Abstract
Background: Point of care ultrasonography (POCUS) by non-cardiologist is a safe and rapidly evolving diagnostic modality for the assessment of left ventricular ejection fraction (LVEF). This study aims to correlate the eyeball estimation of LVEF (EBEF) with modified Simpson’s method and linear measurement in M-mode parasternal long axis view (PLAX).
 Methods: A descriptive cross-sectional study was conducted at Chitwan Medical College. POCUS was performed in all ICU patients on the day of admission with optimal image acquisition and LVEF was estimated by three different methods and correlation of results were analyzed. 
 Results: Out of total 52 patients studied, median age was 58.38 ± 17.58 years (range: 24 – 89 years). There were 28 males (53.8%) and 24 females (46.2%) in this study. LVEF measured by eyeballing method and modified Simpson’s method had excellent correlation (Pearson’s correlation coefficient (r) = 0.956, P<0.001). However, there was only a good correlation (r= 0.882, P<0.001) between linear measurement method in M-mode view and Simpson’s method. It was found that eyeballing method underestimates EF as measured by Simpson’s method by an average of 2.33% (95% CI: 1.12 – 3.55%).Similarly, EF measurement by linear method overestimates EF as compared to results observed by Simpson’s method by an average of 6.57% (95% CI: 4.87 – 8.27%).
 Conclusions: Excellent correlation was observed between EBEF and modified Simpson’s method while linear measurements in M-mode may give incorrect estimation of EF especially in patients with regional wall motion abnormality.
Highlights
The critically ill patient is under an intense threat for life
The rapid, bedside determination of LV function to assist in diagnosis and management of patients in the intensive care unit (ICU) has shown to be acceptable: clinicians with minimal training in cardiac ultrasound have been shown to be capable of assessing LV function with reasonable accuracy, with agreement with a blinded cardiologist’s interpretation.[4,5]
This study was done to estimate the left ventricular ejection fraction of patients admitted in intensive care unit (ICU) of Chitwan Medical College Teaching Hospital (CMC-TH) with different methods and correlate the findings between these methods
Summary
The critically ill patient is under an intense threat for life. the diagnostic methods used in the critical care unit must be fast, reliable and reproducible to assure a successful therapeutic strategy. In the ICU environment, limited training of non-cardiologist residents without previous knowledge in ultrasound appears feasible and efficient to address simple limited clinical questions using point-of-care echocardiography.[3] Intensivists were able to estimate LV function with reasonable accuracy in the ICU, despite having undergone minimal training in image acquisition and interpretation.[4] The rapid, bedside determination of LV function to assist in diagnosis and management of patients in the ICU has shown to be acceptable: clinicians with minimal training in cardiac ultrasound have been shown to be capable of assessing LV function with reasonable accuracy, with agreement with a blinded cardiologist’s interpretation.[4,5] This study was done to estimate the left ventricular ejection fraction of patients admitted in intensive care unit (ICU) of Chitwan Medical College Teaching Hospital (CMC-TH) with different methods and correlate the findings between these methods. This study aims to correlate the eyeball estimation of LVEF (EBEF) with modified Simpson’s method and linear measurement in M-mode parasternal long axis view (PLAX)
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