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Critical Care Research and Practice
Volume 2012, Article ID 513480, 9 pages
Review Article

Can Transthoracic Echocardiography Be Used to Predict Fluid Responsiveness in the Critically Ill Patient? A Systematic Review

Adult Intensive Care Unit, John Radcliffe Hospital Oxford, Headley Way, Headington, Oxford OX3 9DU, UK

Received 3 October 2011; Accepted 24 October 2011

Academic Editor: Dimitrios Karakitsos

Copyright © 2012 Justin C. Mandeville and Claire L. Colebourn. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. We systematically evaluated the use of transthoracic echocardiography in the assessment of dynamic markers of preload to predict fluid responsiveness in the critically ill adult patient. Methods. Studies in the critically ill using transthoracic echocardiography (TTE) to predict a response in stroke volume or cardiac output to a fluid load were selected. Selection was limited to English language and adult patients. Studies on patients with an open thorax or abdomen were excluded. Results. The predictive power of diagnostic accuracy of inferior vena cava diameter and transaortic Doppler signal changes with the respiratory cycle or passive leg raising in mechanically ventilated patients was strong throughout the articles reviewed. Limitations of the technique relate to patient tolerance of the procedure, adequacy of acoustic windows, and operator skill. Conclusions. Transthoracic echocardiographic techniques accurately predict fluid responsiveness in critically ill patients. Discriminative power is not affected by the technique selected.