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Expert Consensus on Advanced Critical Care EchocardiographyAdvanced Critical Care Echocardiography: Opportunity to Do It Right

Gregory A. Schmidt, MD, FCCP
Author and Funding Information

From the Division of Pulmonary Diseases, Critical Care, and Occupational Medicine, Department of Internal Medicine, University of Iowa.

Correspondence to: Gregory A. Schmidt, MD, FCCP, Division of Pulmonary Diseases, Critical Care, and Occupational Medicine, Department of Internal Medicine, University of Iowa, 200 Hawkins Dr, Iowa City, IA 52242; e-mail: Gregory-a-schmidt@uiowa.edu


Financial/nonfinancial disclosures: The author has reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(6):1188-1189. doi:10.1378/chest.14-0502
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Extract

These are exciting times for echocardiography in the ICU. Several factors, including the following, have combined to produce a boom: high-quality ultrasound devices are commonplace in the ICU, increasing numbers of intensivists and fellows have sought out specialized training in critical care ultrasonography and echocardiography, echocardiography regularly reveals findings that complement more traditional measures of hemodynamic status, and intensivists have learned that personally integrating echocardiography into clinical assessment and treatment improves the traditional cardiologist-consultant model of formal echocardiography.1 Basic critical care echocardiography (BCCE) is goal oriented, seeks to answer a limited number of clinical questions, uses five basic views (parasternal long- and short-axis, apical four-chamber, subxiphoid, and inferior vena caval), and should be required training for all intensivists.2 On the other hand, advanced critical care echocardiography (ACCE) requires a comprehensive evaluation of cardiac anatomy and physiology, includes additional views and techniques (including transesophageal echocardiography [TEE] and Doppler), and, because it requires substantial additional training, is optional for the intensivist.2 ACCE addresses a broader range of clinical questions than does BCCE, such as those surrounding regional ventricular function, valvular assessment, measurement of pressures and flows, diastolic function, tamponade, aortic dissection, and many others.

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