CLINICAL ROLE OF CRITICAL CARE ECHOCARDIOGRAPHY IN SEPTIC PATIENTS: CURRENT KNOWLEDGE AND FUTURE DIRECTIONS

Abstract

Critical care echocardiography (CCE) use is rapidly growing and echocardiography is

recommended as first-line approach to patients presenting with shock. In most cases the prompt use

of CCE offers the opportunity to quickly identify the shock aetiology, with the advantage of being a

non-invasive point-of-care tool. Septic shock is among the most common diagnoses of hypotension

both in the emergency department and in the intensive care unit. CCE may have a substantial role in

sepsis. Initially it may exclude other causes of hypotension and support the appropriateness of

fluid-resuscitation. After the initial resuscitation, CCE may help in directing fluid management,

guiding the “optimization” and “stabilization” phases, identifying among others conditions of fluid

responsiveness. In a later stage, CCE can be likewise helpful for the “de-escalation” phase of fluid

management, supporting a goal-directed fluid removal. We summarize the current knowledge on

the use of CCE in sepsis from the gap in knowledge with opened questions for future research to

the use of CCE from clinical perspectives in guiding fluid and pharmacological therapy