Right ventricular fractional area of change is predictive of ventilator support days in trauma and burn patients

• Published in: The American journal of surgery Vol. 216; no. 1; pp. 37 - 41
• Main Authors: Younan, Duraid, Pigott, David C., Gibson, C. Blayke, Gullett, John P., Zaky, Ahmed
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2018; Elsevier Limited
• Subjects: Age; Burn patients; Burns - complications; Burns - physiopathology; Burns - therapy; Clinical outcomes; Critical care; Demographics; Demography; Echocardiography; Echocardiography, Transesophageal - methods; Esophagus; Female; Follow-Up Studies; Heart; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Injuries; Intensive care; Intensive Care Units; Kidneys; Male; Medical records; Middle Aged; Patients; Prognosis; Pulmonary arteries; Regression analysis; Respiration, Artificial - methods; Retrospective Studies; Risk Factors; Sepsis; Systole; Trauma; Urine; Ventilators; Ventricle; Ventricular Dysfunction, Right - diagnosis; Ventricular Dysfunction, Right - etiology; Ventricular Dysfunction, Right - physiopathology; Ventricular Function, Right - physiology; Wounds and Injuries - complications; Wounds and Injuries - physiopathology; Wounds and Injuries - therapy
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2018.02.002

Echocardiography has contributed to the care of critically ill patients but there remains a need for more publications about its association with outcomes to confirm its role. We conducted a retrospective review of trauma and burn patients that were admitted to our intensive care unit between 2015 and 2017 that underwent hemodynamic transesophageal echocardiography. Data collected included demographics, clinical and laboratory data. Right ventricle fractional area of change (RVFAC) measurements were performed on still mages obtained from mid-esophageal four-chamber-view clips. There were 74 patients, mean age was 51 years, and were predominantly white and male. Linear regression was used to test for the association between RVFAC and clinical outcomes. Adjusting for age, injury mechanism and injury severity, higher RVFAC was significantly associated with lower ventilator days (p = 0.03). Conclusion, higher right ventricle systolic function is associated with a lower number of ventilator support days in critically injured trauma and burn patients.
•A retrospective review of trauma and burn patients that were admitted to an intensive care unit between 2015 and 2017 that underwent hemodynamic transesophageal echocardiography.•Right ventricle fractional area of change (RVFAC) and tricuspid area plane systolic excursion (TAPSE) measurements were performed on still mages obtained from mid-esophageal four-chamber-view clip segments.•Higher RVFAC was significantly associated with decreased ventilator days (p = 0.03).