title: Utility of Functional Hemodynamics and Echocardiography to Aid Diagnosis and Management of Shock.
abstract: The utility of functional hemodynamics and bedside ultrasonography is increasingly recognized as advantageous for both improved diagnosis and management of shock states. In contrast to conventional "static" measures, "dynamic" hemodynamic measures and bedside imaging modalities enhance pathophysiology-based comprehensive understanding of shock states and the response to therapy. The current editions of major textbooks in the primary specialties--in which clinicians routinely encounter patients in shock--including surgery, anesthesia, emergency medicine, and internal medicine continue to incorporate traditional (conventional) descriptions of shock that use well-described (but potentially misleading) intravascular pressures to classify shock states. Reliance on such intravascular pressure measurements is not as helpful as newer "dynamic" functional measures including ultrasonography to both better assess volume responsiveness and biventricular cardiac function. This review thus emphasizes the application of current functional hemodynamics and ultrasonography to the diagnosis and management of shock as a contrast to conventional "static" pressure-based measures.
authors.affiliation: *Department of Medicine and Surgery, Division of Critical Care Medicine, Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts †Department of Anesthesiology, Division of Veterans Affairs, Duke University Medical Center, Durham, North Carolina ‡Department of Anesthesiology and Critical Care Medicine, Division of Cardiothoracic Anesthesiology, The Children's Hospital of Philadelphia, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: William T
authors.initials: WT
authors.lastname: McGee
authors.forename: Karthik
authors.initials: K
authors.lastname: Raghunathan
authors.forename: Adam C
authors.initials: AC
authors.lastname: Adler
mesh_terms: D001158:Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D001331:Automation; D003422:Critical Care; D004452:Echocardiography; D004635:Emergency Medicine; D006439:Hemodynamics; D006801:Humans; D011312:Pressure; D012769:Shock / Q000175:diagnosis* / Q000628:therapy*; D012815:Signal Processing, Computer-Assisted; D014463:Ultrasonography; D018084:Ultrasonography, Interventional; D058067:Wavelet Analysis