Focused Critical Care Echocardiography

Abstract

Objective Portable ultrasound is now used routinely in many intensive care units (ICUs) for various clinical applications. Echocardiography performed by non-cardiologists, both transesophageal (TEE) and transthoracic (TTE), has evolved to broad applications in diagnosis, monitoring, and management of critically ill patients. This review provides a current update on Focused Critical Care Echocardiography (FCCE) for the management of critically ill patients. Method Source data were obtained from a PubMed search of the medical literature, including the PubMed “related articles” search methodology. Summary and Conclusions While studies demonstrating improved clinical outcomes for critically ill patients managed by FCCE are generally lacking, there is evidence to suggest that some intermediate outcomes are improved. Furthermore, non-cardiologists can learn FCCE and adequately interpret the information obtained. Non-cardiologists can also successfully incorporate FCCE into advanced cardiopulmonary life support (ACLS). Formal training and proctoring are important for safe application of FCCE in clinical practice. Further outcomes-based research is urgently needed to evaluate the efficacy of FCCE

Basic Critical Care Echocardiography by Pulmonary Fellows

“…B asic critical care echocardiography (BCCE) can be done by noncardiologist intensivists and has revolutionized the care of critically ill patients by allowing rapid noninvasive assessment of hemodynamics, cardiac function, valvular status, and fluid status (1)(2)(3)(4)(5)(6). However, the spread of echocardiography skills to pulmonologists working in intensive care requires overcoming the resource barriers involved in achieving up to 150-300 studies over 3-6 months required by professional cardiology and echocardiography organizations or in purchasing echocardiography simulators to complement experience with real patients (1,7).…”

Inferior vena cava guided fluid resuscitation – Fact or fiction?

“…42 On its own, US assessment of hemodynamic status using IVC parameters may provide the clinician with incorrect information especially given the lack of standardized training for intensivists. 43 One needs to be aware of its limitations and be cautious about using it in isolation to make clinical decisions. Additionally, one should consider that CVP or RAP, which IVC parameters are supposed to be a surrogate of, have been repeatedly found to bear little correlation with intravascular volume status.…”

Levels of training in critical care echocardiography in adults. Recommendations from the College of Intensive Care Medicine Ultrasound Special Interest Group

“…There are many international organisations which have produced recommendations, accreditation statements and guidelines for levels of practice and training in CCE . Achieving consistency with national and international intensive care organisations and related medical bodies was one of the aims of this document.…”