Echography is mandatory for the initial management of critically ill patients: We are not sure

Mayo, Paul H.; Maury, Éric

doi:10.1007/s00134-014-3460-z

Cited by 11 publications

(6 citation statements)

References 9 publications

(8 reference statements)

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“…Patients with COPD exacerbation (not related to CPE) or asthma typically exhibit normal lung aeration reflected by a normal ultrasound pattern (A-lines with lung sliding) [ 91 ]. Overall, thoracic ultrasonography is a valuable extension of clinical examination but fails to replace it [ 92 ].…”

Section: Other Causes Of Acute Respiratory Failurementioning

confidence: 99%

Critical care ultrasonography in acute respiratory failure

et al. 2016

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Acute respiratory failure (ARF) is a leading indication for performing critical care ultrasonography (CCUS) which, in these patients, combines critical care echocardiography (CCE) and chest ultrasonography. CCE is ideally suited to guide the diagnostic work-up in patients presenting with ARF since it allows the assessment of left ventricular filling pressure and pulmonary artery pressure, and the identification of a potential underlying cardiopathy. In addition, CCE precisely depicts the consequences of pulmonary vascular lesions on right ventricular function and helps in adjusting the ventilator settings in patients sustaining moderate-to-severe acute respiratory distress syndrome. Similarly, CCE helps in identifying patients at high risk of ventilator weaning failure, depicts the mechanisms of weaning pulmonary edema in those patients who fail a spontaneous breathing trial, and guides tailored therapeutic strategy. In all these clinical settings, CCE provides unparalleled information on both the efficacy and tolerance of therapeutic changes. Chest ultrasonography provides further insights into pleural and lung abnormalities associated with ARF, irrespective of its origin. It also allows the assessment of the effects of treatment on lung aeration or pleural effusions. The major limitation of lung ultrasonography is that it is currently based on a qualitative approach in the absence of standardized quantification parameters. CCE combined with chest ultrasonography rapidly provides highly relevant information in patients sustaining ARF. A pragmatic strategy based on the serial use of CCUS for the management of patients presenting with ARF of various origins is detailed in the present manuscript.

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Section: Other Causes Of Acute Respiratory Failurementioning

confidence: 99%

Critical care ultrasonography in acute respiratory failure

et al. 2016

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“…The potential benefits from point-of-care ultrasound (US) and fair expectations about its utility in the ICU sometimes need to reconsidered given the general paucity of the literature on the topic, mainly due to the relative novelty of many applications of US. Three articles published in Intensive Care Medicine last year (re)opened an interesting pro/con debate on the use of echography for the initial management of critically ill patients [ 16 – 18 ].…”

Section: Ultrasonography In Critically Ill Patientsmentioning

confidence: 99%

Year in review in Intensive Care Medicine 2014: I. Cardiac dysfunction and cardiac arrest, ultrasound, neurocritical care, ICU-acquired weakness, nutrition, acute kidney injury, and miscellaneous

et al. 2015

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“…Competency standards are well established for both basic and advanced critical care echocardiography and the scope of this review will cover both [2, 3] (Table 1). Both transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) expertise should be available, the latter being seen as part of the armamentaria of the advanced practitioner.…”

Section: Introductionmentioning

confidence: 99%

Echocardiography in shock management

McLean

2016

Crit Care

101

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Echocardiography is pivotal in the diagnosis and management of the shocked patient. Important characteristics in the setting of shock are that it is non-invasive and can be rapidly applied.In the acute situation a basic study often yields immediate results allowing for the initiation of therapy, while a follow-up advanced study brings the advantage of further refining the diagnosis and providing an in-depth hemodynamic assessment. Competency in basic critical care echocardiography is now regarded as a mandatory part of critical care training with clear guidelines available. The majority of pathologies found in shocked patients are readily identified using basic level 2D and M-mode echocardiography. A more comprehensive diagnosis can be achieved with advanced levels of competency, for which practice guidelines are also now available. Hemodynamic evaluation and ongoing monitoring are possible with advanced levels of competency, which includes the use of colour Doppler, spectral Doppler, and tissue Doppler imaging and occasionally the use of more recent technological advances such as 3D or speckled tracking.The four core types of shock—cardiogenic, hypovolemic, obstructive, and vasoplegic—can readily be identified by echocardiography. Even within each of the main headings contained in the shock classification, a variety of pathologies may be the cause and echocardiography will differentiate which of these is responsible. Increasingly, as a result of more complex and elderly patients, the shock may be multifactorial, such as a combination of cardiogenic and septic shock or hypovolemia and ventricular outflow obstruction.The diagnostic benefit of echocardiography in the shocked patient is obvious. The increasing prevalence of critical care physicians experienced in advanced techniques means echocardiography often supplants the need for more invasive hemodynamic assessment and monitoring in shock.

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Echography is mandatory for the initial management of critically ill patients: We are not sure

Cited by 11 publications

References 9 publications

Critical care ultrasonography in acute respiratory failure

Critical care ultrasonography in acute respiratory failure

Year in review in Intensive Care Medicine 2014: I. Cardiac dysfunction and cardiac arrest, ultrasound, neurocritical care, ICU-acquired weakness, nutrition, acute kidney injury, and miscellaneous

Echocardiography in shock management

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