Feasibility of Focused Cardiac Ultrasound Performed by Trainees During Cesarean Delivery
Authors' conclusion
FCU is feasible in the parturient undergoing CD and images of sufficient quality for clinical decision-making were obtained by trainees with limited experience in almost all parturients.
Study context
- Population
- Healthy term parturients (ASA ≤ 3, ≥37 weeks, singleton, body mass index (BMI) <40 kg/m 2, no cardiac disease) undergoing scheduled elective cesarean delivery (CD); Focused cardiac ultrasound (FCU) by 8 trainees with limited experience95 screened
- Participants
- 64 participants
- Exposure
- After spinal anesthesia (SPA) vs After neonatal delivery (ND)
- Outcome
- FCU images of sufficient quality for clinical decision-making (grade ≥3 on 1–5 scale)
Methodological detailsblinded image grading, Each trainee performed a median of 5 [3-8] FCUs, Standardised training: 8-hour online E-learning, 1-day hands-on course, 20 to 30 supervised scans
- Blinded image grading
- Each trainee performed a median of 5 [3-8] FCUs
- Standardised training: 8-hour online E-learning, 1-day hands-on course, 20 to 30 supervised scans
Main finding
As reported in the abstract
Images of sufficient quality
Observational data: associations, not effects.
Further findings
Perfect image quality
Left ventricular function assessable
Right ventricular function assessable
| Outcome | After SPA | After ND |
|---|---|---|
| Grade ≥3 by view (PLAX, PSAX, A4CH) | ||
| PLAX | 53 (82.8 %) | 50 (78.1 %) |
| PSAX | 58 (90.6 %) | 49 (76.6 %) |
| A4CH | 40 (62.5 %) | 29 (45.3 %) |
- Left ventricular function assessable: of 40 women
- Right ventricular function assessable: of 40 women
Image grading between trainees, A4CH view
- Difference in image grading between trainees
- P = 0.0001
Image grading preoperative vs intraoperative
- No difference between preoperative and intraoperative FCUs
Original publication
Feasibility of Focused Cardiac Ultrasound Performed by Trainees During Cesarean Delivery. Anesth Analg. Published 15 July 2024. doi:10.
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