Key result
Focused bedside right heart echo helps intensivists assess RV function and manage critically ill patients.
Why the study?
Although RV dysfunction in critical illness is associated with mortality, bedside echocardiography pedagogy has largely focused on left ventricular function.
Focused bedside echocardiography of the right heart is a valuable tool for intensivists to assess RV dysfunction and guide management in critically ill patients.
BACKGROUND: The impact of critical illness on the right ventricle (RV) can be profound and RV dysfunction is associated with mortality. Intensivists are becoming more facile with bedside echocardiography, however, pedagogy has largely focused on left ventricular function. Here we review measurements of right heart function by way of echocardiographic modalities and list clinical scenarios where the RV dysfunction is a salient feature. MAIN: RV dysfunction is heterogeneously defined across many domains and its diagnosis is not always clinically apparent. The RV is affected by conditions commonly seen in the ICU such as acute respiratory distress syndrome, pulmonary embolism, RV ischemia, and pulmonary hypertension. Basic ultrasonographic modalities such as 2D imaging, M-mode, tissue Doppler, pulsed-wave Doppler, and continuous Doppler provide clinicians with metrics to assess RV function and response to therapy. CONCLUSION: The right ventricle is impacted by various critical illnesses with substantial mortality and mortality. Focused bedside echocardiographic exams with attention to the right heart may provide intensivists insight into RV function and provide guidance for patient management.
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Hockstein et al. (2021) conducted a review in Right ventricular dysfunction in critical illness. Transthoracic right heart echocardiography was evaluated. Focused bedside echocardiographic exams of the right heart provide intensivists with insight into right ventricular function and guidance for managing critically ill patients.
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