Anatomy The oval-shaped kidneys, measuring 9 to 15 cm in length and 4 to 6 cm in width, are located in retroperitoneum between the 12th thoracic and 4th lumbar vertebrae, just lateral to the psoas muscles. The kidneys are surrounded…
Overview Abdominal ultrasound can be used to obtain images of the hepatobiliary, urogenital, and pelvic structures. The approach to the urogenital system, point-of-care pelvic ultrasound, focused assessment with sonography for trauma, and other subjects are discussed in Chapter 42, Chapter…
Overview Despite the well-known advances in cardiovascular surgery over the last 50 years, it remains a high-risk procedure associated with significant morbidity and mortality rates. Currently, patients undergoing cardiovascular operations tend to be older and have more comorbid conditions. This…
Overview Shock is an emergency medical condition caused by inadequate tissue oxygenation. Treatment of shock depends on the underlying cause of the circulatory failure. Ultrasound facilitates rapid evaluation of hemodynamically unstable patients by providing valuable information about not only myocardial…
Overview Fluid therapy is the cornerstone of hemodynamic resuscitation, and its aim is to increase tissue perfusion. Notably, a positive fluid balance is associated with a poor outcome. Thus it is important to optimize fluid administration and identify patients who…
Overview Prescribing fluid therapy is a common therapeutic dilemma in the intensive care unit (ICU); however, different methods of evaluating volume status are available to guide this decision. This chapter discusses these methods briefly. Fluid therapy is of critical importance…
Overview In critical care, the goals of hemodynamic monitoring include mainly detection of cardiovascular insufficiency and diagnosis of the underlying pathophysiology. At the bedside, clinicians are faced with the challenge of translating concepts such as preload, contractility, and afterload into…
Overview Ultrasound is the only imaging modality, apart from magnetic resonance imaging (MRI), that provides real-time functional and structural information on the beating heart. However, modeling moving cardiovascular structures is a complex process that requires three- dimensional (3D) reconstruction of…
Overview Weaning failure is a major complication of mechanical ventilation with associated morbidity and mortality. It is usually defined as an unsuccessful spontaneous breathing trial (SBT) or need for tracheal reintubation within 48 hours following extubation. According to study populations…
Overview Assessment of right ventricular (RV) function is a key element in the hemodynamic evaluation of patients in the intensive care unit (ICU) with shock or respiratory failure. , For several decades the former was considered to play a minor…