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ISSN: 1642-5758
Anaesthesiology Intensive Therapy
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vol. 55
Original paper

Critical care echocardiography: barriers, competencies and solutions. A survey of over 600 participants

Mateusz Zawadka
Adrian Wong
Anna Janiszewska
Filippo Sanfilippo
Luigi La Via
Piotr Sobieraj
Igor Abramovich
Paweł Andruszkiewicz
Ib Jammer

2nd Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, Warsaw, Poland
Department of Critical Care, King’s College Hospital, London, UK
Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
Department of Anaesthesia and Intensive Care, Policlinico-San Marco, site “Policlinico G. Rodolico”, Catania, Italy
Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, Warsaw, Poland
Charité – Universitätsmedizin Berlin, Department of Anaesthesiology and Operative Intensive Care Medicine (CCM, CVK), Berlin, Germany
Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
Anaesthesiol Intensive Ther 2023; 55, 3: 158–162
Online publish date: 2023/08/31
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Critical care echocardiography (CCE) is at the core of point-of-care ultrasound (POCUS), and although a list of the necessary competencies has been created, most European countries do not have established training programmes to allow intensivists to gain such competencies. To address barriers to the implementation of CCE, we conducted an online European survey, and analysed the current barriers to this with the aim of providing novel, modern solutions to them including environmental considerations.

Material and methods:
A 23-item survey was distributed via email with support from the European Society of Intensive Care Medicine, national societies, and social media. Questions focused on bedside CCE prevalence, competencies, and barriers to its implementation. An additional questionnaire was sent to recognised experts in the field of CCE.

A total of 644 responses were recorded. Most respondents were anaesthesia and intensive care physicians [79% (n = 468)], and younger, with 56% in their first five years after specialization (n = 358). Most respondents [92% (n = 594)] had access to an ultrasound machine with a cardiac probe, and 97% (n = 623) reported being able to acquire basic CCE windows. The most common barriers identified by respondents to the implementation of CCE in practice were a lack of sufficient experience/skill [64% (n = 343)], absence of formal qualifications [46% (n = 246)] and lack of a mentor [45% (n = 243)]. Twenty-eight experts responded and identified a lack of allocated time for teaching as a main barrier [60% (n = 17)].

We found that bedside CCE is perceived as a crucial skill for intensive care medicine, especially by younger physicians; however, there remain several obstacles to training and implementation. The most important impediments reported by respondents were inadequate training, absence of formal qualifications and difficulties in finding a suitable mentor.


barriers, point-of-care ultrasound, POCUS, competencies, critical care echocardiography, CCE

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