Bedside echocardiography in critically ill patients

Abstract

The echocardiography has become a vital tool in the diagnosis of critically ill patients. The use of echocardiography by intensivists has been increasing since the 1990’s. This tool has become a common procedure for the cardiovascular assessment of critically ill patients, especially because it is non-invasive and can be applied in fast and guided manner at the bedside. Physicians with basic training in echocardiography, both from intensive care unit or emergency department, can assess the left ventricle function properly with good accuracy compared with assessment made by cardiologists. The change of treatment approach based on echocardiographic findings is commonly seen after examination of unstable patient. This brief review focuses on growing importance of echocardiography as an useful tool for management of critically ill patients in the intensive care setting along with the cardiac output assessment using this resource.

Usefulness of Echocardiography for General Surgery Patients on Intensive Care Units: When and How?

“…An echocardiography is a test with many strengths attributed to its non-invasiveness, rapid real-time testing, portability of ultrasound equipment, and absence of exposure to radiation [9]. It is usually performed after the initial cardiology examinations, and its effectiveness, and widespread use is evident in patients attending outpatient clinics, and general wards.…”

Use of focus assessed transthoracic echocardiography (FATE) in the veterinary emergency room

“…In addition, the intensive care environment is not condusive to CE. Environmental factors, such as inappropriate lighting, and the fragile nature of the patients; i.e, respiratory distress, hemodynamic instability, make examination challenging, and patients can be compromised by being translocated for examination (CASAROTO et al, 2015). Thus, some adjustments were made to produce a standardized cardiac examination in the emergency room and a consensus has been reached for focused echocardiography in human medicine (LABOVITZ et al, 2010;MOK, 2016).…”

“…FATE has some advantages over other techniques for cardiovascular evaluation, it is safe, noninvasive, accessible, does not expose the patient and the staff to ionizing radiation and does not require administration of contrast. It is usually performed with portable equipment, does not require patient displacement and the result are available immediately, which allows serial assessments (MEYER et al, 2008;SPENCER et al, 2013;CASAROTO et al, 2015). FATE can be performed in sternal recumbency, standing or lateral decubitus position while the patient receives oxygen and medications (Figure 1), providing great benefits to veterinary patients (DEFRANCESCO, 2013).…”

“…FATE can be performed in sternal recumbency, standing or lateral decubitus position while the patient receives oxygen and medications (Figure 1), providing great benefits to veterinary patients (DEFRANCESCO, 2013). The time taken to complete such technique is around six minutes, which is significantly faster than CE (BEAULIEU, 2007;CASAROTO et al, 2015).…”

“…In general, emergency physicians tend to overestimate left ventricular function. In addition, non-cardiologists are unlikely to recognize other causes of hemodynamic compromise, such as cor pulmonale or valvular abnormalities (MELAMED et al, 2009;CASAROTO et al, 2015).…”