Abstract
Point-of-care ultrasound can be utilized in an algorithmic approach to the patient with undifferentiated shock. Within minutes, a focused ultrasonographic exam can aid in the clinical classification of the patient, allowing appropriate further testing and treatment to be initiated. In this chapter, we illustrate a protocol for the ultrasound evaluation of shock and also discuss the evidence for the use of ultrasonography in the assessment of intravascular volume status.
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References
Perera P, Mailhot T, Riley D, et al. The RUSH exam: rapid ultrasound in SHock in the evaluation of the critically Ill. Emerg Med Clin North Am. 2010;28(1):29–56.
Atkinson PR, McAuley DJ, Kendall RJ, et al. Abdominal and cardiac evaluation with sonography in shock (ACES): an approach by emergency physicians for the use of ultrasound in patients with undifferentiated hypotension. Emerg Med J. 2009;26:87–91.
Jones AE, Tayal VS, Sullivan DM, Sullivan VS, Kline JA. Randomized, controlled trial of immediate versus delayed goal-directed ultrasound to identify the cause of nontraumatic hypotension in emergency department patients. Crit Care Med. 2004;32(8):1703–8.
Brennan JM, Blair JE, Goonewardena S, et al. A comparison by medicine residents of physical examination versus hand-carried ultrasound for estimation of right atrial pressure. Am J Cardiol. 2007;99:1614–6.
Kobal SL, et al. Comparison of effectiveness of hand-carried ultrasound to bedside cardiovascular physical examination. Am J Cardiol. 2005;96(7):1002–6.
Eisenberg PE, Jaffe AS, Schuster DS. Clinical evaluation compared to pulmonary artery catheterization in the hemodynamic assessment of critically ill patients. Crit Care Med. 1984;12(7):549–53.
Wo CC, Shoemaker WC, Appel PL, et al. Unreliability of blood pressure and heart rate to evaluate cardiac output in emergency resuscitation and critical illness. Crit Care Med. 1993;21(2):218–23.
Harvey S, Harrison DA, Singer M. Assessment of the clinical effectiveness of pulmonary artery catheters in management of patients in intensive care (PAC-Man): a randomized controlled trial. Lancet. 2005;366(9484):472–7.
Dellinger RP, Levy MM, Rhodes A, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med. 2013;39(2):165–228.
Nagdev AD, Merchant RC, Tirado-Gonzalez A, et al. Emergency department bedside ultrasonographic measurement of the caval index for noninvasive determination of low central venous pressure. Ann Emerg Med. 2010;55(3):290–5.
Kumar A, Anel R, Bunnell E, et al. Pulmonary artery occlusion pressure and central venous pressure fail to predict ventricular filling volume, cardiac performance, or the response to volume infusion in normal subjects. Crit Care Med. 2004;32(3):691–9.
Marik PE, Cavallazzi R. Does the central venous pressure predict fluid responsiveness? An updated meta-analysis and a plea for some common sense. Crit Care Med. 2013;41(7):1774–81.
The ProCESS Investigators, Yealy DM, Kellum JA, Huang DT, et al. A randomized trial of protocol-based care for early septic shock. N Engl J Med. 2014;370(18):1683–93. Epub 2014 Mar 18.
Weekes AJ, Tassone HM, Babcock A, et al. Comparison of serial qualitative and quantitative assessments of caval index and left ventricular systolic function during early fluid resuscitation of hypotensive emergency department patients. Acad Emerg Med. 2011;18(9):912–21.
Bodson L, Vieillard-Baron A. Respiratory variation in inferior vena cava diameter: surrogate of central venous pressure or parameter of fluid responsiveness? Let the physiology reply. Crit Care. 2012;16(6):181.
Bendjelid K, Romand JA. Fluid responsiveness in mechanically ventilated patients: a review of indices used in intensive care. Intensive Care Med. 2003;29(3):352–60.
Barbier C, Loubieres Y, Schmit C, et al. Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patients. Intensive Care Med. 2004;30(9):1740–6.
Feissel M, Michard F, Faller JP, et al. The respiratory variation in inferior vena cava diameter as a guide to fluid therapy. Intensive Care Med. 2004;30(9):1834–7.
Machare-Delgado E, Decaro M, Marik PE. Inferior vena cava variation compared to pulse contour analysis as predictors of fluid responsiveness: a prospective cohort study. Intensive Care Med. 2011;26(2):116–24.
Dipti A, Soucy Z, Surana A, Chandra S. Role of inferior vena cava diameter in assessment of volume status: a meta-analysis. Am J Emerg Med. 2012;30(8):1414–9.
Muller L, Bobbia X, Toumi M, et al. Respiratory variations of inferior vena cava diameter to predict fluid responsiveness in spontaneously breathing patients with acute circulatory failure: need for a cautious use. Crit Care. 2012;16(5):R188.
Lanspa MJ, Grissom CK, Hirshberg EL. Applying dynamic parameters to predict hemodynamic response to volume expansion in spontaneously breathing patients with septic shock. Shock. 2013;39(2):155–60.
Corl K, Napoli AM, Gardiner F. Bedside sonographic measurement of the inferior vena cava caval index is a poor predictor of fluid responsiveness in emergency department patients. Emerg Med Australas. 2012;24(5):534–9.
Weingart S. Podcast 86 – IVC ultrasound for fluid tolerance in spontaneously breathing patients. EMCrit Blog. 2012. Available from: http://emcrit.org/podcasts/ivc-ultrasound-for-fluid-tolerance-in-spontaneously-breathing-patients/. Accessed 5 May 2014.
Wallace DJ, Allison M, Stone MB. Inferior vena cava percentage collapse during respiration is affected by the sampling location: an ultrasound study in healthy volunteers. Acad Emerg Med. 2010;17(1):96–9.
Nakao S, Come PC, McKay RG, Ransil BJ. Effects of positional changes on inferior vena caval size and dynamics and correlations with right-sided cardiac pressure. Am J Cardiol. 1987;59:125–32.
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Corl, K., Shah, S., Gartman, E. (2015). Ultrasound Evaluation of Shock and Volume Status in the Intensive Care Unit. In: Jankowich, M., Gartman, E. (eds) Ultrasound in the Intensive Care Unit. Respiratory Medicine. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-1723-5_4
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DOI: https://doi.org/10.1007/978-1-4939-1723-5_4
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