title: The Clinical Impact of Bedside Contrast Echocardiography in Intensive Care Settings: A Korean Multicenter Study.
abstract: OBJECTIVE
  We assessed the ability of portable echocardiography (with contrasts) to clearly delineate the cardiac structure, and evaluated the impact of its use on the diagnosis and management of critically ill patients in Korea.
  
  
  METHODS
  We prospectively enrolled 123 patients (mean age 66±16 years), who underwent portable transthoracic echocardiography (with contrast) for image enhancement at 12 medical centers. The quality of the global left ventricular (LV) images, the number of the regional LV segments visualized, the ability to visualize the LV apex and the right ventricle (RV), and any changes in the diagnostic procedure and treatment strategy were compared before and after the contrast.
  
  
  RESULTS
  Of the 123 patients, 52 (42%) were using mechanical ventilators. The amount of poor or uninterpretable images decreased from 48% to 5% (p<0.001), after the contrast. Before the contrast, 15.6±1.1 of 16 LV segments were seen, which improved to 15.9±0.6 segments (p=0.001) after the contrast. The ability to visualize the LV apex increased from 47% to 94% (p<0.001), while the inability to clearly visualize the RV decreased from 46% to 19% (p<0.001). Changes in the diagnostic procedure (for example, not requiring other types of imaging studies) were observed in 18% of the patients, and the treatment plan (medication) was altered in 26% of patients after the contrast echocardiography.
  
  
  CONCLUSIONS
  The use of a contrast agent during the portable echocardiography, in intensive care settings, can improve the image quality and impact the diagnostic procedures and treatment for Korean patients.
authors.affiliation: Department of Cardiology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Hui-Jeong
authors.initials: HJ
authors.lastname: Hwang
authors.affiliation: Department of Cardiology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Il Suk
authors.initials: IS
authors.lastname: Sohn
authors.affiliation: Department of Cardiology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Woo-Shik
authors.initials: WS
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Geu-Ru
authors.initials: GR
authors.lastname: Hong
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Eui-Young
authors.initials: EY
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Se-Joong
authors.initials: SJ
authors.lastname: Rim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Sang-Chol
authors.initials: SC
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Heart Center, Gachon University Gil Hospital, Gachon University School of Medicine, Incheon, Korea.
authors.forename: Wook-Jin
authors.initials: WJ
authors.lastname: Chung
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Jung-Hyun
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Hospital, Bucheon, Korea.
authors.forename: Hye-Sun
authors.initials: HS
authors.lastname: Seo
authors.affiliation: Division of Cardiology, Department of Internal Medicine, NHIS Ilsan Hospital, Goyang, Korea.
authors.forename: Se Jung
authors.initials: SJ
authors.lastname: Yoon
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea.
authors.forename: Kyoung Im
authors.initials: KI
authors.lastname: Cho
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Hyung Seop
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Yoon
keywords: Echocardiography; Intensive care