Abstract
After performing thousands of critical care echocardiograms, we began placing them into categories to allow more consistent treatment recommendations. The categories became hemodynamic profiles which consider clinical information including heart rate (HR), and mean arterial blood pressure (MAP), combined with ultrasound findings. The profile is then used with the fluid strategy to create recommendations about inotropic support, systemic vasopressors, and fluid management.
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Abbreviations
- CI:
-
Cardiac Index
- CO:
-
Cardiac Output
- D:
-
Diastole
- FREE:
-
Focused Rapid Echocardiographic Evaluation
- HR:
-
Heart Rate
- IVC :
-
Inferior Vena Cava
- LV:
-
Left Ventricle
- MAP :
-
Mean Arterial Blood Pressure
- Ml:
-
Milliliter
- PASP:
-
Pulmonary Artery Systolic Pressure
- RV:
-
Right Ventricle
- S:
-
Systole
- SV:
-
Stoke Volume
- SVI:
-
Stroke Volume Index
- SVR:
-
Systemic Vascular Resistance
- SVRI:
-
Systemic Vascular Resistance Index
- SVVr:
-
Respiratory Stroke Volume Variation
- TAPSE:
-
Transannular Plane Systolic Excursion
- VR:
-
Volume Responsiveness
- VTI :
-
Velocity Time Integral
Suggested Readings
Murthi SB, Markandaya M, Fang R, Hong CM, Galvagno SM, Lissuaer M, Stansbury LG, Scalea TM. Focused comprehensive, quantitative, functionally based echocardiographic evaluation in the critical care unit is feasible and impacts care. Mil Med. 2015;180(3 Suppl):74–9. https://doi.org/10.7205/MILMED-D-14-00374.
Olivieri PP, Patel R, Kolb S, Fatima S, Galvagno SM, Haase DJ, Ramani GV, Ludmir J, Alkhatib H, Herr D, Bruno DA, Scalea TM, Murthi SB. Echo is a good, not perfect, measure of cardiac output in critically ill surgical patients. J Trauma Acute Care Surg. 2019;87(2):379–85. https://doi.org/10.1097/TA.0000000000002304.
Spiegel R, Teeter W, Sullivan S, Tupchong K, Mohammed N, Sutherland M, Leibner E, Rola P, Galvagno SM Jr, Murthi SB. The use of venous Doppler to predict adverse kidney events in a general ICU cohort. Crit Care. 2020;24(1):615. https://doi.org/10.1186/s13054-020-03330-6. PMID: 33076961; PMCID: PMC7574322
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Murthi, S.B. (2021). Hemodynamic Profiles in the FREE. In: Salerno, A., Haase, D.J., Murthi, S.B. (eds) Atlas of Critical Care Echocardiography. Springer, Cham. https://doi.org/10.1007/978-3-030-74687-2_26
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DOI: https://doi.org/10.1007/978-3-030-74687-2_26
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