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Intensive Care Med. 2019 Jun;45(6):770-788. doi: 10.1007/s00134-019-05604-2. Epub 2019 Mar 25.

A decade of progress in critical care echocardiography: a narrative review.

Author information

1
Intensive Care Medicine Unit, Assistance Publique-Hôpitaux de Paris, University Hospital Ambroise Paré, 92100, Boulogne-Billancourt, France. antoine.vieillard-baron@aphp.fr.
2
INSERM U-1018, CESP, Team 5, University of Versailles Saint-Quentin en Yvelines, Villejuif, France. antoine.vieillard-baron@aphp.fr.
3
Department of Critical Care Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, Canada.
4
Department of Anesthesia and Intensive Care, Policlinico-Vittorio Emanuele University Hospital, Catania, Italy.
5
Department of Anaesthesiology and Intensive Care, Medical and Health Sciences, Linköping University, Linköping, Sweden.
6
Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA.
7
Intensive Care Nepean Hospital, University of Sydney, Sydney, Australia.
8
Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
9
Cardiothoracic Anesthesiology and Critical Care Medicine, Cardiovascular Intensive Care Unit, Swedish Heart and Vascular Institute, Swedish Medical Center, US Anesthesia Partners, Seattle, WA, USA.
10
Division of Pulmonary, Critical Care and Sleep Medicine, Northwell Health LIJ/NSUH Medical Center, Zucker School of Medicine, Hofstra/Northwell, USA.
11
Consultant in Cardiothoracic Critical Care, St Georges Hospital, St Georges University of London, London, UK.
12
Cleveland Clinic London, London, UK.

Abstract

INTRODUCTION:

This narrative review focusing on critical care echocardiography (CCE) has been written by a group of experts in the field, with the aim of outlining the state of the art in CCE in the 10 years after its official recognition and definition.

RESULTS:

In the last 10 years, CCE has become an essential branch of critical care ultrasonography and has gained general acceptance. Its use, both as a diagnostic tool and for hemodynamic monitoring, has increased markedly, influencing contemporary cardiorespiratory management. Recent studies suggest that the use of CCE may have a positive impact on outcomes. CCE may be used in critically ill patients in many different clinical situations, both in their early evaluation of in the emergency department and during intensive care unit (ICU) admission and stay. CCE has also proven its utility in perioperative settings, as well as in the management of mechanical circulatory support. CCE may be performed with very simple diagnostic objectives. This application, referred to as basic CCE, does not require a high level of training. Advanced CCE, on the other hand, uses ultrasonography for full evaluation of cardiac function and hemodynamics, and requires extensive training, with formal certification now available. Indeed, recent years have seen the creation of worldwide certification in advanced CCE. While transthoracic CCE remains the most commonly used method, the transesophageal route has gained importance, particularly for intubated and ventilated patients.

CONCLUSION:

CCE is now widely accepted by the critical care community as a valuable tool in the ICU and emergency department, and in perioperative settings.

KEYWORDS:

Critical care echocardiography; Hemodynamic monitoring; Transesophageal echocardiography; Transthoracic echocardiography; Ultrasonography

PMID:
30911808
DOI:
10.1007/s00134-019-05604-2

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