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The Focused Rapid Echocardiographic Evaluation (FREE): Clinical Examples

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Abstract

Using the focused rapid echocardiographic evaluation (FREE) is easier than explaining it. Below are examples of guiding complex resuscitation tailored to patient need with ultrasound. The scenarios are adapted from clinical cases using FREEs to direct management. Even though measurements contained in the FREE evolve, changing from time to time, the structure remains the same; patient assessment, selection of a fluid strategy, ultrasound evaluation of cardiac function, volume status, vascular resistance, and anatomic findings are used to generate recommendations about the use of fluid, vasopressors, and inotropic support.

Keywords

  • FREE; hemodynamic profile
  • Vasodilated
  • Ejection fraction
  • Right ventricular dysfunction
  • COVID-19

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Abbreviations

BP:

Blood pressure

BSA:

Body surface area

CI:

Cardiac index

CRRT :

Continuous renal replacement therapy

FREE:

Focused rapid echocardiographic evaluation

HR:

Heart rate

Ht:

Height

ICU:

Intensive care unit

IVC:

Inferior vena cava

LVOT D:

Left ventricular outflow tract diameter

MAP:

Mean arterial blood pressure

PAC:

Pulmonary artery catheter

PASP:

Pulmonary artery systolic pressure

PEEP :

Positive end expiratory pressure

POCUS:

Point-of-care ultrasound

SVI:

Stroke volume index

SVR:

Systemic vascular resistance

SVV:

Stroke volume variation

TAPSE:

Transannular plane systolic excursion

UTA:

Unable to assess

VR:

Volume responsiveness

VTI:

Velocity time integral

Wt:

Weight

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Correspondence to Sarah B. Murthi .

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1 Electronic Supplementary Material

This video shows a low LVEF (MP4 2547 kb)

This video shows a RV clot (MP4 2774 kb)

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Murthi, S.B. (2021). The Focused Rapid Echocardiographic Evaluation (FREE): Clinical Examples. 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_27

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  • DOI: https://doi.org/10.1007/978-3-030-74687-2_27

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-74685-8

  • Online ISBN: 978-3-030-74687-2

  • eBook Packages: MedicineMedicine (R0)