Intensive Care Medicine

, Volume 44, Issue 6, pp 868–883 | Cite as

The use of echocardiographic indices in defining and assessing right ventricular systolic function in critical care research

  • Stephen J. HuangEmail author
  • Marek Nalos
  • Louise Smith
  • Arvind Rajamani
  • Anthony S. McLean
Systematic Review



Many echocardiographic indices (or methods) for assessing right ventricular (RV) function are available, but each has its strengths and limitations. In some cases, there might be discordance between the indices. We conducted a systematic review to audit the echocardiographic RV assessments in critical care research to see if a consistent pattern existed. We specifically looked into the kind and number of RV indices used, and how RV dysfunction was defined in each study.


Studies conducted in critical care settings and reported echocardiographic RV function indices from 1997 to 2017 were searched systematically from three databases. Non-adult studies, case reports, reviews and secondary studies were excluded. These studies’ characteristics and RV indices reported were summarized.


Out of 495 non-duplicated publications found, 81 studies were included in our systematic review. There has been an increasing trend of studying RV function by echocardiography since 2001, and most were conducted in ICU. Thirty-one studies use a single index, mostly TAPSE, to define RV dysfunction; 33 used composite indices and the combinations varied between studies. Seventeen studies did not define RV dysfunction. For those using composite indices, many did not explain their choices.


TAPSE seemed to be the most popular index in the last 2–3 years. Many studies used combinations of indices but, apart from cor pulmonale, we could not find a consistent pattern of RV assessment and definition of RV dysfunction amongst these studies.


Echocardiography Right ventricular function Critical care Intensive care Emergency Anaesthetics 


Compliance with Ethical Standards

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethics Approval

Ethics approval for systematic review is not required.

Supplementary material

134_2018_5211_MOESM1_ESM.pdf (27 kb)
Supplementary material 1 (PDF 26 kb)
134_2018_5211_MOESM2_ESM.pdf (227 kb)
Supplementary material 2 (PDF 228 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature and ESICM 2018

Authors and Affiliations

  • Stephen J. Huang
    • 1
    Email author
  • Marek Nalos
    • 1
  • Louise Smith
    • 2
  • Arvind Rajamani
    • 1
  • Anthony S. McLean
    • 1
  1. 1.Department of Intensive Care Medicine, Nepean Hospital, Sydney Medical SchoolThe University of SydneySydneyAustralia
  2. 2.Cardiovascular Ultrasound Laboratory, Intensive Care UnitNepean HospitalSydneyAustralia

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