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Echocardiography alone or coupled with other hemodynamic devices?

par Voga, Gorazd;De Backer, Daniel ;Vieillard-Baron, Antoine
Editeur scientifique De Backer, Daniel ;Cholley, B.;Slama, Michel;Vieillard-Baron, Antoine;Vignon, P.
Référence Hemodynamic monitoring using echocardiography in the critically ill, Springer Verlag, Berlin, Heidelberg, New York, page (283-287)
Publication Publié, 2011

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Résumé :

Critical care echocardiography, either via transthoracic or transesophageal approaches, is the perfect tool for the hemodynamic evaluation of the patient with circulatory and respiratory failure and for proper adjustment of various therapeutic options (volume loading, vasoactive treatment, inotropic support, optimal ventilatory support). However, after initial therapy has been initiated or even after initial reevaluation of its effects, the hemodynamic situation can evolve, and repeated assessment of the hemodynamic condition at repeated intervals may be warranted. In addition to basic hemodynamic monitoring (arterial pressure, heart rate, eventually central venous pressure), echocardiography can be used for this purpose, alone or combined with other advanced invasive or minimally invasive hemodynamic devices. Conditions specific to the patient, organization of the intensive care unit and skills and/or activities of the physician influence the decision to combine echocardiography with other hemodynamic devices. The choice of the alternate hemodynamic device should be guided by the variables considered essential to be monitored as well as by a risk/benefit evaluation. In all cases, whatever the tools, the alternate hemodynamic device has to be totally mastered by intensivists and integrated into a clear therapeutic management. © 2011 Springer-Verlag Berlin Heidelberg.