Abstract
Transthoracic echocardiography (TTE) provides the intensivist with a tool that has potential to give a rapid, noninvasive assessment of the hemodynamic status of the critically ill patient at the bedside. Even though critically ill patients have specificities that can make TTE images suboptimal, recent technological advances have allowed interpretable images to be obtained in the vast majority of patients, and TTE should be considered a first-line approach. The echocardiographic modalities with their respective indications for use in the intensive care unit (ICU) are described in this chapter. In addition, the stages involved in performing a TTE study are explained together with practical tips for optimizing imaging quality. The principles of Doppler imaging and indications are also reported.
TTE uses five standard views for hemodynamic evaluation, namely parasternal long- and short-axis views, apical four- and five-chamber views, and the subcostal view of the heart (with examination of the inferior vena cava).
The limitations of TTE in the ICU relate to the patient, the pathology, and the ability of the operator (both technical and in interpretation of the study). When TTE is inconclusive, the transesophageal approach should be considered.
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Price, S. (2011). Transthoracic Echocardiography: Normal Two-Dimensional and Doppler Imaging. In: de Backer, D., Cholley, B., Slama, M., Vieillard-Baron, A., Vignon, P. (eds) Hemodynamic Monitoring Using Echocardiography in the Critically Ill. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-87956-5_2
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DOI: https://doi.org/10.1007/978-3-540-87956-5_2
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