Book contents
- Modern Monitoring in Anesthesiology and Perioperative Care
- Modern Monitoring in Anesthesiology and Perioperative Care
- Copyright page
- Contents
- Contributors
- Preface
- Chapter 1 Statistics Used to Assess Monitors and Monitoring Applications
- Chapter 2 Multimodal Neurological Monitoring
- Chapter 3 Cerebral Oximetry
- Chapter 4 The Oxygen Reserve Index
- Chapter 5 Point-of-Care Transesophageal Echocardiography
- Chapter 6 Point-of-Care Transthoracic Echocardiography
- Chapter 7 Point-of-Care Lung Ultrasound
- Chapter 8 Point-of-Care Ultrasound: Determination of Fluid Responsiveness
- Chapter 9 Point-of-Care Abdominal Ultrasound
- Chapter 10 Noninvasive Measurement of Cardiac Output
- Chapter 11 Assessing Intravascular Volume Status and Fluid Responsiveness: A Non-Ultrasound Approach
- Chapter 12 Assessment of Extravascular Lung Water
- Chapter 13 Point-of-Care Hematology
- Chapter 14 Assessment of Intraoperative Blood Loss
- Chapter 15 Respiratory Monitoring in Low-Intensity Settings
- Chapter 16 The Electronic Health Record as a Monitor for Performance Improvement
- Chapter 17 Future Monitoring Technologies: Wireless, Wearable, and Nano
- Chapter 18 Downside and Risks of Digital Distractions
- Index
- Plate Section (PDF Only)
- References
Chapter 6 - Point-of-Care Transthoracic Echocardiography
Published online by Cambridge University Press: 28 April 2020
Book contents
- Modern Monitoring in Anesthesiology and Perioperative Care
- Modern Monitoring in Anesthesiology and Perioperative Care
- Copyright page
- Contents
- Contributors
- Preface
- Chapter 1 Statistics Used to Assess Monitors and Monitoring Applications
- Chapter 2 Multimodal Neurological Monitoring
- Chapter 3 Cerebral Oximetry
- Chapter 4 The Oxygen Reserve Index
- Chapter 5 Point-of-Care Transesophageal Echocardiography
- Chapter 6 Point-of-Care Transthoracic Echocardiography
- Chapter 7 Point-of-Care Lung Ultrasound
- Chapter 8 Point-of-Care Ultrasound: Determination of Fluid Responsiveness
- Chapter 9 Point-of-Care Abdominal Ultrasound
- Chapter 10 Noninvasive Measurement of Cardiac Output
- Chapter 11 Assessing Intravascular Volume Status and Fluid Responsiveness: A Non-Ultrasound Approach
- Chapter 12 Assessment of Extravascular Lung Water
- Chapter 13 Point-of-Care Hematology
- Chapter 14 Assessment of Intraoperative Blood Loss
- Chapter 15 Respiratory Monitoring in Low-Intensity Settings
- Chapter 16 The Electronic Health Record as a Monitor for Performance Improvement
- Chapter 17 Future Monitoring Technologies: Wireless, Wearable, and Nano
- Chapter 18 Downside and Risks of Digital Distractions
- Index
- Plate Section (PDF Only)
- References
Summary
Point-of-care transthoracic echocardiography (TTE) is integral to the practice of acute care medicine to help assess patients quickly, accurately, and non-invasively. This review discusses how point-of-care TTE works in terms of logistics and diagnostic capabilities, specifying the information available from each point-of-care TTE view. The TTE findings of potentially reversible causes of shock are also described to help distinguish different causes of shock and to guide management and therapeutic interventions. While data have not shown that point-of-care TTE improves patient outcomes or mortality, it can certainly narrow the differential diagnosis for the cause of shock, potentially allowing earlier, more appropriate treatment.
