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Echocardiography in the intensive care unit: from evolution to revolution?

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Abstract

Background

Over recent decades, echocardiography has become a pivotal diagnostic tool for the assessment of patients with hemodynamic compromise in general intensive care units (ICUs). In addition to its imaging capability, echocardiography provides a detailed cardiovascular assessment, based on the combination of real-time two-dimensional evaluation of cardiac structure and function and hemodynamic information provided by Doppler measurement of blood flow velocity. However, despite its ease of use, portability and accuracy, the diffusion of echocardiography among ICUs has been limited by various factors.

Discussion

We discuss here the main reasons for the slow acceptance by the critical care community of echocardiography as a first-line diagnostic tool for the evaluation of hemodynamically unstable patients. One of these reasons is probably the absence, in most countries, of a training program in echocardiography specifically dedicated to intensivists. We report recent French experience in the organization of specific echocardiographic certification aimed at intensivists and anesthesiologists. We strongly believe that a broader use of echocardiography would be beneficial in terms of diagnostic capability and patient management. Therefore, we would like to involve colleagues from other countries and the European Society of Intensive Care Medicine in defining the objectives of echocardiography training for intensivists and in organizing postgraduate courses and training programs aimed at developing the use of echocardiography in ICUs. This would allow the current “evolution” in mentalities to become a true “revolution” in our daily practice.

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Author information

Authors and Affiliations

  1. Intensive Care Unit, Hôpital Ambroise Paré, Assistance Publique – Hôpitaux de Paris, 9, avenue Charles de Gaulle, 92104, Boulogne Cedex, France

    Antoine Vieillard-Baron

  2. Medical Intensive Care Unit, South Hospital, Avenue René Laennec, 80054, Cedex 1, Amiens, France

    Michel Slama

  3. INSERM ERI 12, Amiens, France

    Michel Slama

  4. Department of Anesthesiology, Lariboisière Hospital, Assistance Publique – Hôpitaux de Paris, 2, rue Ambroise Paré, 75010, Paris, France

    Bernard Cholley

  5. Department of Anesthesiology, Pellegrin Hospital, 1, place Amélie Raba-Léon, 33076, Bordeaux, France

    Gérard Janvier

  6. Medical–Surgical Intensive Care Unit, Dupuytren Hospital, 2, avenue Martin Luther King, 87042, Limoges, France

    Philippe Vignon

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  1. Antoine Vieillard-Baron
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  2. Michel Slama
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  3. Bernard Cholley
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  4. Gérard Janvier
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  5. Philippe Vignon
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Correspondence to Antoine Vieillard-Baron.

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From the “ECHO-in-ICU group”

This article is discussed in the editorial available at: http://dx.doi.org/10.1007/s00134-007-0924-4.

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Vieillard-Baron, A., Slama, M., Cholley, B. et al. Echocardiography in the intensive care unit: from evolution to revolution?. Intensive Care Med 34, 243–249 (2008). https://doi.org/10.1007/s00134-007-0923-5

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  • DOI: https://doi.org/10.1007/s00134-007-0923-5

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