1) Have serial measurements of ejection fraction during an admission been conducted?
2) Does it have any potential clinical benefits?
Ejection fraction is very poor predictor of cardiac performance especially in acute situations. You should narrow patient population (dimentions, volumes, age, mi, valve pathologies, inotrops, sepsis...) and keep in mind that ef calculation has intraobserval bias up to 13% - do you really want to use this parameter alone in icu patients?
Dear Konstantin.
Thank you for your answer. No, I would initially not use in in my trial (I am using other measurement with ultrasound of the lungs and IVC) but I was just interested in if serial EF could add some clinical/prognostic information.
as was estimated earlier, EF has poor correlation with cardiac output as proved marker of cardiac performance, so for my opinion, ef is not a goal parameter in acute settings, but I was wonder if you prove some influence on prognosis, so try it! All the best
You could use serial measurements of aortic VTI ( related to ventricular output)
Easy to perform, related to systolic output, but no need to calculate it really
simple measure of VTI in LVOT
Dear Carlo.
Thank you for your input. I am "only" using focused cardiac ultrasound in my project, and VTI is not a part of that protocol.
Carlo, as far as recomendations says, any calculations (and EF) should not be a part of focus cardiac ultrasound, so your protocol is part of limited echo protocol, so put there one more parameter. Best wishes
I feel visual gestault or eyeballing for EF repeatedly before anf after any intervention makes a huge difference inthe world of “less is more”
Dear Santosh.
Thank you for your answer. Could you please elaborate "hugh difference"? It which clinical scenarios do you use serial assessment of EF? Shock, sepsis? Does it interfere with how you treat the patient if the EF changes?
Ejection fraction is a preload and afterload dependant measure of cardiac function and these changes could effect EF irrespective of cardiac function on serial measurements in acute setting
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