Intensive Care Unit Syndrome Clinical Trial
Official title:
Detection of the Incidence of Intensively Medically Relevant Pre-existing Cardio-pulmonary Diseases by Using of Focused Echocardiography Upon Admission to the Intensive Care Unit
Introduction: The uncomplicated and focused transthoracic cardiac ultrasound examination,
which is gentle for the patient, gives the doctor in a short time a lot of information about
possible, as unrecognized pathologies of the organs of the chest.
Before a patient undergoes a planned procedure or intervention with a subsequent intensive
stay, examinations are necessary from which the anesthetist/intensive physician has important
information the state of health of the patient. The findings and the information will be used
to plan the individual anesthesia procedures and intensive medical management, which is
suitable for the patient.
The aim of this work is to investigate whether the use of a modified examination protocol in
patients who need to be admitted to an intensive care unit has an influence on the actions of
the intensive care physician. Does the information that is collected from the findings have a
complementary influence in the planning of intensive care management? The Study objectives
Primary objectives:
What is the frequency with which pathological changes are detected?
Secondary objectives:
Do the additional findings have an influence on the intensive care procedure?
At the end of the 1980s, a protocol for transthoracic cardiac ultrasound examination was
established in order to get a quick overview of the structure and function of a patient's
heart. Under the abbreviation "FATE" (focus assessed transthoracic echocardiography), it was
"FAST"(focused assessment with sonography for trauma) when it was analogous to the ultrasound
examination in traumatized patients, became an important component in the care of the acutely
ill patients ( Walcher.F et al,2009).
The uncomplicated and focused transthoracic cardiac ultrasound examination, which is gentle
for the patient, gives the doctor in a short time a lot of information about possible, as
unrecognized pathologies of the organs of the chest.
In 2014, M.T. Bétker et al. published a study on the preoperative transthoracic sonography of
the heart. Pathologies were detected in 27 percent of the patients included in the study,
that could have a possible influence on the anesthesiological and intensive medical care
procedures (Bøtker, M.T et al,2014).
The aim of this work is to investigate whether the use of a modified examination protocol in
patients who need to be admitted to an intensive care unit has an influence on the actions of
the intensive care physician. Does the information that is collected from the findings have a
complementary influence in the planning of intensive care management? Before a patient
undergoes a planned procedure or intervention with a subsequent intensive stay, examinations
are necessary from which the anesthetist/intensive physician has important information the
state of health of the patient. The findings and the information will be used to plan the
individual anesthesia procedures and intensive medical management, which is suitable for the
patient.
The examination takes place as part of the premedication visit. In addition to the history
and the physical examination, the evaluation of already carried out examinations takes place
here. Potential risks and complications are also discussed if the patient desires.
This evaluation helps to reduce the perioperative and interventional risks for the patient.
particularly the detection of the cardiopulmonary capacity of the patient. Various technical
studies can help to diagnose diseases of the heart, lungs and vascular system or to record
the course of a known disorder (Anästh. Intensivmed (51) ,2010).
In addition to laboratory examinations, the electrocardiogram, the X-ray examination of the
organs of the thorax, the blood vessel sonography, echocardiography is available.
The most common indications of echocardiography are the assessment of left and right
ventricular pumping function and the exclusion of cardiac defects and shunt in patients with
signs of heart failure or pathological auscultation findings.
These findings will be analyzed latest the day before a planned operation or intervention
during the premedication visits and discussed with the patient in order to develop a
patient-specific procedure and regimen.
This possibility exists for urgent interventions or interventions that which must be carried
out on the same day, only conditionally and not for all planned admissions in the intensive
care unit. Completeness of anesthetic and intensive medical findings about a statement the
cardiopulmonary function is not always to be expected. In favor of rapid therapy, this must
usually be dispensed with in a patient-individual risk-benefit-assessment.
The purpose of this study is to help answer the question whether the routine use of focused
transthoracic echocardiography in unplanned admission to the Intensive Care Unit is a useful
additional measure for the anesthesiologist and intensive physician in order to provide the
patient with more safety?
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