Echocardiography and Ultrasound Applications

Echocardiography and ultrasound (US) use is essential in patients admitted to the neurointensive care unit (NICU), allowing real-time diagnosis and assisting in bedside procedures. Brain US can help to evaluate cerebral anatomy, pathology, and cerebral circulation and vasospasm by analyzing blood flow velocities by using transcranial Doppler (TCD), transcranial color-coded duplex sonography (TCCD), or other bedside US modalities. Bedside cardiac US is an essential tool in critically ill patients to evaluate cardiac function and abnormalities and assess volume status by using transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), or cardiac point-of-care ultrasound (POCUS). Vascular access with US guidance has been implemented successfully in critical care practices for decades to assess with bedside peripheral venous, central venous, and intra-arterial cannulation. US can provide a quick and essential assessment in shock and trauma patients by using dedicated protocols including ultrasound in shock (RUSH), abdominal and cardiac evaluation with sonography in shock (ACES), focused assessment with sonography for trauma (FAST), or focused cardiac ultrasound (FOCUS). Bedside US in critical care units is safe, accurate, rapid, and repeatable at the bedside. Data obtained with bedside US are essential and can provide useful tools and skillset that can assist and guide critical care practices in NICU.