TY - JOUR
T1 - Critical care ultrasonography in circulatory shock
AU - Koster, Geert
AU - van der Horst, Iwan C. C.
PY - 2017/8
Y1 - 2017/8
N2 - Purpose of review The objective was to define the role of ultrasound in the diagnosis and the management of circulatory shock by critical appraisal of the literature.Recent findings Assessment of any patient's hemodynamic profile based on clinical examination can be sufficient in several cases, but many times unclarities remain. Arterial catheters and central venous lines are commonly used in critically ill patients for practical reasons, and offer an opportunity for advanced hemodynamic monitoring. Critical care ultrasonography may add to the understanding of the hemodynamic profile at hand. Improvements in ultrasound techniques, for example, smaller devices and improved image quality, may reduce limitations and increase its value as a complementary tool. Critical care ultrasonography has great potential to guide decisions in the management of shock, but operators should be aware of limitations and pitfalls as well. Current evidence comes from cohort studies with heterogeneous design and outcomes. Summary Use of ultrasonography for hemodynamic monitoring in critical care expands, probably because of absence of procedure-related adverse events. Easy applicability and the capacity of distinguishing different types of shock add to its increasing role, further supported by consensus statements promoting ultrasound as the preferred tool for diagnostics in circulatory shock.
AB - Purpose of review The objective was to define the role of ultrasound in the diagnosis and the management of circulatory shock by critical appraisal of the literature.Recent findings Assessment of any patient's hemodynamic profile based on clinical examination can be sufficient in several cases, but many times unclarities remain. Arterial catheters and central venous lines are commonly used in critically ill patients for practical reasons, and offer an opportunity for advanced hemodynamic monitoring. Critical care ultrasonography may add to the understanding of the hemodynamic profile at hand. Improvements in ultrasound techniques, for example, smaller devices and improved image quality, may reduce limitations and increase its value as a complementary tool. Critical care ultrasonography has great potential to guide decisions in the management of shock, but operators should be aware of limitations and pitfalls as well. Current evidence comes from cohort studies with heterogeneous design and outcomes. Summary Use of ultrasonography for hemodynamic monitoring in critical care expands, probably because of absence of procedure-related adverse events. Easy applicability and the capacity of distinguishing different types of shock add to its increasing role, further supported by consensus statements promoting ultrasound as the preferred tool for diagnostics in circulatory shock.
KW - cardiac output
KW - circulatory shock
KW - critical care ultrasonography
KW - diagnosis
KW - echocardiography
KW - management
KW - PULMONARY-ARTERY CATHETER
KW - INTENSIVE-CARE
KW - TRANSTHORACIC ECHOCARDIOGRAPHY
KW - ILL PATIENTS
KW - CARDIAC-OUTPUT
KW - EMERGENCY-DEPARTMENT
KW - FLUID RESPONSIVENESS
KW - SEPTIC SHOCK
KW - UNDIFFERENTIATED HYPOTENSION
KW - FOCUSED ECHOCARDIOGRAPHY
U2 - 10.1097/MCC.0000000000000428
DO - 10.1097/MCC.0000000000000428
M3 - Review article
SN - 1070-5295
VL - 23
SP - 326
EP - 333
JO - Current opinion in critical care
JF - Current opinion in critical care
IS - 4
ER -