Index. K Knobology, TTE artifact, image resolution, ultrasound, 14

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1 A Acute aortic regurgitation (AR), Acute aortic syndrome (AAS) classic aortic dissection diagnosis, evolutive patterns, pathology, classifications, incomplete aortic dissection diagnosis, 265, 269 evolutive patterns, 267 pathology, intramural aortic hematoma diagnosis, , 264, 265 evolutive patterns, pathology, , 263 management strategy, patient, risk identification, penetrating aortic ulcer diagnosis, evolutive patterns, pathology, Acute circulatory failure (ACF) acute therapy, efficacy and safety, 106 cardiogenic shock, , Complicating cardiac surgery, Differential diagnosis, echocardiography, steps, mechanisms, 101 Monitoring effects of therapy, 106 pulmonary venous congestion, Septic shock, systemic venous congestion, Tamponade, Acute cor pulmonale (ACP) clinical scenarios acute respiratory distress syndrome (ARDS), 145 acute RV failure, of sepsis, 145 massive pulmonary embolism, preload/volume responsiveness, 146 RV infarction, 145 definition, 135 and pulmonary hypertension, 140 RV diastolic overload, RV systolic overload, vs. subacute chronic cor pulmonale, Acute myocardial infarction, cardiogenic shock cause, 118 diagnosis, 118 mechanical complications acute MR, ventricular free-wall rupture, 121 ventricular septal rupture, pulmonary artery systolic pressure, 119 Acute respiratory distress syndrome (ARDS), 145, See also Pulmonary edema echocardiography use, PEEP effect, monitor, prone positioning role, 200, 201 tidal volume and PP adaptation, Acute right ventricular failure, Alveolar pressure, 43 Aortic blood flow, 85 Aortic dissection, 126, Aortic stenosis (AS), , 129 Arrhythmias atrial fibrillation (AF), hemodynamic consequences cardiac output effects, diastolic function effects, 90 systolic function effects, 90 echocardiographic evaluation, of patients Doppler assessment, 94 LV diastolic pressure, LV strain and strain rate, 94 stroke volume, systolic function, 91 Atrial fibrillation (AF), hemodynamic consequences cardiac output effects, diastolic function effects, 90 systolic function effects, 90 B Blunt cardiac trauma cardiac rupture, mechanisms of injury, 226 segmental/global ventricular systolic function, 227 septal defects, valvular injuries, Blunt chest trauma management, traumatic aortic injury angiography, D. De Backer et al. (eds.), Hemodynamic Monitoring Using Echocardiography in the Critically Ill, DOI: / , Springer-Verlag Berlin Heidelberg

2 308 chest radiography, clinical presentation, computed tomography, incidence and natural history, mechanism of injury, 206 pathology, TAI screening, transesophageal echocardiography (TEE), C Cardiac depression, septic shock Cardiac function alteration aortic blood flow, 85 contractility, LV external mechanical power, LV wall stress relationship, 85 maximal elastance, mitral regurgitation jet acceleration time, 85 speckle tracking, 87 velocity of circumferential fiber (VCF) shortening, Cardiac tamponade echocardiographic identification clinical context, 158 Doppler analysis, two-dimensional, 157 Cardiogenic shock acute myocardial infarction cause, 118 diagnosis, 118 mechanical complications, pulmonary artery systolic pressure, 119 diagnosis, myocarditis, 124 stress cardiomyopathy, valvular disease acute aortic regurgitation (AR), aortic stenosis (AS), , 129 mitral stenosis (MS), Cardiopulmonary bypass (CBP) postoperative period localized tamponade, 243 mechanical valve thrombosis, 244 transesophageal echo, 244 transthoracic echo, 244 prior to acute right ventricular failure, aortic dissection, hypovolemia, intraoperative TEE, recommendations, 235, 236 weaning from dynamic left ventricular outflow tract obstruction, injuries, surgical procedure, ischemic disorders, Circulatory failure acute therapy, efficacy and safety, 106 definitions, 100 diagnostic algorithms acute circulatory failure, conditions, 101 LV systolic function, pulmonary venous congestion, RV systolic function, 103 systemic venous congestion, echocardiography advantages, 100 indications, 100 Classic aortic dissection diagnosis, evolutive patterns, pathology, Critical care echocardiography (CCE) competence level advanced, basic, curriculum advanced, basic, 278 definition, history, 1 2 indications, 3 4 specificities, 2 heart lung interactions, 3 hemodynamic assessment, 3 nonscheduled management and care, 3 TEE, tolerance of, 4 5 therapeutic impact, 5 6 TTE vs. TEE, 4 D Destination therapy. See Extracorporeal life support, ICU Doppler echocardiography, principles of color doppler, 20, 22 continuous-wave (CW) doppler, 17, 21, 22 pulsed-wave (PW) doppler, 19, 22 E Ejection fraction evaluation LV volume estimation, 81 short-axis area measurements, LV, 81 unidimensional approach, M-mode, measurement, RV systolic dysfunction assessment, 142 Extracorporeal life support, ICU monitoring assistance, echo and circulatory failure, contraindications, 166 IABP, 166 Impella, 166, 167 principles, 165 respiratory failure, short-term circulatory assistance axial pumps, 164 catecholamine-resistant cardiac failure, 163 centrifugal pumps, intra-aortic balloon pump (IABP), 164 weaning from assistance,

