title: Focused ultrasound of the pleural cavities and the pericardium by nurses after cardiac surgery.
abstract: OBJECTIVE
  We aimed to study the feasibility and reliability of focused ultrasound (US) examinations to quantify pericardial (PE)- and pleural effusion (PLE) by a pocket-size imaging device (PSID) performed by nurses in patients early after cardiac surgery.
  
  
  METHODS
  After a 3-month training period, with cardiologists as supervisors, two nurses examined 59 patients (20 women) with US using a PSID at a median of 5 days after cardiac surgery. The amount of PE and PLE was classified in four categories by US (both) and chest x-ray (PLE only). Echocardiography, including US of the pleural cavities, by experienced cardiologists was used as reference.
  
  
  RESULTS
  Focused US by the nurses was more sensitive than x-ray to detect PLE. The correlations of the quantification of PE and PLE by the nurses and reference was r (95% confidence interval) 0.76 (0.46-0.89) and 0.81 (0.73-0.89), both p < 0.001. PE and PLE were drained in one and six (eight cavities) patients, all classified as large amount by the nurses.
  
  
  CONCLUSIONS
  Cardiac nurses were able to obtain reliable measurements and quantification of both PE and PLE bedside by focused US and outperform the commonly used chest x-ray regarding PLE after cardiac surgery.
authors.affiliation: Department of Medicine, Levanger Hospital, Nord-Trøndelag Health Trust , Levanger , Norway.
authors.forename: Torbjørn
authors.initials: T
authors.lastname: Graven
authors.forename: Alexander
authors.initials: A
authors.lastname: Wahba
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Hammer
authors.forename: Ove
authors.initials: O
authors.lastname: Sagen
authors.forename: Øystein
authors.initials: Ø
authors.lastname: Olsen
authors.forename: Kyrre
authors.initials: K
authors.lastname: Skjetne
authors.forename: Jens Olaf
authors.initials: JO
authors.lastname: Kleinau
authors.forename: Havard
authors.initials: H
authors.lastname: Dalen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D015150:Echocardiography, Doppler / Q000295:instrumentation / Q000451:nursing*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D010490:Pericardial Effusion / Q000000981:diagnostic imaging* / Q000209:etiology; D010496:Pericardium / Q000000981:diagnostic imaging*; D035422:Pleural Cavity / Q000000981:diagnostic imaging*; D010996:Pleural Effusion / Q000000981:diagnostic imaging* / Q000209:etiology; D019095:Point-of-Care Systems; D011182:Postoperative Care / Q000451:nursing*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011859:Radiography; D015203:Reproducibility of Results; D013997:Time Factors; D016896:Treatment Outcome
keywords: PSID; echocardiography; pocket-size; postoperative; training