Department of Medicine, Leon H. Charney Division of Cardiology, NYU Langone Medical Center, New York, NY, USA.
Echocardiography. 2021 Mar;38(3):446-449. doi: 10.1111/echo.14996. Epub 2021 Feb 15.
The coronavirus disease-2019 (COVID-19) led to a large influx of critically ill patients and altered echocardiography laboratory workflow. We developed a point-of-care ultrasound (POCUS) first approach to patients requiring echocardiography and describe our workflow and findings.
We performed a single-center retrospective analysis of all POCUS studies performed on critically ill patients with COVID-19. Sonography was performed by intensivists, uploaded and archived, and rapidly reviewed by echocardiographers. We evaluated each study based on the number of views obtained. Additionally, we provide a description of the workflow during the COVID-19 surge at a tertiary care hospital in New York City.
Fifty patients had POCUS studies performed by intensivists and reviewed by echocardiographers obviating the need for sonographer-performed studies. Of the 48 cardiac POCUS studies, 17% of patients had 4 of 4 standard views available while 53% had 3 of 4 standard views. The parasternal long-axis view was obtained on 81%, subxiphoid view on 79%, apical 4-chamber view on 71%, and parasternal short-axis view on 63% of patients.
Our POCUS workflow allowed intensivists to perform cardiac sonography for rapid bedside diagnosis of pathology with immediate interpretation performed by echocardiographers. At least 3 views were obtained in the majority of cases.
2019 年冠状病毒病(COVID-19)导致大量重症患者涌入,并改变了超声心动图实验室的工作流程。我们开发了一种即时护理超声心动图(POCUS)的方法,用于需要进行超声心动图的患者,并描述了我们的工作流程和发现。
我们对所有 COVID-19 重症患者进行的即时护理超声心动图研究进行了单中心回顾性分析。由重症监护医师进行超声检查、上传和存档,并由超声心动图医师进行快速审查。我们根据获得的视图数量评估了每个研究。此外,我们还描述了纽约市一家三级保健医院在 COVID-19 高峰期的工作流程。
50 名患者由重症监护医师进行即时护理超声心动图检查,并由超声心动图医师进行审查,从而避免了由超声技师进行的研究。在 48 例心脏即时护理超声心动图研究中,17%的患者有 4 个标准视图,53%的患者有 3 个标准视图。81%的患者获得了胸骨旁长轴视图,79%的患者获得了剑突下视图,71%的患者获得了心尖 4 腔视图,63%的患者获得了胸骨旁短轴视图。
我们的即时护理超声心动图工作流程使重症监护医师能够进行心脏超声检查,以便快速床边诊断病理学,并由超声心动图医师立即进行解释。在大多数情况下,都获得了至少 3 个视图。