3 309 F Fluid challenge cutoffs, guidance, echocardiography, 75 hydrostatic pressure changes, 72 indications response evaluation, 56-57, tolerance evaluation, type and administration rate, 73 Fluid requirements assessment fluid challenge cutoffs, hydrostatic pressure changes, 72 indications, fluid responsiveness clinical application, 67 definition, dynamic parameters, Frank Starling relationship, 62 hypovolemia, 61 static parameter, Fractional area contraction LV, RV, 142 Frank Starling curve, 62 H Heart lung interactions, in mechanical ventilation intravascular vs. transmural pressures, 44 pressures types, reverse pulsus paradoxus ddown component, definition, 45 dup component, Hemodynamic assessment alternative hemodynamic measurements cardiac output, 285 flow and global tissue perfusion, 285 PAC monitoring, 286 pulmonary artery pressure, 285 stroke volume variation, 285 echocardiography merits cardiac function, 106, 284 transesophageal echocardiography (TEE), 278, 285 transthoracic echocardiography, 284 Hemodynamic instability. See acute circulatory failure Hydrostatic pulmonary edema, Hypovolemia, 61 cardiopulmonary bypass (CBP), septic shock, I ICU applications, echocardiographic technologies hand-carried ultrasound (HCU), 301, 303 intracardiac echocardiography (ICE), Impella system, 164 Incomplete aortic dissection diagnosis, 265, 269 evolutive patterns, 267 pathology, Inotropes/vasodilators, 57, 59 Intra-aortic balloon pump (IABP), 164, 166 Intracardiac echocardiography (ICE), Intramural aortic hematoma (IAH) diagnosis, , 264, 265 evolutive patterns, pathology, , 263 Intrathoracic pressure, Intravascular pressure, 44 Ischemic disorders, CBP, K Knobology, TTE artifact, image resolution, ultrasound, 14 L Left ventricular (LV) diastolic pressure volume, 181 evaluation, Left ventricular strain (LVSt), 94 Left ventricular (LV) systolic function evaluation cardiac function alteration aortic blood flow, 85 contractility, LV external mechanical power, LV wall stress relationship, 85 maximal elastance, mitral regurgitation jet acceleration time, 85 speckle tracking, 87 velocity of circumferential fiber (VCF) shortening, ejection fraction evaluation, measurement, systolic function evaluation, Left ventricular wall area index (LVWAI), 172 Localized tamponade, 243 LV filling pressures estimation Doppler assessment validation, , 185, 188 Doppler patterns evolution, , 185, 186 principles and technique, 180, 182, 183 M Massive pulmonary embolism, Maximal elastance, Mechanical valve thrombosis, 244 Mechanical ventilation, 195 Mitral inflow, 74 Mitral regurgitation jet acceleration time, 85 Mitral stenosis (MS), M-mode echocardiography, Myocardial depression, septic shock Myocardial performance index (MPI), 144 Myocarditis, 124 N Nitric oxide inhalation, 57 58

