title: The Critical Importance of Hepatic Venous Blood Flow Doppler Assessment for Patients in Shock.
abstract: Hepatic venous blood flow can be easily obtained using bedside ultrasound with either transthoracic or transesophageal echocardiography. Six critically ill patients with shock associated with absent or significantly reduced hepatic venous blood flow in the presence of normal or increased pulmonary venous flow are presented. In all these patients, the etiology of shock was secondary to increased resistance to venous return from either an intraabdominal process or through extrinsic or intrinsic occlusion of the proximal inferior vena cava or right atrium. These shock situations are secondary to increased resistance to venous return. Their treatment is highly specific and typically involves a surgical intervention.
authors.affiliation: From the *Department of Anesthesiology and Critical Care, Division of the Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada; †Critical Care Division of the Centre Hospitalier de l'Université de Montréal, Montreal, Quebec; and ‡Department of Anesthesiology, Centre Hospitalier Universitaire de Nantes, Nantes, France.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Hulin
authors.forename: Pierre
authors.initials: P
authors.lastname: Aslanian
authors.forename: Georges
authors.initials: G
authors.lastname: Desjardins
authors.forename: Mustapha
authors.initials: M
authors.lastname: Belaïdi
authors.forename: André
authors.initials: A
authors.lastname: Denault
mesh_terms: D000328:Adult; D000368:Aged; D016638:Critical Illness; D017548:Echocardiography, Transesophageal; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging*; D006801:Humans; D008099:Liver / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012769:Shock / Q000000981:diagnostic imaging* / Q000209:etiology; D018608:Ultrasonography, Doppler