Darlington Ashley, Hillerson Dustin, Ternus Brad, Mankad Sunil
Department of Cardiovascular Disease, Mayo Clinic, Rochester, MN, USA.
Mayo Clinic College of Medicine, 200 First Street Southwest, Rochester, MN, 55905, USA.
Curr Cardiol Rep. 2025 Jan 16;27(1):25. doi: 10.1007/s11886-024-02176-6.
Critical Care Echocardiography (CCE) is now established as an important tool in the intensive care unit (ICU). This paper aims to examine the expanding role of cardiovascular ultrasound in the ICU, focusing on its applications, benefits, and challenges, while highlighting recent advancements shaping the future of critical care echocardiography.
Non-invasive echocardiographic measurement of hemodynamic parameters including stroke volume, cardiac output, left ventricular filling pressures, and pulmonary pressures have been well-validated against invasive measurements. Myocardial perfusion can also be evaluated using ultrasound enhancing agent techniques to further risk-stratify patients with chest pain. Echocardiography enables clinicians to visualize cardiac anatomy and physiology directly at the bedside, providing immediate feedback in rapidly changing clinical situations. Assessment of stroke volume, cardiac output, and left ventricular filling pressures can be readily measured at the bedside and correspond with clinical outcomes including mortality. Measurement of central venous pressure and pulmonary pressures may guide clinical decisions in fluid management and mechanical ventilation strategies. Lastly, myocardial perfusion imaging can supplement the 2D echocardiographic evaluation to further risk-stratify patients presenting with chest pain.
重症超声心动图（CCE）现已成为重症监护病房（ICU）中的一项重要工具。本文旨在探讨心血管超声在ICU中不断扩大的作用，重点关注其应用、益处和挑战，同时突出塑造重症超声心动图未来的近期进展。
包括每搏量、心输出量、左心室充盈压和肺压在内的血流动力学参数的无创超声心动图测量已通过有创测量得到充分验证。心肌灌注也可以使用超声增强剂技术进行评估，以进一步对胸痛患者进行风险分层。超声心动图使临床医生能够在床边直接观察心脏解剖结构和生理功能，在快速变化的临床情况下提供即时反馈。每搏量、心输出量和左心室充盈压的评估可以在床边轻松进行，并且与包括死亡率在内的临床结果相关。中心静脉压和肺压的测量可以指导液体管理和机械通气策略方面的临床决策。最后，心肌灌注成像可以补充二维超声心动图评估，以进一步对胸痛患者进行风险分层。
