Critical Care Echocardiography: A Primer for the Nephrologist

Critical care echocardiography (CCE) refers to the goal-directed use of transthoracic or transesophageal echocardiography and represents one of the most common applications of critical care ultrasound. CCE can be performed at the point of care, is easily repeated following changes in clinical status, and does not expose the patient to ionizing radiation. Nephrologists who participate in the care of patients in the intensive care unit will regularly encounter CCE as part of the decision-making and bedside management of ICU patients. The four primary indications for CCE are the characterization of shock, evaluation of preload tolerance, evaluation of volume responsiveness, and serial hemodynamic assessment to evaluate response to therapeutic interventions. This article provides an overview of the anatomical structures that are routinely assessed in basic CCE, describes how these findings are incorporated into the clinical assessment of critically ill patients, and introduces some common applications of advanced CCE. Q 2021 by the National Kidney Foundation, Inc. All rights reserved.

Automated summary

Critical care echocardiography (CCE) is a common application of critical care ultrasound that involves the goal-directed use of transthoracic or transesophageal echocardiography. Nephrologists working in the ICU will regularly encounter CCE as part of patient care. The four primary indications for CCE include shock characterization, preload evaluation, volume responsiveness evaluation, and hemodynamic assessment.