Validation of an echochardiography training program for intensivists

Introduction

The use of echocardiogram performed by intensivists, as a modality of hemodynamic monitoring, is becoming increasingly frequent in ICUs worldwide. Several training programs and curriculums have been proposed to avoid the misuse and misinterpretation of this tool. However, until now, there have been few reports validating this type of training. The aim of the present study is to compare these measurements in order to evaluate the efficacy of our institutional training program.

Methods

In our institution, we have performed a 140-hour bedside echocardiography training (plus 10-hour theoretical classes) for seven intensivists. At the end of the training period, the intensivists and the teachers (experienced level III echocardiographists) registered echocardiography-derived hemodynamic variables of the same patient a few minutes apart.

Results

We have obtained 46 paired measurements. The velocity–time integral of ventricular outflow tract showed a Pearson correlation coefficient = 0.860 (P < 0.01), a bias of 1.19 cm and a mean error of 29% between paired measurements. The systolic volume classification (between low or normal and high) resulted in a kappa coefficient of 0.696 (± 0.105). Myocardial contractility resulted in a kappa coefficient of 0.823 (± 0.121).

Conclusion

Our study demonstrates that our training program was efficient. Hemodynamic-focused echocardiography can be accurately performed by intensivists after attendance of this training program.