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Anaesthesiology
Transthoracic Echocardiography The Basics
Built from Practical Ultrasound in Anesthesia
What’s inside
7 sections · 53 slides
Overview
- What this deck covers
Basic TTE in Circulatory Failure
Sorting the cause of a failing circulation at the bedside.
- Echocardiography in critical care
- Two levels of expertise
- What basic TTE is asked to do
- Pulmonary embolism and acute cor pulmonale
- Acute cor pulmonale
- Cardiac tamponade
- Cardiac tamponade
- Severe mitral regurgitation
- Three drivers of circulatory failure
- Sorting the cause of shock
Left Ventricular Function
Size, wall thickness, squeeze, and filling pressure.
- Reading left ventricular function
- Causes of LV systolic dysfunction
- Typical Echo Pattern of the Usual Causes of LV Systolic Dysfunction in the ICU
- Left ventricular size and thickness
- Left ventricular hypertrophy and dynamic obstruction
- 50-65%
- Measuring ejection fraction
- Fractional area change and stroke volume
- Cardiac output measurement
- Segmental wall motion
- Wall segmentation of the left ventricle
- Diastolic function and the E wave
- Measuring LV filling pressure
- The three mitral Doppler patterns
- Mitral Doppler flow patterns
- Beyond the grey zone
Right Heart Function
Size, septum, squeeze, and systemic congestion.
- Why the right ventricle matters
- Right ventricular size
- RV hypertrophy and the septum
- TAPSE and S' velocity
- RV fractional area change
- Right-sided congestion
- VExUS score
Echo Management of Fluid Requirement
Who will respond to fluid, and who must not get more.
- Judging blood volume
- Testing the circulation
- Predicting fluid responsiveness
- When not to give fluid
- Fluid: give or hold
TTE in Respiratory Failure
Cardiogenic or not - and the weaning question.
- Sorting pulmonary edema
- Lung and pleural ultrasound
- Reading pleural fluid
- B-lines
- B-lines in pulmonary edema
- How weaning-induced edema develops
- >0.95
- Combining the indices
Summary
One bedside tool for circulation and lungs.
- What basic TTE gives the intensivist
- References
- References (continued)
- References (continued)
- References (continued)
- Practical Ultrasound in Anesthesia for Critical Care and Pain Management