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Review
. 2024 Nov;24(11):399-408.
doi: 10.1016/j.bjae.2024.07.003. Epub 2024 Sep 7.

Critical care echocardiography: training, imaging, and indications

J K Cheng  1 , R Arntfield  2
Affiliations
Review

Critical care echocardiography: training, imaging, and indications

J K Cheng et al. BJA Educ. 2024 Nov.
No abstract available

Keywords: critical care; echocardiography; ultrasound.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig 1
Fig 1
Examples of currently available multipurpose ultrasound machines available with quantitative cardiac software, multi-purpose probe support and capabilities for transoesophageal echocardiography. (A) Fujifilm Sonosite LX, (B) Mindray M9 Premium and (C) Philips 5500 Series.
Fig 2
Fig 2
Minimum transthoracic echocardiography views for critical care echocardiography (CCE) to facilitate basic assessment and example of phased-array probe suitable for transthoracic echocardiography. A4C, apical-four chamber; AV, aortic valve; DTA, descending thoracic aneurysm; HPV, hepatic vein; IVC, inferior vena cava; LA, left atrium; LV, left ventricle; MV, mitral valve; PLAX, parasternal long axis; PSAX, parasternal short axis; RA, right atrium; RV, right ventricle; RVOT, right ventricular outflow tract; S4C, subcostal four chamber, ; SLAX, subcostal long axis.
Fig 3
Fig 3
Resuscitative transoesophageal views with multiplane degrees for reference and structures that can be visualised in each view. (A) (mid-oesophageal four-chamber view) is ideal for global assessment of left and right ventricular function and for assessment of mitral and tricuspid valve disease. Pericardial fluid collections can also be visualised. (B) (mid-oesophageal long axis view) can be used during cardiac arrest to assess chest compression position and for assessment of dynamic left ventricular outflow tract obstruction, aortic and mitral valve disease, and global left ventricular function. (C) (mid-oesophageal bicaval view) is useful for assessing the superior vena cava for fluid responsiveness but also for use during cannulation for extracorporeal membrane oxygenation. (D) (transgastric mid-papillary short axis view) can be used for global left ventricular function and identification of segmental wall motion abnormalities. AV, aortic valve; IVC, inferior vena cava; LA, left atrium; LV, left ventricle; LVOT, left ventricular outflow tract; MV, mitral valve; RA, right atrium; RV, right ventricle; RVOT, right ventricular outflow tract; SVC, superior vena cava; TV, tricuspid valve.
Fig 4
Fig 4
Example of severe right ventricular dysfunction on transthoracic echocardiography. (A) Parasternal short axis demonstrating large right ventricle with flattening of the interventricular septum in systole and diastole (see accompanying Fig. 4 online video). (B) apical four-chamber demonstrating an enlarged right ventricle (greater in size than left ventricle) with impaired longitudinal motion of the tricuspid valve annulus. (C) M-mode imaging across the tricuspid valve showing reduced tricuspid annular plane systolic excursion <16 mm.
See this image and copyright information in PMC

References

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