Affiliations: [a] Department of Anaesthesia and Intensive Care Medicine, Philipps-University of Marburg, Marburg, Germany | [b] Department of Anesthesia and Intensive Care Medicine, Clinique Bénigne Joly, Talant, France | [c] Department of Anaesthesia, Intensive Care Medicin and Pain Therapy, Unfallkrankenhaus, Berlin, Germany | [d] Department of Cardiology and Medecine, Sportklinik Bad Nauheim, Bad Nauheim, Germany | [e] Institute of Medical Biometry and Epidemiology, Philipps-University of Marburg, Bunsenstr, Marburg, Germany | [f] Department of Orthopedics and Rheumatology, University Hospital Marburg, Marburg, Germany
Correspondence:
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Corresponding author: T. Kratz, Department of Anaesthesia and Intensive Care Medicine, Clinique Bénigne Joly, 4 Allée Roger Renard, F-21240 Talant, France. Tel.: +33 645477425; Fax: +33 380583698; E-mail:thkratz21@gmail.com
Abstract: BACKGROUND: The intraoperative application of focused transthoracic echocardiography (TTE) is often considered to be restricted. Echocardiography with pocket-sized hand held ultrasound systems has been shown to be feasible in various settings. OBJECTIVE: The aim of this study was to investigate the feasibility of the
intraoperative application of pocket-sized echocardiography and the
comparison of its imaging quality and diagnostic reliability and variability
with a standard ultrasound system. METHODS: After written informed consent, TTE was performed on 40 anaesthetised
general, vascular, visceral, thoracic surgical and orthopaedic patients
according to the FATE protocol: first, with a pocket-sized and second, with
a high-end ultrasound system randomly by two anaesthetists. Imaging quality
of four basic and three additional FATE views was rated on an established
scale from 1 (impossible) to 5 (perfect). Successful TTE was defined, if one
basic FATE views would be rated as grade 4 or 5 or alternatively two views
as grade 3. Pathologic findings by both ultrasound devices were documented
and imaging quality and pathologic findings were compared. RESULTS: All 40 patients presented acceptable imaging quality, resulting in a success
rate of 1.0 (97.5%-CI 0.91-1, p= 0.015). The individual imaging ratings
of each view were significantly lower with the pocket-sized system, but
still showed acceptable imaging quality.
With the high-end device more pathologic findings were detected (107 vs.
87), but none of the relevant or severe pathologies were overseen with the
hand-held device. CONCLUSION: The application of a pocket-sized echocardiography device for focused
intraoperative TTE is feasible and can appropriate be used for the initial
evaluation of relevant pathologies in the operating theatre.
Keywords: Focused TTE, intraoperative echocardiography, pocket-sized echocardiography device, hand held echocardiography
