الفهرس 
Echocardiography; Basics and principlesOnly 14 pages are availabe for public view
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Abstract
Hemodynamic monitoring plays an important role in the management of intensive care unit (ICU) patients. Hemodynamic instability is common in critically-ill patients, and the usefulness of monitoring systems in situations of shock is based on the capacity to obtain quantifiable and reliable hemodynamic variables able to assess preload (central venous pressure or pulmonary capillary pressure), afterload (vascular resistances), and contractility (ventricle function and cardiac output, CO). Once these variables have been obtained, they can be grouped to establish hemodynamic profiles in specific clinical situations producing shock, such as hypovolemia, left or right ventricle dysfunction or diminished peripheral resistances, and to assess different anatomical structures (pericardium, major vessels and heart valves).
Echocardiography has been established as a tool to evaluate the causes of hemodynamic instability in ICU patients by the visualization of cardiac chambers, valves and pericardium and cardiac functional abnormalities.
Transthoracic echocardiography (TTE) can be used as a first-line approach for a quick and focused examination to diagnose acute cor pulmonale, cardiac tamponade or major left ventricular systolic dysfunction. Trans-esophageal echo (TEE) can have a better diagnostic capability and is more reproducible than TTE.
Hemodynamic monitoring using echocardiography has the following objectives:
• Objective 1: To exclude serious structural heart disease as the cause of hemodynamic instability, particularly cardiac tamponade, infective endocarditis, structural valve disease, acute aortic syndrome and acute myocardial infarction.
• Objective 2: To monitor right and left ventricle function.
• Objective 3: To monitor dynamic parameters of preload, and contractility.
Bedside echocardiography can also provide at the point of care, timely, repeatable diagnostic information the moment a question arises. When a patient is suddenly symptomatic in the intensive care unit, bedside echocardiography can provide critical information quickly.
Bedside echocardiography can help in diagnosis and management of the following diseases:
• Pericardial effusion.
• Myocardial ischemia and its complications.
• Valvular structure and functions.
• Infective endocarditis.
• Pulmonary embolism and pulmonary hypertension.
• Aortic dissection.
• Management of shock patients.
• Management of cardiac arrest.
• Post cardiac surgery patient.