Intensive Care Medicine

, Volume 45, Issue 6, pp 770–788 | Cite as

A decade of progress in critical care echocardiography: a narrative review

  • Antoine Vieillard-BaronEmail author
  • S. J. Millington
  • F. Sanfilippo
  • M. Chew
  • J. Diaz-Gomez
  • A. McLean
  • M. R. Pinsky
  • J. Pulido
  • P. Mayo
  • N. Fletcher



This narrative review focusing on critical care echocardiography (CCE) has been written by a group of experts in the field, with the aim of outlining the state of the art in CCE in the 10 years after its official recognition and definition.


In the last 10 years, CCE has become an essential branch of critical care ultrasonography and has gained general acceptance. Its use, both as a diagnostic tool and for hemodynamic monitoring, has increased markedly, influencing contemporary cardiorespiratory management. Recent studies suggest that the use of CCE may have a positive impact on outcomes. CCE may be used in critically ill patients in many different clinical situations, both in their early evaluation of in the emergency department and during intensive care unit (ICU) admission and stay. CCE has also proven its utility in perioperative settings, as well as in the management of mechanical circulatory support. CCE may be performed with very simple diagnostic objectives. This application, referred to as basic CCE, does not require a high level of training. Advanced CCE, on the other hand, uses ultrasonography for full evaluation of cardiac function and hemodynamics, and requires extensive training, with formal certification now available. Indeed, recent years have seen the creation of worldwide certification in advanced CCE. While transthoracic CCE remains the most commonly used method, the transesophageal route has gained importance, particularly for intubated and ventilated patients.


CCE is now widely accepted by the critical care community as a valuable tool in the ICU and emergency department, and in perioperative settings.


Critical care echocardiography Transthoracic echocardiography Transesophageal echocardiography Ultrasonography Hemodynamic monitoring 


Compliance with ethical standards

Conflicts of interest

AVB has received grant funds from GSK for conducting clinical research and was a member of the scientific advisory board for the study. SJM declares no conflict of interest. FSF declares no conflict of interest. MC has received honoraria and travel grants from Edwards Lifesciences. JDG declares no conflict of interest. AML declares no conflict of interest. MRP has received honoraria for lectures from Edwards Lifesciences, Cheetah Medical and LiDCO Ltd and is a scientific advisor to Edwards Lifesciences and LiDCO Ltd. JP declares no conflict of interest. PM declares no conflict of interest. NF declares no conflict of interest.

Ethical approval

An approval by an ethics committee was not applicable.

Supplementary material

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019
corrected publication April 2019

Authors and Affiliations

  • Antoine Vieillard-Baron
    • 1
    • 2
    Email author
  • S. J. Millington
    • 3
  • F. Sanfilippo
    • 4
  • M. Chew
    • 5
  • J. Diaz-Gomez
    • 6
  • A. McLean
    • 7
  • M. R. Pinsky
    • 8
  • J. Pulido
    • 9
  • P. Mayo
    • 10
  • N. Fletcher
    • 11
    • 12
  1. 1.Intensive Care Medicine UnitAssistance Publique-Hôpitaux de Paris, University Hospital Ambroise ParéBoulogne-BillancourtFrance
  2. 2.INSERM U-1018, CESP, Team 5, University of Versailles Saint-Quentin en YvelinesVillejuifFrance
  3. 3.Department of Critical Care Medicine, The Ottawa HospitalUniversity of OttawaOttawaCanada
  4. 4.Department of Anesthesia and Intensive CarePoliclinico-Vittorio Emanuele University HospitalCataniaItaly
  5. 5.Department of Anaesthesiology and Intensive Care, Medical and Health SciencesLinköping UniversityLinköpingSweden
  6. 6.Department of Critical Care MedicineMayo ClinicJacksonvilleUSA
  7. 7.Intensive Care Nepean HospitalUniversity of SydneySydneyAustralia
  8. 8.Department of Critical Care MedicineUniversity of PittsburghPittsburghUSA
  9. 9.Cardiothoracic Anesthesiology and Critical Care Medicine, Cardiovascular Intensive Care UnitSwedish Heart and Vascular Institute, Swedish Medical Center, US Anesthesia PartnersSeattleUSA
  10. 10.Division of PulmonaryCritical Care and Sleep Medicine, Northwell Health LIJ/NSUH Medical Center, Zucker School of MedicineHofstra/NorthwellUSA
  11. 11.Consultant in Cardiothoracic Critical Care, St Georges Hospital, St Georges University of LondonLondonUK
  12. 12.Cleveland Clinic LondonLondonUK

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