Table 1.
Echocardiographic indices of perfusion and congestion in patients in CICU, detailed on the basis of their utility and normal values or ranges.
| Utility | Normal Values or Ranges | ||
|---|---|---|---|
| Perfusion parameters | LVOT VTI and CI | A reliable quantitative parameter that truly reflects circulatory status and global end organ perfusion | LVOT VTI ≥ 18 cm CI ≥ 2.5 L/min/m2 |
| LV GLS | A valuable and sensitive tool for follow-up examinations | LV GLS < −20% | |
| RVOT VTI | Gives information about the right ventricle function and pulmonary vascular resistance | RVOT VTI ≥ 12 cm | |
| RV 2D FAC | Provides an estimate of global RV systolic function | RV FAC ≥ 35% | |
| TAPSE | Represents a measure of RV longitudinal function | TAPSE ≥ 17 mm | |
| TDI S’ | Correlates well with other measures of global RV systolic function | S’ ≥ 9.5 cm/s | |
| Global longitudinal RV free wall strain | Useful for estimating RV global and regional systolic function | RV free wall strain < −20% | |
| LVOTO | Its diagnosis leads to drastic changes in the clinical management | LVOTO < 30 mmHg | |
| Congestion parameters | IVC diameter | Used to estimate RA pressures | IVC < 21 mm that collapses > 50% |
| TDI e’ | Associated with increase mortality in the critically ill patients | Avg e’ ≥ 10 cm/s lateral e’ < 8 cm/s |
|
| E/e’ | A load-independent marker of LV filling pressure | E/e’ < 15 | |
| PASP | The most used non-invasive tool for estimating PAP | PASP > 35 mmHg | |
| PAAT | Represents pulmonary flow acceleration, which increases as the vascular resistance is augmented | PAAT 136–153 ms | |
| PALS | An additional index of congestion to optimize therapeutic management | PALS ≥ 15% | |
CI, cardiac index; IVC, inferior vena cava; LV GLS, left ventricular global longitudinal strain; LVOTO, left ventricular outflow tract obstruction; LVOT VTI, left ventricular outflow tract velocity time integral; PAAT, pulmonary artery acceleration time; PALS, peak atrial longitudinal strain; PASP, pulmonary artery systolic pressure; RV, right ventricular; RV 2D FAC, RV 2 dimensional fractional area change; RVOT VTI, right ventricular outflow tract velocity time integral; TAPSE, tricuspid annular plane systolic excursion; TDI e’, tissue doppler imaging e’ wave; TDI S’, tissue doppler imaging S wave.