Background: Cardiology divisions reshaped their activities during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to analyze the organization of echocardiographic laboratories and echocardiography practice during the second wave of the COVID-19 pandemic in Italy, and the expectations for the post-COVID era. Methods: We analyzed two different time periods: the month of November during the second wave of the COVID-19 pandemic (2020) and the identical month during 2019 (November 2019). Results: During the second wave of the COVID-19 pandemic, the hospital activity was partially reduced in 42 (60%) and wholly interrupted in 3 (4%) echocardiographic laboratories, whereas outpatient echocardiographic activity was partially reduced in 41 (59%) and completely interrupted in 7 (10%) laboratories. We observed an important change in the organization of activities in the echocardiography laboratory which reduced the operator-risk and improved self-protection of operators by using appropriate personal protection equipment. Operators wore FFP2 in 58 centers (83%) during trans-thoracic echocardiography (TTE), in 65 centers (93%) during transesophageal echocardiography (TEE) and 63 centers (90%) during stress echocardiography. The second wave caused a significant reduction in number of echocardiographic exams, compared to November 2019 (from 513 +/- 539 to 341 +/- 299 exams per center, -34%, p < 0.001). On average, there was a significant increase in the outpatient waiting list for elective echocardiographic exams (from 32.0 +/- 28.1 to 45.5 +/- 44.9 days, +41%, p < 0.001), with a reduction of in-hospital waiting list (2.9 +/- 2.4 to 2.4 +/- 2.0 days, -17%, p < 0.001). We observed a large diffusion of point-of-care cardiac ultrasound (88%), with a significant increase of lung ultrasound usage in 30 centers (43%) during 2019, extended to all centers in 2020. Carbon dioxide production by examination is an indicator of the environmental impact of technology (100-fold less with echocardiography compared to other cardiac imaging techniques). It was ignored in 2019 by 100% of centers, and currently it is considered potentially crucial for decision-making in cardiac imaging by 65 centers (93%). Conclusions: In one year, major changes occurred in echocardiography practice and culture. The examination structure changed with extensive usage of point-of-care cardiac ultrasound and with lung ultrasound embedded by default in the TTE examination, as well as the COVID-19 testing.

Ciampi, Q., Antonini-Canterin, F., Barbieri, A., Barchitta, A., Benedetto, F., Cresti, A., et al. (2021). Reshaping of Italian Echocardiographic Laboratories Activities during the Second Wave of COVID-19 Pandemic and Expectations for the Post-Pandemic Era. JOURNAL OF CLINICAL MEDICINE, 10(16), 3466 [10.3390/jcm10163466].

Reshaping of Italian Echocardiographic Laboratories Activities during the Second Wave of COVID-19 Pandemic and Expectations for the Post-Pandemic Era

Cammalleri, V;Esposito, R;Mantovani, F;Spinelli, L;
2021

Abstract

Background: Cardiology divisions reshaped their activities during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to analyze the organization of echocardiographic laboratories and echocardiography practice during the second wave of the COVID-19 pandemic in Italy, and the expectations for the post-COVID era. Methods: We analyzed two different time periods: the month of November during the second wave of the COVID-19 pandemic (2020) and the identical month during 2019 (November 2019). Results: During the second wave of the COVID-19 pandemic, the hospital activity was partially reduced in 42 (60%) and wholly interrupted in 3 (4%) echocardiographic laboratories, whereas outpatient echocardiographic activity was partially reduced in 41 (59%) and completely interrupted in 7 (10%) laboratories. We observed an important change in the organization of activities in the echocardiography laboratory which reduced the operator-risk and improved self-protection of operators by using appropriate personal protection equipment. Operators wore FFP2 in 58 centers (83%) during trans-thoracic echocardiography (TTE), in 65 centers (93%) during transesophageal echocardiography (TEE) and 63 centers (90%) during stress echocardiography. The second wave caused a significant reduction in number of echocardiographic exams, compared to November 2019 (from 513 +/- 539 to 341 +/- 299 exams per center, -34%, p < 0.001). On average, there was a significant increase in the outpatient waiting list for elective echocardiographic exams (from 32.0 +/- 28.1 to 45.5 +/- 44.9 days, +41%, p < 0.001), with a reduction of in-hospital waiting list (2.9 +/- 2.4 to 2.4 +/- 2.0 days, -17%, p < 0.001). We observed a large diffusion of point-of-care cardiac ultrasound (88%), with a significant increase of lung ultrasound usage in 30 centers (43%) during 2019, extended to all centers in 2020. Carbon dioxide production by examination is an indicator of the environmental impact of technology (100-fold less with echocardiography compared to other cardiac imaging techniques). It was ignored in 2019 by 100% of centers, and currently it is considered potentially crucial for decision-making in cardiac imaging by 65 centers (93%). Conclusions: In one year, major changes occurred in echocardiography practice and culture. The examination structure changed with extensive usage of point-of-care cardiac ultrasound and with lung ultrasound embedded by default in the TTE examination, as well as the COVID-19 testing.
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/11
English
COVID-19
point-of-care cardiac ultrasound
lung ultrasound
Ciampi, Q., Antonini-Canterin, F., Barbieri, A., Barchitta, A., Benedetto, F., Cresti, A., et al. (2021). Reshaping of Italian Echocardiographic Laboratories Activities during the Second Wave of COVID-19 Pandemic and Expectations for the Post-Pandemic Era. JOURNAL OF CLINICAL MEDICINE, 10(16), 3466 [10.3390/jcm10163466].
Ciampi, Q; Antonini-Canterin, F; Barbieri, A; Barchitta, A; Benedetto, F; Cresti, A; Miceli, S; Monte, I; Petrella, L; Trocino, G; Aquila, I; Barbati, G; Barletta, V; Barone, D; Beraldi, M; Bergandi, G; Bilardo, G; Boriani, G; Bossone, E; Bongarzoni, A; Bovolato, F; Bursi, F; Cammalleri, V; Carbonella, M; Casavecchia, G; Cicco, S; Cioffi, G; Cocchia, R; Colonna, P; Cortigiani, L; Cucchini, U; D'Alfonso, M; D'Andrea, A; Dell'Angela, L; Dentamaro, I; De Paolis, M; De Stefanis, P; Deste, W; Di Fulvio, M; Di Giannuario, G; Di Lisi, D; Di Nora, C; Fabiani, I; Esposito, R; Fazzari, F; Ferrara, L; Filice, G; Forno, D; Giorgi, M; Giustiniano, E; Greco, C; Iannuzzi, G; Izzo, A; Lanzone, A; Malagoli, A; Mantovani, F; Manuppelli, V; Mega, S; Merli, E; Ministeri, M; Morrone, D; Napoletano, C; Nunziata, L; Pastorini, G; Pedone, C; Petruccelli, E; Polito, M; Polizzi, V; Prota, C; Rigo, F; Rivaben, D; Saponara, S; Sciacqua, A; Sartori, C; Scarabeo, V; Serra, W; Severino, S; Spinelli, L; Tamborini, G; Tota, A; Villari, B; Carerj, S; Picano, E; Pepi, M
Articolo su rivista
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/305003
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 2
  • ???jsp.display-item.citation.isi??? 2
social impact