Haemodynamic Monitoring Using Echocardiography in the Critically Ill: A Review

Table 2

Indications for echocardiography in acute care settings, evaluated using appropriate use scores (AUS).

Indication	AUS
Hypotension/haemodynamic instability of uncertain or suspected cardiac aetiology	A
Assessment of volume status in critically ill patient	U
Acute chest pain with suspected MI, inconclusive ECG during pain	A
No chest pain but laboratory and/or other features indicative of MI	A
Suspected complication of MI	A
Respiratory failure/hypoxemia of uncertain aetiology	A
Respiratory failure/hypoxemia when noncardiac aetiology is already established	U
To establish diagnosis of suspected PE	I
To guide therapy of known acute PE	A
Routine surveillance of prior PE, with normal RV function and PAP	I
Reevaluation of known PE after therapy for change RV function and PAP	A
Severe deceleration injury/chest trauma with suspected or possible pericardial effusion, valvular, or cardiac injury	A
Routine evaluation in mild chest trauma without ECG or biomarker changes	I

I: inappropriate test for that indication (not generally acceptable and not a reasonable approach. Score 1–3 out of 9); U: uncertain for specific indication (may be acceptable and may be a reasonable approach. Also implies that further patient information/research needed to classify indication definitively. Score 4–6 out of 9); A: appropriate test for that indication. Test is generally acceptable and is a reasonable approach for the indication. Score 4–6 out of 9). MI: myocardial infarction, PE: pulmonary embolism, RV: right ventricle, PAP: pulmonary arterial pressure. Adapted from Douglas et al. [11].