Chapter 21: Echocardiography-guided patient management in the intensive care unit

As a first-line tool for the diagnosis and management of acute cardiovascular and respiratory failure, echocardiography is essential in evaluating critically ill patients in the intensive care unit (ICU).
Assessment of ICU patients is complex: the ventricular systolic and diastolic function parameters must be contextualized with volume and inotropic conditions and the presence of respiratory and/or mechanical circulatory support.
The integrative multi-parametric approach, including assessment of commonly used indices (left ventricular ejection fraction and congestion indices) along with electro-mechanical and systo-diastolic synchrony (total isovolumic time and mitral annular plane systolic excursion), is important to define not only the global ventricular function but also the underlying mechanism limiting cardiac output.

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