Limited transthoracic echocardiography assessment in anaesthesia and critical care

Faris, John G.; Veltman, Michael; Royse, Colin

doi:10.1016/j.bpa.2009.02.008

Cited by 50 publications

(30 citation statements)

References 43 publications

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“…6,7 As with the development of intraoperative transesophageal echocardiography, guidelines, training, and ultimately certification will be critical given the potential dangers posed by inexperienced examiners.…”

Section: Discussionmentioning

confidence: 99%

Critical Care Transthoracic Echocardiography

Schulman

Gelow

Merkel

et al. 2014

Journal of Investigative Medicine High Impact Case Reports

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A 70-year-old man with end-stage heart failure and a continuous-flow left ventricular assist device received repeated electrical discharges from his biventricular implantable cardiac defibrillator. Although the electrocardiogram demonstrated ventricular fibrillation, the patient was awake and in no distress. A focused transthoracic echocardiogram was performed to assess ventricular function revealing simultaneous atrial sinus rhythm and ventricular fibrillation. This clinical scenario highlights a unique clinical finding, the complexity of the care of continuous-flow left ventricular assist device patients, and the challenges of intensivist-performed bedside focused transthoracic echocardiogram.

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Section: Discussionmentioning

confidence: 99%

Critical Care Transthoracic Echocardiography

Schulman

Gelow

Merkel

et al. 2014

Journal of Investigative Medicine High Impact Case Reports

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“…A description of these protocols goes beyond the scope of this review, but some of the most commonly used are the following: focused cardiac ultrasound [10], focus assessed transthoracic echocardiography [11], focused assessment with sonography in trauma [12], rapid ultrasound for shock and hypotension [13] and HeartScan [14]. Regardless of the protocol used, as POCUS provides the clinician with valuable, rapid and reliable information to diagnose and treat the patient, there is strong support for the use of ultrasonography in the acute care setting (see [8▪▪,15▪▪], and Table 1).…”

Section: Hemodynamic Monitoringmentioning

confidence: 99%

The crashing patient: hemodynamic collapse

Gidwani

Gómez²

2017

Current Opinion in Critical Care

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Purpose of review Rapid restoration of tissue perfusion and oxygenation are the main goals in the resuscitation of a patient with circulatory collapse. This review will focus on providing an evidence based framework of the technological and conceptual advances in the evaluation and management of the patient with cardiovascular collapse. Recent findings The initial approach to the patient in cardiovascular collapse continues to be based on the Ventilate–Infuse–Pump rule. Point of care ultrasound is the preferred modality for the initial evaluation of undifferentiated shock, providing information to narrow the differential diagnosis, to assess fluid responsiveness and to evaluate the response to therapy. After the initial phase of resuscitative fluid administration, which focuses on re-establishing a mean arterial pressure to 65mmHg, the use of dynamic parameters to assess preload responsiveness such as the passive leg raise test, stroke volume variation, pulse pressure variation and collapsibility of the inferior vena cava in mechanically ventilated patients is recommended. Summary The crashing patient remains a clinical challenge. Using an integrated approach with bedside ultrasound, dynamic parameters for the evaluation of fluid responsiveness and surrogates of evaluation of tissue perfusion have made the assessment of the patient in shock faster, safer and more physiologic.

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“…Der Einzug der Echokardiographie in die Anästhesie und Intensivmedizin ent wickelte sich primär über den TEEUnter suchungsweg [21]. So hat auch in Deutsch land die perioperative Echokardiographie, vornehmlich in Form der TEE, einen ho hen Stellenwert erreicht [72].…”

Section: Herz Und Kreislaufunclassified

In welcher Weise sollte ein Anästhesist sonographieren können?

Maecken

Zinke²,

Zenz³

et al. 2011

Anaesthesist

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Ultrasound imaging has attained great significance as a tool for diagnostics in emergency and intensive care medicine. The major advantages of this technique are its instantaneous bedside availability and the possibility to perform repeatable examinations. These advantages are based on recent developments, such as portable ultrasound devices offering excellent imaging quality as well as a quick-start-function. Ultrasound imaging in critically ill patients is frequently performed under pressure of time depending on the current acute physical state. All standard examinations in echocardiography, vascular, abdominal and thoracic ultrasound scanning can be applied in these patients. Based on the clinical scenario the duration of examinations may vary from seconds during cardiopulmonary resuscitations to time-consuming repeated scanning. The transition from basic to subject-specific detailed examinations is flowing and has to be adjusted to local conditions. In the field of emergency and intensive care medicine the technique used is whole-body sonography. The goal is to classify the patient's present physical state and to define a targeted therapeutic approach. The characteristics of whole-body sonography are similar to the field of anesthesiology which is an interdisciplinary one. Currently, these characteristics deserve more attention in training in sonography.

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Limited transthoracic echocardiography assessment in anaesthesia and critical care

Cited by 50 publications

References 43 publications

Critical Care Transthoracic Echocardiography

Critical Care Transthoracic Echocardiography

The crashing patient: hemodynamic collapse

In welcher Weise sollte ein Anästhesist sonographieren können?

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