Departments of Emergency Medicine and Critical Care, 8405MedStar Washington Hospital Center, Washington, DC, USA.
Department of Emergency Medicine, 4608Loma Linda University Medical Center, Loma Linda, CA, USA.
J Intensive Care Med. 2021 Sep;36(9):1098-1109. doi: 10.1177/08850666211003475. Epub 2021 Apr 15.
The impact of critical illness on the right ventricle (RV) can be profound and RV dysfunction is associated with mortality. Intensivists are becoming more facile with bedside echocardiography, however, pedagogy has largely focused on left ventricular function. Here we review measurements of right heart function by way of echocardiographic modalities and list clinical scenarios where the RV dysfunction is a salient feature.
RV dysfunction is heterogeneously defined across many domains and its diagnosis is not always clinically apparent. The RV is affected by conditions commonly seen in the ICU such as acute respiratory distress syndrome, pulmonary embolism, RV ischemia, and pulmonary hypertension. Basic ultrasonographic modalities such as 2D imaging, M-mode, tissue Doppler, pulsed-wave Doppler, and continuous Doppler provide clinicians with metrics to assess RV function and response to therapy.
The right ventricle is impacted by various critical illnesses with substantial mortality and mortality. Focused bedside echocardiographic exams with attention to the right heart may provide intensivists insight into RV function and provide guidance for patient management.
危重病对右心室（RV）的影响可能是深远的，RV 功能障碍与死亡率相关。重症监护医师越来越擅长床边超声心动图，但教学主要集中在左心室功能上。本文通过超声心动图模式回顾了右心功能的测量方法，并列出了 RV 功能障碍为突出特征的临床情况。
RV 功能障碍在许多领域的定义存在差异，其诊断并不总是在临床上显而易见。RV 受到 ICU 中常见疾病的影响，如急性呼吸窘迫综合征、肺栓塞、RV 缺血和肺动脉高压。基本的超声心动图模式，如二维成像、M 模式、组织多普勒、脉冲波多普勒和连续多普勒，为临床医生提供了评估 RV 功能和对治疗反应的指标。
各种危重病都会对右心室产生影响，导致死亡率高。通过对右心进行有针对性的床边超声心动图检查，可以为重症监护医师提供 RV 功能的深入了解，并为患者管理提供指导。
