Ultrasonography in circulatory failure

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 function but also the peripheral vasculature. When performed in real time, intensivist-guided bedside ultrasonography can be used to differentiate between shock states, facilitate efficient early goal-directed therapy, and monitor the response to therapy. ^, Proficiency in basic critical care ultrasonography allows the intensivist to distinguish among shock secondary to obstruction (pulmonary embolism or cardiac tamponade), hypovolemia, and distributive causes (septic shock). Ultrasound is a bedside, reproducible, and noninvasive imaging modality. Furthermore, it obviates the need to transport unstable patients to the radiology department. This chapter discusses the role of ultrasound in the diagnosis and management of circulatory failure in the intensive care unit (ICU).