The use of computerized echocardiographic simulation improves the learning curve for transesophageal hemodynamic assessment in critically ill patients
Identifieur interne : 000039 ( Main/Exploration ); précédent : 000038; suivant : 000040The use of computerized echocardiographic simulation improves the learning curve for transesophageal hemodynamic assessment in critically ill patients
Auteurs : Gwénaël Prat [France] ; Cyril Charron [France] ; Xavier Repesse [France] ; Pierre Coriat [France] ; Pierre Bailly [France] ; Erwan L Er [France] ; Antoine Vieillard-Baron [France]Source :
- Annals of Intensive Care [ 2110-5820 ] ; 2016.
Abstract
Our aim was to evaluate the impact of a computerized echocardiographic simulator on the learning curve for transesophageal echocardiography (TEE) hemodynamic assessment of ventilated patients in the ICU.
We performed a prospective study in two university hospital medical ICUs. Using our previously validated skill assessment scoring system (/40 points), we compared learning curves obtained with (interventional group,
Competency was achieved after an average of 32.5 ± 10 supervised studies in the control group compared with only 13.6 ± 8.5 in the interventional group (
Inclusion of echocardiographic simulator sessions in a standardized curriculum may improve the learning curve for hemodynamic evaluation of ventilated ICU patients.
The online version of this article (doi:10.1186/s13613-016-0132-x) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s13613-016-0132-x
PubMed: 27055668
PubMed Central: 4824699
Affiliations:
- France
- Région Bretagne, Île-de-France
- Boulogne-Billancourt, Brest, Paris, Rennes, Villejuif
- Université de Bretagne Occidentale
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first="Gwénaël" last="Prat">Gwénaël Prat</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Medical Intensive Care Unit, University Hospital of Brest, Cavale Blanche, 29609 Brest Cedex, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Medical Intensive Care Unit, University Hospital of Brest, Cavale Blanche, 29609 Brest Cedex</wicri:regionArea><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Brest</settlement></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff2">Centre de Simulation en Santé, Université de Bretagne Occidentale, Brest, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Centre de Simulation en Santé, Université de Bretagne Occidentale, Brest</wicri:regionArea><placeName><settlement type="city">Brest</settlement></placeName><orgName type="university">Université de Bretagne Occidentale</orgName><placeName><settlement type="city">Brest</settlement><region type="region" nuts="2">Région Bretagne</region></placeName></affiliation></author><author><name sortKey="Charron, Cyril" sort="Charron, Cyril" uniqKey="Charron C" first="Cyril" last="Charron">Cyril Charron</name><affiliation wicri:level="3"><nlm:aff id="Aff3">Intensive Care Unit, Section Thorax-Vascular Disease-Abdomen-Metabolism, Assistance Publique-Hôpitaux de Paris, University Hospital Ambroise Pare, 9, Avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Intensive Care Unit, Section Thorax-Vascular Disease-Abdomen-Metabolism, Assistance Publique-Hôpitaux de Paris, University Hospital Ambroise Pare, 9, Avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Boulogne-Billancourt</settlement></placeName></affiliation></author><author><name sortKey="Repesse, Xavier" sort="Repesse, Xavier" uniqKey="Repesse X" first="Xavier" last="Repesse">Xavier Repesse</name><affiliation wicri:level="3"><nlm:aff id="Aff3">Intensive Care Unit, Section Thorax-Vascular Disease-Abdomen-Metabolism, Assistance Publique-Hôpitaux de Paris, University Hospital Ambroise Pare, 9, Avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Intensive Care Unit, Section Thorax-Vascular Disease-Abdomen-Metabolism, Assistance Publique-Hôpitaux de Paris, University Hospital Ambroise Pare, 9, Avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Boulogne-Billancourt</settlement></placeName></affiliation></author><author><name sortKey="Coriat, Pierre" sort="Coriat, Pierre" uniqKey="Coriat P" first="Pierre" last="Coriat">Pierre Coriat</name><affiliation wicri:level="1"><nlm:aff id="Aff4">Hospital Pitié-Salpêtrière, Department of Anesthesiology and Critical Care, Assistance Publique-Hôpitaux de Paris, University Pierre et Marie-Curie-Paris 6, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Hospital Pitié-Salpêtrière, Department of Anesthesiology and Critical Care, Assistance Publique-Hôpitaux de Paris, University Pierre et Marie-Curie-Paris 6, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Bailly, Pierre" sort="Bailly, Pierre" uniqKey="Bailly P" first="Pierre" last="Bailly">Pierre Bailly</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Medical Intensive Care Unit, University Hospital of Brest, Cavale Blanche, 29609 Brest Cedex, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Medical Intensive Care Unit, University Hospital of Brest, Cavale Blanche, 29609 Brest Cedex</wicri:regionArea><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Brest</settlement></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff2">Centre de Simulation en Santé, Université de Bretagne Occidentale, Brest, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Centre de Simulation en