Transthoracic Focused Rapid Echocardiographic Examination: Real-Time Evaluation of Fluid Status in Critically Ill Trauma Patients

Abstract

IVC diameter and IVC respiratory variation was able to be obtained in the majority of cases, giving an estimate of fluid status. Estimation of ejection fraction was useful in guiding the treatment plan regarding the requirement of fluid boluses versus ionotropic support. We conclude that the FREE can provide meaningful data in difficult to image critically ill trauma patients.

Clinical Applications of Ultrasound Skills

“…Surgeons, especially those of us that are also critical care physicians, need to approach the subject of learning this technique more enthusiastically, for the only way to have a voice in the matter is to speak the same language [1,[7][8][9][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Surgeons described the use of ultrasound to evaluate for intra-abdominal fluid while treating trauma patients, and how these teachings are included in the Advanced Life Support Training available for all providers [27].…”

“…A problemoriented cardiac evaluation is not only feasible, but lifesaving, in many situations, including hypovolemia, right-sided cardiac failure, decreased left ventricular function and the presence of hemodynamically significant pericardial effusion [4,7,8,[43][44][45].…”

“…For the critical care physician, ultrasound has become an essential tool for guiding therapy [6][7][8][9][10].…”

Transfusion medicine in trauma patients: an update

“…Likewise, clinician utilization of point-of-care ultrasound techniques provides immediate critical visual information. �ocused assessment sonography for trauma can demonstrate free fluid in the pericardium and abdomen, alerting the clinician to the possibility of occult bleeding, and focused rapid echocardiographic examination can demonstrate pericardial fluid, ventricular function and volume status [50,51]. High speed whole-body C� scanning can recognize sites of occult bleeding (Figure 2) [52].…”

Update on point of care ultrasound in the care of the critically ill patient

“…Point-of-care ultrasound protocols now specifically focus on cardiac ultrasound to evaluate ejection fractions, cardiac output and patient volume status [15][16][17] . The dynamic nature of the techniques and ability to repeat an examination rapidly, as needed without additional radiation or waiting on an imaging specialist to perform the examination and interpret it, allows the individual intensivist to monitor patient progress and effects of therapeutic interventions [18] .…”