Echocardiography in the Critically Ill: Current and Potential Roles

Overview

Journal Intensive Care Med

Specialty Critical Care

Date 2005 Nov 18

PMID 16292626

Citations 25

Authors

S Price

E Nicol

D G Gibson

T W Evans

Affiliations

Soon will be listed here.

Abstract

Background: The use of echocardiography in the critically ill presents specific challenges. However, information of direct relevance to clinical management can be obtained relating to abnormalities of structure and function and can be used to estimate pulmonary arterial and venous pressures.

Discussion: Investigation of the consequences of myocardial ischaemia, valvular dysfunction and pericardial disease can be facilitated, and changes characteristic of specific conditions (e.g. sepsis, pulmonary thromboembolism) detected. Echocardiography can also be used to monitor the effects of therapeutic interventions.

Conclusions: The applications of echocardiography in the critical care setting (excluding standard peri-operative echocardiography for cardiac surgery) are reviewed, with particular emphasis on the assessment of cardiac physiology.

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References

Parrillo J . Pathogenetic mechanisms of septic shock. N Engl J Med. 1993; 328(20):1471-7. DOI: 10.1056/NEJM199305203282008. View

Vieillard-Baron A, Loubieres Y, Schmitt J, Page B, Dubourg O, Jardin F . Cyclic changes in right ventricular output impedance during mechanical ventilation. J Appl Physiol (1985). 1999; 87(5):1644-50. DOI: 10.1152/jappl.1999.87.5.1644. View

Schwartz S, Gillam L, Weintraub A, Sanzobrino B, Hirst J, Hsu T . Intracardiac echocardiography in humans using a small-sized (6F), low frequency (12.5 MHz) ultrasound catheter. Methods, imaging planes and clinical experience. J Am Coll Cardiol. 1993; 21(1):189-98. DOI: 10.1016/0735-1097(93)90736-k. View

Wang X, Deng Y, Nanda N, Deng J, Miller A, Xie M . Live three-dimensional echocardiography: imaging principles and clinical application. Echocardiography. 2003; 20(7):593-604. DOI: 10.1046/j.1540-8175.2003.03106.x. View

Pieper E, Hellemans I, Hamer H, Ravelli A, Cheriex E, Tijssen J . Value of systolic pulmonary venous flow reversal and color Doppler jet measurements assessed with transesophageal echocardiography in recognizing severe pure mitral regurgitation. Am J Cardiol. 1996; 78(4):444-50. DOI: 10.1016/s0002-9149(96)00335-9. View

Jardin F, Dubourg O, Bourdarias J . Echocardiographic pattern of acute cor pulmonale. Chest. 1997; 111(1):209-17. DOI: 10.1378/chest.111.1.209. View

Nguyen T, Dhond M, Sabapathy R, Bommer W . Contrast microbubbles improve diagnostic yield in ICU patients with poor echocardiographic windows. Chest. 2001; 120(4):1287-92. DOI: 10.1378/chest.120.4.1287. View

Henein M, Gibson D . Long axis function in disease. Heart. 1999; 81(3):229-31. PMC: 1728969. DOI: 10.1136/hrt.81.3.229. View

Vieillard-Baron A, Augarde R, Prin S, Page B, Beauchet A, Jardin F . Influence of superior vena caval zone condition on cyclic changes in right ventricular outflow during respiratory support. Anesthesiology. 2001; 95(5):1083-8. DOI: 10.1097/00000542-200111000-00010. View

10.

Vieillard-Baron A, Prin S, Chergui K, Dubourg O, Jardin F . Echo-Doppler demonstration of acute cor pulmonale at the bedside in the medical intensive care unit. Am J Respir Crit Care Med. 2002; 166(10):1310-9. DOI: 10.1164/rccm.200202-146CC. View

11.

Cullen S, Shore D, Redington A . Characterization of right ventricular diastolic performance after complete repair of tetralogy of Fallot. Restrictive physiology predicts slow postoperative recovery. Circulation. 1995; 91(6):1782-9. DOI: 10.1161/01.cir.91.6.1782. View

12.

Ozier Y, Gueret P, Jardin F, Farcot J, Bourdarias J, MARGAIRAZ A . Two-dimensional echocardiographic demonstration of acute myocardial depression in septic shock. Crit Care Med. 1984; 12(7):596-9. DOI: 10.1097/00003246-198407000-00011. View

13.

Miyatake K, Yamagishi M, Tanaka N, Uematsu M, Yamazaki N, Mine Y . New method for evaluating left ventricular wall motion by color-coded tissue Doppler imaging: in vitro and in vivo studies. J Am Coll Cardiol. 1995; 25(3):717-24. DOI: 10.1016/0735-1097(94)00421-L. View

14.

Lutz J, Giebler R, Peters J . The 'TEI-index' is preload dependent and can be measured by transoesophageal echocardiography during mechanical ventilation. Eur J Anaesthesiol. 2003; 20(11):872-7. DOI: 10.1017/s0265021503001406. View

15.

Slama M, Masson H, Teboul J, Susic D, Frohlich E, Andrejak M . Respiratory variations of aortic VTI: a new index of hypovolemia and fluid responsiveness. Am J Physiol Heart Circ Physiol. 2002; 283(4):H1729-33. DOI: 10.1152/ajpheart.00308.2002. View

16.

Kimchi A, Ellrodt A, Berman D, Riedinger M, Swan H, Murata G . Right ventricular performance in septic shock: a combined radionuclide and hemodynamic study. J Am Coll Cardiol. 1984; 4(5):945-51. DOI: 10.1016/s0735-1097(84)80055-8. View

17.

Gibson D, Francis D . Clinical assessment of left ventricular diastolic function. Heart. 2003; 89(2):231-8. PMC: 1767551. DOI: 10.1136/heart.89.2.231. View

18.

Jardin F, Fourme T, Page B, Loubieres Y, Vieillard-Baron A, Beauchet A . Persistent preload defect in severe sepsis despite fluid loading: A longitudinal echocardiographic study in patients with septic shock. Chest. 1999; 116(5):1354-9. DOI: 10.1378/chest.116.5.1354. View

19.

Parker M, Shelhamer J, Bacharach S, Green M, Natanson C, Frederick T . Profound but reversible myocardial depression in patients with septic shock. Ann Intern Med. 1984; 100(4):483-90. DOI: 10.7326/0003-4819-100-4-483. View

20.

Vieillard-Baron A, Prin S, Chergui K, Dubourg O, Jardin F . Hemodynamic instability in sepsis: bedside assessment by Doppler echocardiography. Am J Respir Crit Care Med. 2003; 168(11):1270-6. DOI: 10.1164/rccm.200306-816CC. View