title: Clinician-performed ultrasound in hemodynamic and cardiac assessment: a synopsis of current indications and limitations.
abstract: Accurate hemodynamic and intravascular volume status assessment is essential in the diagnostic and therapeutic management of critically ill patients. Over the last two decades, a number of technological advances were translated into a variety of minimally invasive or non-invasive hemodynamic monitoring modalities. Despite the promise of less invasive technologies, the quality, reliability, reproducibility, and generalizability of resultant hemodynamic and intravascular volume status data have been lacking. Since its formal introduction, ultrasound technology has provided the medical community with a more standardized, higher quality, broadly applicable, and reproducible method of accomplishing the above-mentioned objectives. With the advent of portable, hand-carried devices, the importance of sonography in hemodynamic and volume status assessment became clear. From basic venous collapsibility and global cardiac assessment to more complex tasks such as the assessment of cardiac flow and tissue Doppler signals, the number of real-life indications for sonology continues to increase. This review will provide an outline of the essential ultrasound applications in hemodynamic and volume status assessment, focusing on evidence-based uses and indications.
authors.affiliation: Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: N
authors.initials: N
authors.lastname: Kelly
authors.affiliation: Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: R
authors.initials: R
authors.lastname: Esteve
authors.affiliation: Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: T J
authors.initials: TJ
authors.lastname: Papadimos
authors.affiliation: Level I Regional Trauma Center, St Luke's University Hospital, Bethlehem, PA, USA.
authors.forename: R P
authors.initials: RP
authors.lastname: Sharpe
authors.affiliation: Level I Regional Trauma Center, St Luke's University Hospital, Bethlehem, PA, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Keeney
authors.affiliation: Department of Anesthesiology, St Luke's University Health Network, Bethlehem, PA, USA.
authors.forename: R
authors.initials: R
authors.lastname: DeQuevedo
authors.affiliation: Level I Regional Trauma Center, St Luke's University Hospital, Bethlehem, PA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Portner
authors.affiliation: Department of Emergency Medicine, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: D P
authors.initials: DP
authors.lastname: Bahner
authors.affiliation: Level I Regional Trauma Center, St Luke's University Hospital, Bethlehem, PA, USA. stawicki.ace@gmail.com.|Department of Research and Innovation, St Luke's University Health Network, NW2 Administration, 801 Ostrum Street, Bethlehem, PA, 18015, USA. stawicki.ace@gmail.com.
authors.forename: S P
authors.initials: SP
authors.lastname: Stawicki
mesh_terms: D015510:Clinical Medicine / Q000379:methods; D004562:Electrocardiography; D004947:Esophagus / Q000000981:diagnostic imaging; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D019095:Point-of-Care Systems; D018084:Ultrasonography, Interventional; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging
keywords: Echocardiography; Hemodynamic assessment; Inferior vena cava collapsibility index (IVC-CI); Intravascular volume estimation; Point-of-care testing; Ultrasound