Focused training for goal-oriented hand-held echocardiography performed by noncardiologist residents in the intensive care unit

Byline: Philippe Vignon (1,2), Anthony Dugard (1,2), Julie Abraham (1), Dominique Belcour (1), Guillaume Gondran (1), Frederic Pepino (1), Benoit Marin (4), Bruno Francois (1,2), Herve Gastinne (1,3) Keywords: Transthoracic echocardiography; Two-dimensional echocardiography; Curriculum; Intensive care Abstract: Objective We sought to evaluate the efficacy of a limited training dedicated to residents without knowledge in ultrasound for performing goal-oriented echocardiography in ICU patients. Design Prospective pilot observational study. Setting Medical-surgical ICU of a teaching hospital. Patients 61 consecutive adult ICU patients (SAPSa-II score: 38a-+-a-17 46 ventilated patients) requiring a transthoracic echocardiography were studied. Interventions After a curriculum including a 3-h training course and 5a-h of hands-on training, one of four noncardiologist residents and an intensivist experienced in ultrasound subsequently performed hand-held echocardiography (HHE), independently and in random order. Assessable 'rule in, rule out' clinical questions were purposely limited to easily identifiable conditions by the sole use of two-dimensional imaging. Measurements and results When compared with residents, the experienced intensivist performed shorter examinations (4a-+-a-1 vs. 11a-+-a-4a-min: pa- Conclusions Limited training of noncardiologist ICU residents without previous knowledge in ultrasound appears feasible and efficient to address simple clinical questions using point-of-care echography. Influence of the learning curve on diagnostic accuracy and potential therapeutic impact remain to be determined. Author Affiliation: (1) Medical-Surgical Intensive Care Unit, CHU Dupuytren, 2 Ave. Martin Luther King, 87042, Limoges Cedex, France (2) Centre de Recherche Clinique, CHU Limoges, Limoges, France (3) University of Limoges, Limoges, France (4) Unit of Clinical Research and Biostatistics, Dupuytren Teaching Hospital, 2 Ave. Martin Luther King, 87042, Limoges Cedex, France Article History: Registration Date: 22/05/2007 Received Date: 13/03/2007 Accepted Date: 16/05/2007 Online Date: 16/06/2007