Which parameters of ventricular function should be evaluated in the intensive care unit?

Echocardiography is one of the most pow-erful diagnostic and monitoring tools available to the modern intensivist, pro-viding the means to diagnose cardiac dys-function, its underlying cause and suggest therapeutic interventions. Although seem-ingly simple, meaningful and clinically relevant evaluation of ventricular func-tion is challenging, and standard measures frequently unhelpful. Although at present the widespread application of physiologi-cal echocardiography and advanced echo-cardiographic techniques within intensive care remains disappointingly limited, the huge potential for collaborative research between cardiologists and intensivists within this field is evident.

echocardiographic assessment, cardiac function, intensive care unit

1. Duncan A, Francis D, Gibson D, Pepper J, Henein M. Electromechanical left ventricular resynchronisation by coronary artery bypass surgery.Eur J Cardiothorac Surg. 2004;26(4):711-719.

2. Milliez P, Thomas O, Haggui A, Schurando P, Squara P, Cohen-Solal A, Mebazaa A, Leenhardt A. Cardiac resynchronisation as a rescue therapy in patients with catecholamine-dependent overt heart failure: results from a short and mid-term study. Eur J Heart Fail. 2008;10(3):291-297. doi: 10.1016/j.ejheart.2008.02.006. Epub 2008 Feb 29.

3. Marwick TH. Measurement of strain and strain rate by echocardiography: ready for prime time? J Am Coll Cardiol. 2006;47(7):1313-1327. Epub 2006 Mar 20.

4. Basu S, Frank LH, Fenton KE, Sable CA, Levy RJ, Berger JT. Two-dimensional speckle tracking imaging detects impaired myocardial performance in children with septic shock, not recognized by conventional echocardiography. Pediatr Crit Care Med. 2012;13(3):259-

264. doi: 10.1097/PCC.0b013e3182288445.

5. Cullen S, Shore D, Redington AN. Characterization of right ventricular diastolic performance after complete repair of tetralogy of Fallot: restrictive physiology predicts slow postoperative recovery. Circulation. 1995;91:1782–1789