4 310 P Passive leg-raising (PLR) test, Penetrating aortic ulcer diagnosis, evolutive patterns, pathology, Pericardial effusion. See also Cardiac tamponade; Pericardiocentesis anatomy, 151 identification, Pericardiocentesis equipment requirements, identification, 158 site selection, Pericardium anatomy, 151 Pulmonary artery occluded pressure (PAOP), 74 Pulmonary artery pressures. See Right ventricular function Pulmonary edema definitions, diagnostic algorithm acute respiratory distress syndrome vs. hydrostatic pulmonary edema, hydrostatic pulmonary edema, ongoing therapy influence, LV diastolic function and filling pressures, 179 LV filling pressures estimation Doppler assessment validation, , 185, 188 Doppler patterns evolution, , 185, 186 principles and technique, 180, 182, 183 pathophysiology left ventricular (LV) diastolic pressure volume, 181 systolic and diastolic left ventricular failure, R Real-time 3D echocardiography (RT3DE) applications, full-volume data, 295 limitations, 296 prototype software, 297 texture tracking, 297, 298 three-dimensional volumetric rendering, 299 Real-time 3D TEE (RT3D TEE), 299, 302 Reverse pulsus paradoxus ddown component, 45, 47 hemodynamic effect, mechanical ventilation, 47 RV afterload, systemic venous return, definition, 45 dup component, Right ventricular function acute cor pulmonale (ACP) cor pulmonale and pulmonary hypertension, 140 definition, 135 RV diastolic overload, RV systolic overload, vs. subacute chronic cor pulmonale, anatomy and function contraction manners, pathophysiological changes, PHT and right-heart dysfunction evaluation, 134 pressure/volume loop technique, 134 clinical scenarios acute respiratory distress syndrome (ARDS), 145 acute RV failure, of sepsis, 145 massive pulmonary embolism, preload/volume responsiveness, 146 RV infarction, 145 echocardiographic estimates, pulmonary artery pressure, systolic dysfunction assessment contractile function, 141 dp/dt, ejection fraction, 142 fractional area contraction, 142 myocardial performance index (MPI), 144 tissue doppler, 143 tricuspid annular motion, S Septic shock bacteremia/fungemia, 115 echocardiographic evaluation cardiac function, cardiac output, 112 clinical management, 111, 112 response to fluids, hypovolemia, myocardial depression, 115 Speckle tracking, 87 applications, limitations, 292 strain calculation, 292 systolic contraction, 292 Stress cardiomyopathy, Stroke volume and cardiac output measurement echocardiography and doppler limitations, 55 mitral/pulmonary valves, 55 step-by-step procedure, heart rate, 53 systemic arterial pressure, 52 therapeutic maneuver effects fluids, inotropes/vasodilators, 57, 59 nitric oxide inhalation, tissue perfusion, 51 venous return determinants, Systolic and diastolic left ventricular failure, 178, 180 T Tamponade echocardiographic identification clinical context, 158 Doppler analysis, two-dimensional, 157

5 311 TEE. See Transesophageal echocardiography Thoracic trauma blunt cardiac trauma cardiac rupture, mechanisms of injury, 226 segmental/global ventricular systolic function, 227 septal defects, valvular injuries, blunt chest trauma management, traumatic aortic injury, Tissue Doppler imaging (TDI), 143 constrictive vs. restrictive cardiomyopathy, 290 dobutamine stress echocardiography, 291 for the evaluation of PAOP hypertrophic, nonobstructive cardiomyopathy (HNOCM), 292 left ventricular ejection fraction (LVEF), 291 pulsed wave Doppler, 289 RV function, 141, 143 velocity and strain limitations, 290 in weaning from assist cardiac devices, 173 Transesophageal echocardiography (TEE) acute respiratory distress syndrome (ARDS), 196 advantages, 32 blunt chest trauma, equipment, hemodynamic assessment, in ICU, hemodynamic instability, 235 safety considerations, 32 two-dimensional imaging aortic views, deep transgastric views, 33, 34 mid-esophageal views, transgastric short-axis views, upper esophageal views, Transmural pressure, 44 Transpulmonary pressure (TPP), 44 Transthoracic echocardiography (TTE) apical four-and five-chamber views, apical two-and three-chamber views, 26 hemodynamic assessment, 28 knobology artifact, image resolution, ultrasound, 14 limitations of, parasternal long-axis view, parasternal short-axis view, subcostal view, 24 25, 27 suprasternal view, 25 26, 28 ultrasound modalities applications, in intensive care unit, 18 doppler echocardiography, M-mode echocardiography, two-dimensional echocardiography, 17 uses, Tricuspid annular motion, Two-dimensional echocardiography, 17 Two-dimensional imaging, TEE aortic views, deep transgastric views, 33, 34 mid-esophageal views, transgastric short-axis views, upper esophageal views, U Ultrasound, principles, 14 V Valvular disease, cardiogenic shock acute aortic regurgitation (AR), aortic stenosis (AS), , 129 mitral stenosis (MS),