| Autor: |
Hodgson LE; Anaesthetics & Intensive Care Department, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital, Worthing, UK.; Primary Care and Population Sciences, University of Southampton, Southampton General Hospital, Southampton, Hampshire, UK., Venn R; Anaesthetics & Intensive Care Department, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital, Worthing, UK., Forni LG; Intensive Care Department, The Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, UK., Samuels TL; Intensive Care Department, The Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, UK., Wakeling HG; Anaesthetics & Intensive Care Department, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital, Worthing, UK. |
| Abstrakt: |
Traditionally, assessment of the cardiac output has been limited to theatre or the intensive care unit. However, non-invasive cardiac output estimation is now readily available, and its application may have wider benefit in the emergency setting. The non-invasive ultrasonic cardiac output monitor (USCOM) was investigated to determine its learning curve and inter-rater reliability. Four trainee operators each performed stroke volume measurements on 25 volunteers, compared to an experienced operator pre- and post-passive leg raise. Inter-rater reliability was then assessed on 24 acute emergency in-patients. Mean percentage difference in stroke volume decreased from 19% (95% confidence intervals 14-23) across volunteers 1-5, to 6% (4-8) for the last 5 volunteers scanned. Consequently, on acute emergency in-patients, excellent inter-rater reliability (Lin's concordance correlation coefficient (ρ c ) 0.96 (0.92-0.98)) and agreement of a change ≥10% in stroke volume following passive leg raise on 23/24 cases were found. Following a training period of less than 5 h, USCOM stroke volume measurements demonstrated excellent inter-rater reliability. |
