Concordancia de resultados ecoscópicos realizado por no cardiológico comprado con ecocardiografía. Fundación Cardioinfantil Bogotá 2013- 2016
Guerrero Chálela, Carlos
Introduction: Focused cardiac ultrasound (FCU) has been proposed as a tool that narrows the diagnostic possibilities in critically ill patients. There is limited information on echocardiographic experience, optimal time and methodology for training in FCU. METHODS: With a 4-week cardiac echo training period, one inmate, two residents of Internal Medicine and two Intensivists participated in the study. Ejection fraction (LVEF): (normal / reduced), right ventricular dysfunction: measurements of the following parameters were performed (normal / dysfunction), left atrial enlargement (yes / no) Pulmonary Hypertension (yes / No), valves: (normal / abnormal) (for each valve), pericardial effusion: (yes / no). The results were compared with echocardiograms performed by Level III Cardiologists using Kappa concordance analysis. Results: 221 studies were analyzed, obtaining the following results: moderate concordance in left systolic function (Kappa 0.541 P = 0.000) and right (Kappa: 0.403 P = 0.000). For dilation of the left atrium, a moderate concordance was found (Kappa: 0.413 P = 0.000). A moderate agreement was obtained for mitral valvulopathy (Kappa 0.466 P = 0.000) and tricuspid valve (Kappa 0.437 P = 0.000). Aortic valvulopathy showed weak agreement. Pericardial effusion has poor concordance and the presence of pulmonary hypertension has a weak agreement. CONCLUSIONS: With limited training time, using echocopy they reached a moderate agreement in most measurements when compared with conventional echocardiography performed by expert. A study that determines the ideal training time that are comparable with echocardiography is necessary.