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…
Overview Left ventricular (LV) diastolic dysfunction is a clinical entity that remains poorly understood and identified in the intensive care unit (ICU) setting. It is essential to clarify the difference between diastolic heart failure, LV diastolic dysfunction, and increased LV…
Overview The incidence of out-of-hospital cardiac arrest is estimated to be 50 to 55 per 100,000 in the United States. When a primary electrical cause of cardiac arrest is found, definitive treatment is directed toward reversing the rhythm disturbance (cardioversion,…
Overview Cardiac injury as a result of blunt or penetrating chest trauma is common and associated with significant morbidity and mortality. Approximately 25% of traumatic deaths are caused by cardiac-related injuries, with the majority involving either cardiac or great-vessel damage.…
Overview After development of an esophageal stethoscope, the first transesophageal echocardiographic (TEE) equipment provided simple M-mode images to measure left ventricular (LV) dimensions. First used for intraoperative monitoring of LV function and intracardiac air more than 30 years ago, TEE…