Santé, Université de Bretagne Occidentale, Brest</wicri:regionArea><placeName><settlement type="city">Brest</settlement></placeName><orgName type="university">Université de Bretagne Occidentale</orgName><placeName><settlement type="city">Brest</settlement><region type="region" nuts="2">Région Bretagne</region></placeName></affiliation></author><author><name sortKey="L Er, Erwan" sort="L Er, Erwan" uniqKey="L Er E" first="Erwan" last="L Er">Erwan L Er</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Medical Intensive Care Unit, University Hospital of Brest, Cavale Blanche, 29609 Brest Cedex, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Medical Intensive Care Unit, University Hospital of Brest, Cavale Blanche, 29609 Brest Cedex</wicri:regionArea><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Brest</settlement></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff5">LATIM INSERM UMR 1101, Université de Bretagne Occidentale, Brest, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>LATIM INSERM UMR 1101, Université de Bretagne Occidentale, Brest</wicri:regionArea><placeName><settlement type="city">Brest</settlement></placeName><orgName type="university">Université de Bretagne Occidentale</orgName><placeName><settlement type="city">Brest</settlement><region type="region" nuts="2">Région Bretagne</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff6">FHU TechSan, Université de Bretagne Occidentale/Université de Rennes, Rennes, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>FHU TechSan, Université de Bretagne Occidentale/Université de Rennes, Rennes</wicri:regionArea><placeName><settlement type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Vieillard Baron, Antoine" sort="Vieillard Baron, Antoine" uniqKey="Vieillard Baron A" first="Antoine" last="Vieillard-Baron">Antoine Vieillard-Baron</name><affiliation wicri:level="3"><nlm:aff id="Aff3">Intensive Care Unit, Section Thorax-Vascular Disease-Abdomen-Metabolism, Assistance Publique-Hôpitaux de Paris, University Hospital Ambroise Pare, 9, Avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Intensive Care Unit, Section Thorax-Vascular Disease-Abdomen-Metabolism, Assistance Publique-Hôpitaux de Paris, University Hospital Ambroise Pare, 9, Avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Boulogne-Billancourt</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff7">INSERM U-1018, CESP, Team 5 (EpReC, Renal and Cardiovascular Epidemiology), UVSQ, 94807 Villejuif, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>INSERM U-1018, CESP, Team 5 (EpReC, Renal and Cardiovascular Epidemiology), UVSQ, 94807 Villejuif</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Villejuif</settlement></placeName></affiliation></author></analytic><series><title level="j">Annals of Intensive Care</title><idno type="eISSN">2110-5820</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Our aim was to evaluate the impact of a computerized echocardiographic simulator on the learning curve for transesophageal echocardiography (TEE) hemodynamic assessment of ventilated patients in the ICU.</p></sec><sec><title>Methods</title><p>We performed a prospective study in two university hospital medical ICUs. Using our previously validated skill assessment scoring system (/40 points), we compared learning curves obtained with (interventional group, <italic>n</italic> = 25 trainees) and without (control group, <italic>n</italic> = 31 trainees) use of a simulator in the training. Three evaluations were performed after 1 (M1), 3 (M3) and 6 months (M6) while performing two TEE examinations graded by an expert. Competency was defined as a score >35/40.</p></sec><sec><title>Results</title><p>Competency was achieved after an average of 32.5 ± 10 supervised studies in the control group compared with only 13.6 ± 8.5 in the interventional group (<italic>p</italic> < 0.0001). At M6, a significant between-group difference in number of supervised TEE was observed (17 [14–28] in the control group vs. 30.5 [21.5–39.5] in the interventional group, <italic>p</italic> = 0.001). The score was significantly higher in the interventional group at M1 (32.5 [29.25–35.5] vs. 24.75 [20–30.25]; <italic>p</italic> = 0.0001), M3 (37 [33.5–38.5] vs. 32 [30.37–34.5]; <italic>p</italic> = 0.0004), but not at M6 (37.5 [33–39] vs. 36 [33.5–37.5] <italic>p</italic> = 0.24).</p></sec><sec><title>Conclusion</title><p>Inclusion of echocardiographic simulator sessions in a standardized curriculum may improve the learning curve for hemodynamic evaluation of ventilated ICU patients.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s13613-016-0132-x) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Rosen, Kr" uniqKey="Rosen K">KR Rosen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Good, Ml" uniqKey="Good M">ML 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last="Repesse">Xavier Repesse</name><name sortKey="Vieillard Baron, Antoine" sort="Vieillard Baron, Antoine" uniqKey="Vieillard Baron A" first="Antoine" last="Vieillard-Baron">Antoine Vieillard-Baron</name><name sortKey="Vieillard Baron, Antoine" sort="Vieillard Baron, Antoine" uniqKey="Vieillard Baron A" first="Antoine" last="Vieillard-Baron">Antoine Vieillard-Baron</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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