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VOLUME 3 , ISSUE 3 ( September-December, 2024 ) > List of Articles

REVIEW ARTICLE

Critical Care Echocardiography: A Review Article

Rajavardhan Rangappa, Raghavendra Deshpande

Keywords : Critical care echocardiography, Echocardiography, Intensive care unit

Citation Information : Rangappa R, Deshpande R. Critical Care Echocardiography: A Review Article. J Acute Care 2024; 3 (3):134-140.

DOI: 10.5005/jp-journals-10089-0137

License: CC BY-NC 4.0

Published Online: 15-01-2025

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Ultrasonography is increasingly being utilized in critical care units. With the advent of portable ultrasound machines and advancements in technology, it has become easier and more fundamental to patient assessment. Echocardiography performed by intensivists, both basic and advanced, has evolved in the diagnosis, monitoring, and management of patients admitted to the intensive care unit (ICU). Critical care echocardiography (CCE) enhances patient safety by providing real-time and dynamic information at the bedside. While transthoracic echocardiography is most commonly used, the importance of transesophageal echocardiography (TEE) has increased, particularly for intubated and ventilated patients. Recent studies indicate that the use of CCE may have a positive impact on outcomes. CCE can be employed in the early evaluation of critically ill patients in the emergency department and during ICU admission and stay. CCE has also proven useful in perioperative settings and in the management of patients on mechanical circulatory support, such as extracorporeal membrane oxygenation (ECMO). Both basic and advanced CCE require extensive training and certification. In recent years, worldwide certification programs in CCE have been established. CCE influences septic shock management, identifying cardiovascular phenotypes and improving early detection and prognosis of septic cardiomyopathy. It is essential for hemodynamic monitoring, evaluating cardiac function, fluid responsiveness, and therapy impacts in critically ill patients. Right ventricular (RV) function is influenced by increased pulmonary vascular resistance (PVR) and pulmonary hypertension, with echocardiographic parameters aiding in assessment with high sensitivity and specificity. CCE aids in identifying weaning difficulties by linking worse diastolic function (E wave, e’ wave, E/e’ ratio) to weaning failure, with no significant correlation to systolic dysfunction. This review article aims to highlight the importance of CCE, outlining its pivotal role in acute care settings.

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