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A pillow was placed only under the left hemithorax in the prone position to elevate and ease the apical and subcostal windows. A critical care cardiologist (prone group) acquired and evaluated the images using the apical-subcostal protocol. Besides, we used ambulatory echocardiograms performed as a comparative group (supine group).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>86 patients were included, 43 in the prone and 43 in the supine. In the prone group, the indication to perform an echocardiogram was hemodynamic monitoring. All patients were ventilated with protective parameters, and the mean end-expiratory pressure was 10.6 cmH2O. The protocol was performed entirely in 42 of 43 patients in the prone group because one patient did not have any acoustic window. In the 43 patients in the prone group analyzed and compared to the supine group, global biventricular function was assessed in 97.7% (<jats:italic>p<\/jats:italic>\u2009=\u20091.0), severe heart valve disease in 88.4% (<jats:italic>p<\/jats:italic>\u2009=\u20090.055), ruled out of the presence of pulmonary hypertension in 76.7% (<jats:italic>p<\/jats:italic>\u2009=\u20090.80), pericardial effusion in 93% (<jats:italic>p<\/jats:italic>\u2009=\u20090.12), and volume status by inferior vena cava in 93% (<jats:italic>p<\/jats:italic>\u2009=\u20090.48). Comparing prone versus supine position, a statistical difference was found when evaluating the left ventricle apical 2-chamber view (65.1 versus 100%,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and its segmental function (53.4 versus 100%,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The echocardiogram using an apical-subcostal protocol is feasible in patients in the\u00a0IMV and prone position.<\/jats:p><\/jats:sec><jats:sec><jats:title>Graphical Abstract<\/jats:title><\/jats:sec>","DOI":"10.1186\/s12947-024-00326-y","type":"journal-article","created":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T05:01:55Z","timestamp":1717995715000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Echocardiogram by apical-subcostal protocol in prone position during invasive mechanical ventilation in cardiovascular intensive care unit"],"prefix":"10.1186","volume":"22","author":[{"given":"C\u00e9sar","family":"Del Castillo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Verdugo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franco","family":"Appiani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisca","family":"Y\u00e1\u00f1ez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camila","family":"Bont\u00e1","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Torres-Herrera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Garcia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zorba","family":"Bl\u00e1zquez-Bermejo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Castrodeza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Requena","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreina","family":"Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arquimedes","family":"Silvio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agust\u00edn","family":"Gatica","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnulfo","family":"Begazo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Alfaro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,10]]},"reference":[{"issue":"2","key":"326_CR1","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1093\/ehjci\/jeu210","volume":"16","author":"P Lancellotti","year":"2015","unstructured":"Lancellotti P, Price S, Edvardsen T, et al. 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Informed Consent was not required due to a non-interventional study. The Institutional Review Board of DIPRECA Hospital approved the original study protocol as the corresponding principal institution (approval certificate number 11, 2022).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Nothing to declare.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"7"}}