Echo for Haemodynamics by Yastrebov
Stan Yastrebov is an echo guru and an ICU professor of echo at St George hospital in Sydney.
In this talk that he gave at an ICN NSW meeting last month he goes through the nuts and bolts of haemodynamic assessment with echo.
Whether you’re a novice or a regular echo user in crit care, this talk has something for you.
Stan’s energy and enthusiasm (and accent!) are some of the reasons why trainees came from all over Sydney to hear this talk.
Major Problems to look for
- Severe systolic failure
- Severe diastolic failure
- Hypovolaemia
- Vasodilatation
- Haemodynamically significant valvular problem
- Pulmonary embolism
- Pericardial effusion
Stan explains practically how to look for these…
Echo for Hypotension
- Obtain 2D images of LV (SAX or Ap 4Ch or Subcostal)
- Eyeball EDA and ESA, conclude on EDV volume status and EF
- Note the size of the LA and IAS movements
- Note the size and eyeball function of RV
- Note presence or absence of fluid around the heart
- Assess aortic and mitral valve appearance on 2D imaging , then apply colour doppler
- Consider advanced assessment / full study / TOE
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