Objective: To assess the accuracy of echocardiography for hemodynamic monitoring.
Data sources: A computerized MEDLINE search was used with the following search headings: monitoring (physiologic and intra-operative) and both echocardiography and transesophageal echocardiography. A number of studies were obtained from the reference lists of cardiology reviews and textbooks.
Study Selection: Studies that were designed to assess the accuracy of hemodynamic monitoring.
Data Extraction: From the selected studies, the accuracy of different techniques for measuring preload and cardiac output was compared.
Data Synthesis: Hypovolemia can be detected accurately by measuring left ventricular end-diastolic area. At high preload, Doppler-based methods are more accurate, although further studies in critical care patients are needed. Cardiac output is best measured by measuring Doppler flow, preferably across the aortic valve.
Conclusions: Echocardiography can be used to make accurate hemodynamic measurements; however, training is required. Further studies are needed to validate these methods in the management of critically ill patients.
From the Intensive Care Unit, Princess Alexandra Hospital, Brisbane, Australia.
Echocardiography has the potential to be used clinically for accurate hemodynamic monitoring.