Appreciating the Strengths and Weaknesses of Transthoracic Echocardiography in Hemodynamic Assessments英文文献资料.docVIP

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Appreciating the Strengths and Weaknesses of Transthoracic Echocardiography in Hemodynamic Assessments英文文献资料.doc

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Appreciating the Strengths and Weaknesses of Transthoracic Echocardiography in Hemodynamic Assessments英文文献资料

HindawiPublishingCorporation CardiologyResearchandPractice Volume2012,ArticleID894308,7pages doi:10.1155/2012/894308 ReviewArticle AppreciatingtheStrengthsandWeaknessesof TransthoracicEchocardiographyinHemodynamicAssessments StephenJ.HuangandAnthonyS.McLean DepartmentofCriticalCareMedicine,NepeanHospital,SydneyMedicalSchool,Penrith,NSW2750,Australia CorrespondenceshouldbeaddressedtoStephenJ.Huang,stephen.huang@.au Received7June2011;Accepted14November2011 AcademicEditor:PhilippeVignon Copyright?2012S.J.HuangandA.S.McLean. This is an open access article distributed under the Creative Commons AttributionLicense,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkis properlycited. Transthoracicechocardiography(TTE)isbecomingthechoiceofhemodynamicassessmenttoolinmanyintensivecareunits.With aneverincreasingnumberoftrainingprogramsavailableworldwide,learningtheskillstoperformTTEisnolongeralimitingfac- tor.Instead,thefutureemphasiswillbeshiftedtoteachtheusershowtorecognizemeasurementerrorsandartefacts(internal validity),torealizethelimitationsofTTEinvariousapplications,and?nallyhowtoapplytheinformationtothepatientinques- tion (external validity). This paper aims to achieve these objectives in a common area of TTE application—hemodynamic assessments.WeexplorethestrengthsandweaknessesofTTEinsuchassessmentsinthispaper.Variousmethodsofhemodynamic assessments,suchascardiacoutputmeasurements,estimationofpreload,andassessmentof?uidresponsiveness,willbediscussed. 1.Introduction errorsassociatedwiththestudyproceduresuchasartefacts andmeasurementerrors,andexternalvalidityreferstothe applicability of the study ?ndings to a particular patients. Thisarticlewilldiscusssomeofthestrengthsandvalidities ofTTEinhemodynamicassessments. Hemodynamic assessments form an indispensable part in optimizing ?uid status, with the objective of improving adequatetissueperfusionincriticallyillpatients.Inthelast decadeortwo,thepracticeofcriticalcaremedicineisslow