Focused ultrasound of the pleural cavities and the pericardium by nurses after cardiac surgery

Scand Cardiovasc J. 2015 Feb;49(1):56-63. doi: 10.3109/14017431.2015.1009383. Epub 2015 Feb 6.

Abstract

Objectives: We aimed to study the feasibility and reliability of focused ultrasound (US) examinations to quantify pericardial (PE)- and pleural effusion (PLE) by a pocket-size imaging device (PSID) performed by nurses in patients early after cardiac surgery.

Design: After a 3-month training period, with cardiologists as supervisors, two nurses examined 59 patients (20 women) with US using a PSID at a median of 5 days after cardiac surgery. The amount of PE and PLE was classified in four categories by US (both) and chest x-ray (PLE only). Echocardiography, including US of the pleural cavities, by experienced cardiologists was used as reference.

Results: Focused US by the nurses was more sensitive than x-ray to detect PLE. The correlations of the quantification of PE and PLE by the nurses and reference was r (95% confidence interval) 0.76 (0.46-0.89) and 0.81 (0.73-0.89), both p < 0.001. PE and PLE were drained in one and six (eight cavities) patients, all classified as large amount by the nurses.

Conclusions: Cardiac nurses were able to obtain reliable measurements and quantification of both PE and PLE bedside by focused US and outperform the commonly used chest x-ray regarding PLE after cardiac surgery.

Trial registration: ClinicalTrials.gov NCT01847859.

Keywords: PSID; echocardiography; pocket-size; postoperative; training.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiac Surgical Procedures* / adverse effects
  • Echocardiography, Doppler / instrumentation
  • Echocardiography, Doppler / nursing*
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Norway
  • Pericardial Effusion / diagnostic imaging*
  • Pericardial Effusion / etiology
  • Pericardium / diagnostic imaging*
  • Pleural Cavity / diagnostic imaging*
  • Pleural Effusion / diagnostic imaging*
  • Pleural Effusion / etiology
  • Point-of-Care Systems*
  • Postoperative Care / nursing*
  • Predictive Value of Tests
  • Prospective Studies
  • Radiography
  • Reproducibility of Results
  • Time Factors
  • Treatment Outcome

Associated data

  • ClinicalTrials.gov/NCT01847859