General chest ultrasound in neurocritical care

Overview

Neurocritical care patients often require hemodynamic monitoring to optimize cerebral blood flow and brain tissue oxygen delivery. Hemodynamic monitoring also aids in the management of usual coexisting disorders, such as acute lung injury and acute respiratory distress syndrome (ARDS), as well as shock states. General chest ultrasound (see Chapter 1 ), which consists of cardiovascular and lung ultrasound, is a noninvasive bedside tool that facilitates hemodynamic monitoring in modern neurocritical care. The manipulation of the cardiac output (CO), mean arterial pressure (MAP), systemic filling pressures and volumes, as well as the assessment of dynamic markers of fluid responsiveness and evaluation for pulmonary edema are all essential in optimizing cardiorespiratory function in the acutely brain- or spinal cord–injured patient. This chapter illustrates the role of general chest ultrasound in neurocritical care.