WHY EVERYONE SHOULD KNOW ABOUT CRITICAL CARE ULTRASOUND

Ultrasound monitoring

WHY EVERYONE SHOULD KNOW ABOUT CRITICAL CARE ULTRASOUND

Ultrasound monitoring

Points to ponder

• Have you got an Echo machine?• Have you got an US machine?• Are you competently trained in

Echo/US?• Are all the doctor colleagues in

your dept trained to use AND interpret the images?

• Are your nurses trained to follow the clinical protocols and pathways from the images obtained?

The perfect

monitor

• Precision• Accuracy•Reproducible•Continuous

We suggest that, when further hemodynamic assessment is needed, echocardiography is the preferred modality to initially evaluate the type of shock as opposed to more invasive technologies. Level 2; QoE moderate (B)Echocardiography can be used for the sequential evaluation of cardiac function in shock. Statement of fact

• no hemodynamic monitoring technique can improve outcome by itself

• monitoring requirements may vary over time and can depend on local equipment availability and training

• there are no optimal hemodynamic values that are applicable to all patients

• we need to combine and integrate variables

• measurements of SvO2 can be helpful

• a high cardiac output and a high SvO2 are not always best

• cardiac output is estimated, not measured

• monitoring hemodynamic changes over short periods of time is important

• continuous measurement of all hemodynamic variables is preferable

• non-invasiveness is not the only issue

A fool with a tool is a dangerous fool

Summary

• No monitoring device improves outcome without being paired to appropriate treatment• A good diagnostic/procedural tool does not necessarily mean a good monitoring tool• Just because you can, doesn’t mean you should