Echocardiography in Intensive Care: The Basics. Part II

Objective: To review the current status of echocardiography in critically ill patients with special reference to the advantages and disadvantages of the transthoracic and transoesophageal approaches. Data sources: A review of articles published in peer reviewed journals from 1976-1999 and identified through a MEDLINE search on echocardiography. Summary of review: Echocardiography is a rapidly evolving field which is relatively new to intensivists. Both transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE) are extremely useful in managing critically ill patients. In intensive care practice echocardiograpy is used to evaluate clinical syndromes such as unexplained hypotension, search for source of sepsis or source of emboli, as well as haemodynamic assessment and monitoring. TOE although somewhat invasive, provides superb images which often assist in both diagnosis and improved treatment. Conclusions: Echocardiography often provides useful information in critically ill patients. Intensivists should familiarise themselves with this new technology and if possible become skilled practitioners of this exciting technique. The care of critically ill patients will benefit from its widespread use.