Echographic evaluation of ICU patients with tissue Doppler imaging more studies and more consensus are still needed.docVIP

Fichet et al. Critical Care 2012, 16:433 /content/16/3/433 LETTER Echographic evaluation of ICU patients with tissue Doppler imaging: more studies and more consensus are still needed Jér?me Fichet*, Benjamin Sztrymf and Frédéric M Jacobs See related research by Moschietto et al., /content/16/3/R81, and related research by Weng et al., /content/16/3/R71 In many intensive care units (ICUs), cardiac transthoracic measure men ts (E ) at a certain time of the respiratory a echocardio graphy (TTE) has replaced invasive monitor- cycle may be questioned. Moreover, methodo logical ing in routine evaluation of acutely ill patients. Since the mid ’80s, there have been many studies of ICU patients, di? erences between studies may be confusing (Table 1). ese di? erences may lead to a loss of information in most of whom were receiving mechanical ventilation some cases and eventually may explain the di? erences (MV). With the emergence of new TTE modalities such as tissue Doppler imaging (TDI) and strain rate or three- dimensional imaging, new studies are currently available. observed between TTE and invasive monitoring. At the bedside, the clinician may be tempted to use a simple beat measurement and disregard the res pira tory time. TDI is now widely used in cardiology and is a powerful Further studies focusing on the feasibility and in? uence tool in the assessment of left ventricular ? lling pressures of MV on TDI parameters are needed [5]. Guidelines (LVFPs), relaxation, or right ventricular function. It was suggested that the ratio of pulsed Doppler mitral ? ow in early diastole (E wave) over early diastolic mitral annulus regarding the methods and designs of future trials in the ICU will be valuable, as these studies demon strate that a quantitative assessment of cardiovascular parameters velocity (E with TDI), known as E/E , was closely related