A survey of United Kingdom intensive care echocardiography provision

Area of Science:

• Critical Care Medicine
• Cardiovascular Imaging
• Health Services Research

Background:

• Donor echocardiography is crucial for assessing organ viability.
• Implementation in UK Intensive Care Units (ICUs) requires evaluation.
• National Health Service Blood & Transplant oversees organ donation processes.

Purpose of the Study:

• To assess the current feasibility and implementation of comprehensive and focused donor echocardiography in UK ICUs.
• To identify barriers and facilitators to echocardiography acquisition and interpretation in the donor pathway.

Main Methods:

• A nationwide survey of 95 hospitals across all four UK nations.
• Data collected on personnel trained in echocardiography, acquisition times for comprehensive and focused scans, and availability of point-of-care ultrasound (POCUS) machines.
• Inquiry into remote viewing capabilities for echocardiogram images.

Main Results:

• Most ICUs have trained staff and POCUS machines with echocardiographic capabilities.
• Significant delays exist in acquiring comprehensive echocardiograms (48% within 6h weekdays, 11% outside hours) and focused echocardiograms (60% within 6h weekdays, 20% outside hours).
• Over 50% of hospitals require >24h for scans outside regular working hours, and only 52% have remote viewing.

Conclusions:

• Current implementation of donor echocardiography in UK ICUs is feasible but faces significant time-based limitations, particularly outside standard working hours.
• Availability of POCUS machines is high, but challenges remain in timely acquisition and interpretation, impacting the organ donation pathway.
• Improving timely access to comprehensive and focused echocardiography, alongside enhanced remote viewing, is essential for optimizing organ donor management.