Keywords
- Type
- Chapter
- Information
- Publisher: Cambridge University PressPrint publication year: 2020
References
Shillcutt, SK, Bick, JS. A comparison of basic transthoracic and transesophageal echocardiography views in the perioperative setting. Anesth Analg 2013;116:1231–6.Google Scholar
Griffee, MJ, Merkel, MJ, Wei, KS. The role of echocardiography in hemodynamic assessment of septic shock. Crit Care Clin 2010;26:365–82.Google Scholar
Mahmood, F, Matyal, R, Skubas, N, et al. Perioperative ultrasound training in anesthesiology: a call to action. Anesth Analg 2016;122:1794–804.CrossRefGoogle Scholar
Perera, P, Lobo, V, Williams, SR, et al. Cardiac echocardiography. Crit Care Clin 2014;30:47–92.CrossRefGoogle ScholarPubMed
Sturgess, DJ. Transthoracic echocardiography: an overview. In: Lumb, P, Karakitsos, D, eds. Critical Care Ultrasound. Philadelphia: Elsevier Saunders, 2015;139–45.Google Scholar
Nagueh, SF, Smiseth, OA, Appleton, CP, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur Heart J Cardiovasc Imaging 2016;17:1321–60.CrossRefGoogle ScholarPubMed
Lang, R, Badano, L, Mor-Avi, V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2015;16:233–70.CrossRefGoogle ScholarPubMed
McKaigney, CJ, Krantz, MJ, La Rocque, CL, et al. E-point septal separation: a bedside tool for emergency physician assessment of left ventricular ejection fraction. Am J Emerg Med 2014;32:493–7.Google Scholar
Rudski, LG, Lai, WW, Afilalo, J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography. J Am Soc Echocardiogr 2010;23:685–713.CrossRefGoogle ScholarPubMed
Narasimhan, M, Koenig, SJ, Mayo, PH. Advanced echocardiography for the critical care physician, Part 2. Chest 2014;145:135–42.Google Scholar
Cowie, B, Kluger, R. Evaluation of systolic murmurs using transthoracic echocardiography by anaesthetic trainees. Anaesthesia 2011;66:785–90.Google Scholar
Zimmerman, JM, Coker, BJ. The nuts and bolts of performing focused cardiovascular ultrasound (FoCUS). Anesth Analg 2017;124:753–60.Google Scholar
Slama, M, Maizel, J. Echocardiographic measurement of ventricular function. Curr Opin Crit Care 2006;12:241–8.CrossRefGoogle ScholarPubMed
Maizel, J, El-Dash, S, Slama, M. Evaluation of left ventricular diastolic function in the intensive care unit. In: Lumb, P, Karakitsos, D, eds. Critical Care Ultrasound. Philadelphia: Elsevier Saunders, 2015;175–8.Google Scholar
Maizel, J, Salhi, A, Tribouilloy, C, et al. The subxiphoid view cannot replace the apical view for transthoracic echocardiographic assessment of hemodynamic status. Crit Care 2013;17:R186.Google Scholar
Wallace, DJ, Allison, M, Stone, MB. Inferior vena cava percentage collapse during respiration is affected by the sampling location: an ultrasound study in healthy volunteers. Acad Emerg Med 2010;17:96–9.Google Scholar
Shokoohi, H, Boniface, KS, Pourmand, A, et al. Bedside ultrasonography reduces diagnostic uncertainty and guides resuscitation in patients with undifferentiated hypotension. Crit Care Med 2015;43:2562–9.CrossRefGoogle ScholarPubMed
Jones, AE, Tayal, VS, Sullivan, M, et al. Randomized, controlled trial of immediate versus delayed goal-directed ultrasound to identify the cause of nontraumatic hypotension in emergency department patients. Crit Care Med 2004;32:1703–8.CrossRefGoogle ScholarPubMed
Bøtker, MT, Vang, ML, Grøfte, T, et al. Routine pre-operative focused ultrasonography by anesthesiologists in patients undergoing urgent surgical procedures. Acta Anaesthesiol Scand 2014;58:807–14.CrossRefGoogle ScholarPubMed
Canty, DJ, Royse, CF, Kilpatrick, D, et al. The impact of pre-operative focused transthoracic echocardiography in emergency non-cardiac surgery patients with known or risk of cardiac disease. Anaesthesia 2012;67:714–20.Google Scholar
Melamed, R, Sprenkle, MD, Ulstad, VK, et al. Assessment of left ventricular function by intensivists using hand-held echocardiography. Chest 2009;135:1416–20.CrossRefGoogle ScholarPubMed
De Backer, D. Ultrasonic evaluation of the heart. Curr Opin Crit Care 2014;20:309–14.CrossRefGoogle ScholarPubMed
Vieillard-Baron, A, Prin, S, Chergui, K, et al. Echo-Doppler demonstration of acute cor pulmonale at the bedside in the medical intensive care unit. Am J Respir Crit Care Med 2002;166:1310–9.Google Scholar
Hellenkamp, K, Unsöld, B, Mushemi-Blake, S, et al. Echocardiographic estimation of mean pulmonary artery pressure: a comparison of different approaches to assign the likelihood of pulmonary hypertension. J Am Soc Echocardiogr 2017;31(1):89–98.CrossRefGoogle ScholarPubMed
Atkinson, P, Bowra, J, Milne, J, et al. International Federation for Emergency Medicine Consensus Statement: Sonography in hypotension and cardiac arrest (SHoC): an international consensus on the use of point of care ultrasound for undifferentiated hypotension and during cardiac arrest. CJEM 2017;19:459–70.Google Scholar
Blyth, L, Atkinson, P, Gadd, K, et al. Bedside focused echocardiography as predictor of survival in cardiac arrest patients: a systematic review. Acad Emerg Med 2012;19:1119–26.CrossRefGoogle ScholarPubMed
Gaspari, R, Weekes, A, Adhikari, S, et al. Emergency department point-of-care ultrasound in out-of-hospital and in-ED cardiac arrest. Resuscitation 2016;109:33–9.Google Scholar
Gaspari, R, Weekes, A, Adhikari, S, et al. A retrospective study of pulseless electrical activity, bedside ultrasound identifies interventions during resuscitation associated with improved survival to hospital admission. Resuscitation 2017;120:103–7.CrossRefGoogle ScholarPubMed
Chardoli, M, Heidari, F, Rabiee, H, et al. Echocardiography integrated ACLS protocol versus conventional cardiopulmonary resuscitation in patients with pulseless electrical activity cardiac arrest. Chin J Traumatol 2012;15:284–7.Google Scholar