Echocardiography in a critical care unit: a contemporary review

ABSTRACT

Introduction

Echocardiography is a rapid, noninvasive, and complete cardiac assessment tool for patients with hemodynamic instability. Relevant articles were extracted after searching on databases by two reviewers and incorporated in this review in anarrative style.

Areas covered

his review provides an overview of the evidence for current practices in critical care units (CCUs), incorporating the use of echocardiography in different etiologies of shock.

Expert opinion

In an acute scenario, a basic echocardiographic study yields prompt diagnosis, allowing for the initiation of treatment. The most common pathologies in shocked patients are identified promptly using two-dimensional (2D) and M-mode echocardiography. A more comprehensive assessment can follow after patients have been stabilized. There are four types of shock: (i) cardiogenic shock, (ii) hypovolemic shock, (iii) obstructive shock, and (iv) septic shock. All of them can be readily identified by echocardiography. As echocardiography is increasingly being used in an intensive care setting, its applications and evidence base should be expanded by randomized controlled trials to demonstrate patient outcomes in critical care.

KEYWORDS:

• Cardiogenic shock
• hypovolemia
• septic shock
• RACE
• ICU

Article highlights

• Shock is considered a life-threatening causing inadequate oxygen delivery to the vital organs

• There are 4 types of shock and associated mortality reaches 56% without the diagnosis

• Echocardiography is a rapid, and noninvasive cardiac assessment tool for patients with shock

• The most common pathologies in shocked patients can be identified using conventional echocardiography

• Evidence base of echocardiography should be expanded by randomized controlled trials to demonstrate patient outcomes in critical care

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.