heart Catheterization and Transthoracic Echocardiography in the Critically Ill Patients: A Prospective Study


The Open Critical Care Medicine Journal, 2012, 5: 1-8

Hassan Khouli, Edward Eden, Peter Homel, Mark V. Sherrid

Section of Critical Care, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, 1000 10th Avenue, New York, NY 10019, USA.

Electronic publication date 23/5/2012
[DOI: 10.2174/1874828701005010001]

CrossRef Citations:
0


Article Metrics:

Geographical View
Total Statistics:

Abstract HTML Views: 160
PDF Downloads: 77
Total Views/Downloads: 237

Unique Statistics:

Abstract HTML Views: 128
PDF Downloads: 65
Total Views/Downloads: 193


Abstract:

Background:

Tranthoracic echocardiography (TTE) is increasingly utilized in the management of critically ill patients in whom right heart catheterization (RHC) was frequently used in the past. We tested the hypothesis that bedside TTE can substitute for RHC for determining the etiology of cardiopulmonary compromise in critically ill patients when initial clinical assessment is limited.

Methods:

We prospectively enrolled 51 patients from medical and surgical Intensive Care Units with unknown etiology of cardiopulmonary compromise. Patients underwent assessment of their cardiopulmonary compromise by RHC and TTE. A final clinical assessment, considered the gold standard was adjudicated by the intensivist caring for the patient.

Results:

There was complete agreement between TTE data and RHC data in determining the etiology of cardiopulmonary compromise as cardiac or non-cardiac in 46 (90%) of the 51 patients. The kappa statistic for the agreement between TTE data and gold standard in determining the etiology of cardiopulmonary compromise as cardiac or non-cardiac was 0.90 (95% confidence interval [CI], 0.73 to 0.98; p<0.001). The kappa statistic for the agreement between RHC data and gold standard was 0.84 (95% confidence interval [CI], 0.63 to 0.95; p < 0.001). Based on the results of the gold standard assessment, the positive predictive value and negative predictive value for TTE data determining the etiology of cardiopulmonary compromise were 93% and 97% respectively. The positive predictive value and negative predictive value for RHC data determining the etiology of cardiopulmonary compromise were 100% and 92% respectively. TTE was highly suggestive of pulmonary embolism and cardiac tamponade in three patients where RHC was not.

Conclusion:

In this era where transthoracic echocardiography is increasingly utilized to manage critically ill patients with cardiopulmonary compromise, we found transthoracic echocardiography to be a useful diagnostic tool in determining the etiology of cardiopulmonary compromise when initial clinical assessment is limited. While both methods can be complementary to each other, bedside transthoracic echocardiography is an acceptable non-invasive alternative to right heart catheterization in determining the etiology of cardiopulmonary compromise in most critically ill patients when initial clinical assessment is limited.


Download PDF

Endorsements



"Open access will revolutionize 21st century knowledge work and accelerate the diffusion of ideas and evidence that support just in time learning and the evolution of thinking in a number of disciplines."


Daniel Pesut
(Indiana University School of Nursing, USA)

"It is important that students and researchers from all over the world can have easy access to relevant, high-standard and timely scientific information. This is exactly what Open Access Journals provide and this is the reason why I support this endeavor."


Jacques Descotes
(Centre Antipoison-Centre de Pharmacovigilance, France)

"Publishing research articles is the key for future scientific progress. Open Access publishing is therefore of utmost importance for wider dissemination of information, and will help serving the best interest of the scientific community."


Patrice Talaga
(UCB S.A., Belgium)

"Open access journals are a novel concept in the medical literature. They offer accessible information to a wide variety of individuals, including physicians, medical students, clinical investigators, and the general public. They are an outstanding source of medical and scientific information."


Jeffrey M. Weinberg
(St. Luke's-Roosevelt Hospital Center, USA)

"Open access journals are extremely useful for graduate students, investigators and all other interested persons to read important scientific articles and subscribe scientific journals. Indeed, the research articles span a wide range of area and of high quality. This is specially a must for researchers belonging to institutions with limited library facility and funding to subscribe scientific journals."


Debomoy K. Lahiri
(Indiana University School of Medicine, USA)

"Open access journals represent a major break-through in publishing. They provide easy access to the latest research on a wide variety of issues. Relevant and timely articles are made available in a fraction of the time taken by more conventional publishers. Articles are of uniformly high quality and written by the world's leading authorities."


Robert Looney
(Naval Postgraduate School, USA)

"Open access journals have transformed the way scientific data is published and disseminated: particularly, whilst ensuring a high quality standard and transparency in the editorial process, they have increased the access to the scientific literature by those researchers that have limited library support or that are working on small budgets."


Richard Reithinger
(Westat, USA)

"Not only do open access journals greatly improve the access to high quality information for scientists in the developing world, it also provides extra exposure for our papers."


J. Ferwerda
(University of Oxford, UK)

"Open Access 'Chemistry' Journals allow the dissemination of knowledge at your finger tips without paying for the scientific content."


Sean L. Kitson
(Almac Sciences, Northern Ireland)

"In principle, all scientific journals should have open access, as should be science itself. Open access journals are very helpful for students, researchers and the general public including people from institutions which do not have library or cannot afford to subscribe scientific journals. The articles are high standard and cover a wide area."


Hubert Wolterbeek
(Delft University of Technology, The Netherlands)

"The widest possible diffusion of information is critical for the advancement of science. In this perspective, open access journals are instrumental in fostering researches and achievements."


Alessandro Laviano
(Sapienza - University of Rome, Italy)

"Open access journals are very useful for all scientists as they can have quick information in the different fields of science."


Philippe Hernigou
(Paris University, France)

"There are many scientists who can not afford the rather expensive subscriptions to scientific journals. Open access journals offer a good alternative for free access to good quality scientific information."


Fidel Toldrá
(Instituto de Agroquimica y Tecnologia de Alimentos, Spain)

"Open access journals have become a fundamental tool for students, researchers, patients and the general public. Many people from institutions which do not have library or cannot afford to subscribe scientific journals benefit of them on a daily basis. The articles are among the best and cover most scientific areas."


M. Bendandi
(University Clinic of Navarre, Spain)

"These journals provide researchers with a platform for rapid, open access scientific communication. The articles are of high quality and broad scope."


Peter Chiba
(University of Vienna, Austria)

"Open access journals are probably one of the most important contributions to promote and diffuse science worldwide."


Jaime Sampaio
(University of Trás-os-Montes e Alto Douro, Portugal)

"Open access journals make up a new and rather revolutionary way to scientific publication. This option opens several quite interesting possibilities to disseminate openly and freely new knowledge and even to facilitate interpersonal communication among scientists."


Eduardo A. Castro
(INIFTA, Argentina)

"Open access journals are freely available online throughout the world, for you to read, download, copy, distribute, and use. The articles published in the open access journals are high quality and cover a wide range of fields."


Kenji Hashimoto
(Chiba University, Japan)

"Open Access journals offer an innovative and efficient way of publication for academics and professionals in a wide range of disciplines. The papers published are of high quality after rigorous peer review and they are Indexed in: major international databases. I read Open Access journals to keep abreast of the recent development in my field of study."


Daniel Shek
(Chinese University of Hong Kong, Hong Kong)

"It is a modern trend for publishers to establish open access journals. Researchers, faculty members, and students will be greatly benefited by the new journals of Bentham Science Publishers Ltd. in this category."


Jih Ru Hwu
(National Central University, Taiwan)


Browse Contents



Webmaster Contact: info@benthamopen.net
Copyright © 2019 Bentham Open