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Echokardiographische Kompetenz in der herzchirurgischen Intensivmedizin

Echocardiographic competence in cardiac surgical intensive care medicine

  • Perioperative Medizin
  • Published:
Zeitschrift für Herz-,Thorax- und Gefäßchirurgie Aims and scope

Zusammenfassung

Herzchirurgisch-intensivmedizinische Echokardiographie ist ein wichtiger Baustein im therapeutischen Gesamtkonzept der herzchirurgischen Intensivstation. Sie leistet wertvolle bettseitige Diagnostik und Therapieunterstützung und kann zudem als hämodynamisches Monitoringverfahren eingesetzt werden. Die herzchirurgisch-intensivmedizinische Echokardiographie stellt dabei besondere inhaltliche Herausforderungen an den Untersucher. Diese werden in sechs fokussierten Szenarien (Hämodynamik, Herzklappen, Pulmonale Hypertonie, Füllungsdruckerhöhung, Lungenversagen und Thorax-/Aortensyndrom) dargestellt. Da eine zertifizierte Aus- und Weiterbildung nicht existiert, wird ein Curriculum für die herzchirurgisch-intensivmedizinische Echokardiographie mit Supervision vorgestellt. Dabei wird deutlich, dass die spezialisierten Inhalte der fokussierten Szenarien sich sowohl von den aktuellen Bestrebungen der minimalistischen echokardiographischen Ausbildung für Intensivmediziner, als auch von den Anforderungen für Kardiologen unterscheiden. Die Integration der zertifizierten echokardiographischen Ausbildung in das herzchirurgisch-intensivmedizinische Weiterbildungscurriculum sollte erfolgen.

Abstract

Cardiac surgical intensive care echocardiography is an integral part of the therapeutic concept in the cardiac surgical intensive care unit. Bedside diagnostics and therapeutic support are highly facilitated; in addition, echocardiography can be used as a hemodynamic monitoring tool. In cardiac surgical echocardiography, examiners are faced with particular challenges. These are presented in the paper using six scenarios (i.e., hemodynamic assessment, heart valves, pulmonary hypertension, elevated filling pressures, lung injury, and thoracic syndromes). In the absence of certified teaching or training, a curriculum is presented for cardiac surgical intensive care echocardiography, including supervision. It becomes evident that the specialized contents of the focused scenarios differ from both the present attempts to train intensive care physicians using minimalistic curricula and from the classical cardiologic training program. It is now time to integrate certified echocardiography training into the cardiac surgical intensive care curriculum.

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Literatur

  1. Carl M, Alms A, Braun J et al (2010) S3 guidelines for intensive care in cardiac surgery patients: hemodynamic monitoring and cardiocirculary system. Ger Med Sci 8 (Doc 12)

  2. Cholley BP, Vieillard-Baron A, Mebazaa A (2005) Echocardiography in the ICU: time for widespread use! Intensive Care Med 32:9–10

    Article  PubMed  Google Scholar 

  3. Mayo PH, Beaulieu Y, Doelken P et al (2009) American College of Chest Physicians/La Société de Réanimation de Langue Française statement on competence in critical care ultrasonography. Chest 135:1050–1060

    Article  PubMed  Google Scholar 

  4. Expert Round Table on Ultrasound in ICU (2011) International expert statement on training standards for critical care ultrasonography. Intensive Care Med 37:1077–1083

    Article  Google Scholar 

  5. Popescu BA, Andrade MJ, Badano LP et al (2009) European Association of Echocardiography recommendations for training, competence and quality improvement in echocardiography. Eur J Echocardiogr 10:893–905

    Article  PubMed  Google Scholar 

  6. Boksch W, Fateh-Moghadam (2007) Echokardiographie auf der Intensivstation. Kardiochirurgische Intensivstation. In: Flachskampf FA (Hrsg) Praxis der Echokardiographie, 2. Aufl. Georg Thieme, Stuttgart, S 530

  7. Armstrong WF, Ryan T (2010) (Hrsg) Feigenbaum’s Echocardiography. ICU and operative/perioperative applications 7. Aufl. Lippincott Williams & Wilkins, Philadelphia, S 667–710

  8. Jardin F, Dubourg O, Bourdarias JP (1997) Echocardiographic pattern of acute cor pulmonale. Chest 111:209–217

    Article  PubMed  CAS  Google Scholar 

  9. Albers J, Ister D, Kayhan N, Vahl CF (2011) Postoperative non-invasive assessment of pulmonary vascular resistance using doppler echocardiography. Interact Cardiovasc Thorac Surg 13(6):584. doi 10.1510/icvts.2011.271619A

    Article  Google Scholar 

  10. European Study Group on Diastolic Heart Failure (1998) How to diagnose diastolic heart failure. Eur Heart J 19:990–1003

    Article  Google Scholar 

  11. Pinsky MR, Payen D (2005) Functional hemodynamic monitoring. Crit Care 9:566–572

    Article  PubMed  Google Scholar 

  12. Weigang E, Nienaber CA, Rehders TC et al (2008) Management von Patienten mit Aortendissektion. Dtsch Arztebl 105:639–645

    Google Scholar 

  13. Manasia AR, Nagaraj HM, Kodali RB et al (2005) Feasibility and potential clinical utility of goal-directed transthoracic echocardiography performed by noncardiologist intensivists using a small hand-carried device (SonoHeart) in critically ill patients. J Cardiothorac Vasc Anesth 19:155–159

    Article  PubMed  Google Scholar 

  14. Vignon P, Dugard A, Abraham J et al (2007) Focused training for goal-oriented hand-held echocardiography performed by noncardiologist residents in the intensive care unit. Intensive Care Med 33:1795–1799

    Article  PubMed  Google Scholar 

  15. Vignon P, Cholley BP, DeBacker D et al (2011) Learning and competence in critical care echocardiography. In: DeBacker D, Cholley BP, Slama M, Vieillard-Baron, Vignon P (Hrsg) Hemodynamic monitoring using echocardiography in the critically ill. Springer, Heidelberg, S 275–281. DOI 10.1007/978-3-540-87956-5

  16. Ryan T, Armstrong WF, Khandheria BK (2008) Task force 4: training in echocardiography endorsed by the American Society of Echocardiography. J Am Coll Cardiol 51:361–367

    Article  PubMed  Google Scholar 

  17. Quinones MA, Douglas PS, Foster E et al (2003) ACC/AHA clinical competence statement on echocardiography: a report of the American College of Cardiology/American Heart Association/American College of Physicians-American Society of Internal Medicine task force on clinical competence. J Am Coll Cardiol 41:687–708

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Sektion Intensivmedizin, Klinik und Poliklinik für Herz-, Thorax- und Gefäßchirurgie, Universitätsmedizin Johannes-Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland

    J. Albers, H. Taspinar, A.L. Poetini, D. Ister & C.F. Vahl

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  1. J. Albers
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  2. H. Taspinar
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  3. A.L. Poetini
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  4. D. Ister
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  5. C.F. Vahl
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Correspondence to J. Albers.

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Albers, J., Taspinar, H., Poetini, A. et al. Echokardiographische Kompetenz in der herzchirurgischen Intensivmedizin. Z Herz- Thorax- Gefäßchir 26, 113–122 (2012). https://doi.org/10.1007/s00398-011-0892-4

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  • DOI: https://doi.org/10.1007/s00398-011-0892-4

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