Wednesday February 8, 2006
EARLY GOAL-DIRECTED ECHOCARDIOGRAPHY !
Dr. Anthony Manasia and Coll. from Mount Sinai School of Medicine, New York, NY, have introduced this term in one of their paper presented at American College of Chest Physicians (ACCP) meeting last year at Montreal, Canada. Based on their study of 18 patients, they claim that the first echo (done within 5-6 hours of admission) changed the treatment plan in 38.8% (7/18) of the circulatory shock patients when compared to the initial management instituted by the primary ICU team. The treatment plan was changed in 11.7% (2/17) of patients following the second echo exam (done 24 hours later). The echocardiographic exam was performed by an echo-trained intensivist not involved in the patient’s care. But similar kind of retrospective observational study of 100 patients in medical ICU, 2 years back from Mayo Clinic, Rochester, MN failed to show any impressive result but to note time-period of echo was within 48 hours.
Does ultra early echo in shock patients really make difference in 38.8% of patients ?. May be its time for a bigger study.
References: Click to get article/abstract: (appears in popup window and second popup overwrites first popup).
1. CLINICAL IMPACT OF EARLY GOAL-DIRECTED ECHOCARDIOGRAPHY IN SHOCK PATIENTS PERFORMED BY NON-CARDIOLOGIST INTENSIVISTS - chest, 2005
2. Echo in the Medical Intensive Care Unit: Does It Really Impact Patient Management? A Retrospective Observational Study - chest, 2003