Point of care ultrasound for basic haemodynamic assessment: novice compared with an expert operator

Miniaturisation of ultrasound equipment has led to the development of hand-held echocardiography devices suitable for bedside evaluation of cardiac function. Basic assessment of the haemodynamic state can be performed using a limited transthoracic echocardiography examination. This study evaluated a third generation device (SonoSite Titan(TM)) used by novice and expert operators. Limited transthoracic examination was performed on 30 healthy volunteers by an expert and a novice operator. The novice had performed 10 studies prior to data accrual. Agreement analysis was performed using weighted least products regression and Bland-Altman analysis. Acceptable results for the novice were achieved following 20 studies (including practice sessions) for basic haemodynamic assessment and following 40 studies for all measured parameters. The SonoSite Titan is acceptable for basic transthoracic measurements to determine the basic haemodynamic state and cardiac output measurements. We recommend a minimum of 20 training studies for novice operators prior to clinical use.