John Libbey Eurotext




Hand-held echocardiography in critical care.
MT Cardio. Volume 1, Number 4, 349-56, JUILLET-AOÛT 2005, Revue
Résumé Article gratuit
Author(s) : Philippe Vignon
Summary : Echocardiographic systems which have the size of a laptop computer are currently available. These hand-held ultrasound units are very easy to use at patient bedside in various clinical settings. According to the miniaturized devices, spectral Doppler may not be available and power Doppler may replace true color Doppler. Validation studies of hand-held echocardiography have been initially conducted in critically ill patients. Diagnostic ability of hand-held echocardiography is similar to that of upper-end platforms for diagnoses based on two-dimensional imaging: left ventricular systolic function, detection of wall motion abnormalities, size of cardiac chambers, identification of pericardial or pleural effusions. In contrast, first generation hand-held echocardiography had important limitations in specific clinical settings, such as shock, pulmonary hypertension, assessment of valvulopathy or valvular prosthesis, dynamic left outflow tract obstruction, left ventricular restriction or construction. At its present stage of development, hand-carried ultrasound units do not allow to perform a comprehensive examination which relies on the use of a full-feature system, especially when a precise hemodynamic evaluation is required. First-generation hand-carried ultrasound devices may be considered as a « visual stethoscope » which provides an extension of the physical examination, but not as a potential alternative to standard transthoracic echocardiography. Its large potential clinical field of use raises the concern of tailored training programs to intensive care specialists which could be focused on goal-directed echocardiographic examinations. Constant progress in digitization promise to extand rapidly the diagnostic of hand-held echocardiography.
Keywords : critical care, diagnostic techniques and procedures, echocardiography Doppler, therapeutics

Hand-held echocardiography in critical care.