Bridging the gap: Hybrid cardiac echo in the critically ill.

Area of Science:

• Point-of-care ultrasound
• Cardiac imaging
• Critical care medicine

Background:

• Point-of-care ultrasound (POCUS) is vital for critically ill patients but often lacks the quantitative detail of transthoracic echocardiography (TTE).
• The Focused Rapid Echocardiographic Examination (FREE) was developed as a hybrid POCUS tool emphasizing cardiac function over detailed anatomy.
• FREE aims to provide actionable clinical data comparable to TTE.

Purpose of the Study:

• To evaluate the correlation between quantitative measurements obtained from FREE and standard TTE.
• To determine if FREE provides clinically useful information for decision-making in critically ill patients.

Main Methods:

• A cohort of patients who underwent both FREE and TTE on the same day was identified.
• Quantitative cardiac function parameters, including ejection fraction, diastolic function, and right ventricular function, were measured using both FREE and TTE.
• Correlation analyses were performed to compare measurements between the two echocardiographic modalities.

Main Results:

• FREE demonstrated strong correlations with TTE for ejection fraction (r=0.89) and other key parameters like left ventricular internal dimension end diastole (r=0.94).
• Right ventricular function agreement was observed in 82% of patients, and pericardial effusion detection showed 94% concordance.
• FREE effectively assessed cardiac function without missing significant valvular anatomy.

Conclusions:

• The FREE examination provides a functional cardiac assessment that strongly correlates with TTE measurements.
• FREE offers significant clinical value for critically ill patients, particularly in remote or resource-limited environments.
• This hybrid ultrasound approach enhances clinical decision-making by offering rapid, actionable cardiac insights.