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Vascular Ultrasound in the Critically Ill

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Ultrasonography in the ICU

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Abstract

Over the past two decades, the use of ultrasound has become more ubiquitous in intensive care units (ICUs) around the world. One of its most beneficial contributions to the bedside care of these patients comes from its ability to visualize vascular anatomy. As technology has become more operator-friendly and economical, tissue resolution has also improved, allowing vascular structures of all sizes to be clearly evaluated and interrogated in real-time. Two indications that have been studied extensively in the ultrasound-focused literature include the diagnosis of deep venous thrombosis (DVT) and the placement of vascular access. Once the observation of unilateral lower-extremity swelling is made, confirming the diagnosis of DVT by means of invasive venogram has since been replaced by ultrasound examination. In regards to access-based procedures, reliance on superficial landmarks and direct visualization of vessels remains important to the process of cannulating vessels, however, ultrasound guidance has improved cannulation success rates among all levels of practitioners and trainees. This chapter analyzes the data surrounding these common practices and makes recommendations on how best to incorporate ultrasound into daily practice.

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Authors and Affiliations

  1. Department of Surgery, Bridgeport Hospital, 267 Grant Street, Perry 3, 06610, Bridgeport, CT, USA

    Shea C. Gregg MD

  2. Department of Emergency Medicine, Bridgeport Hospital, 267 Grant Street, 06610, Bridgeport, CT, USA

    Kristin L. Gregg MD RDMS

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Correspondence to Shea C. Gregg MD .

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  1. Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA

    Paula Ferrada

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Video Legends

Video Legends

Video 4.1 Color-flow Doppler showing femoral artery pulsatility.

Video 4.2 Compression of popliteal vein with ultrasound probe.

Video 4.3 Popliteal vein showing augmented flow upon compression of calf muscle.

Video 4.4 Bedside echocardiography showing right ventricular strain in pulmonary embolism.

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Gregg, S., Gregg, K. (2015). Vascular Ultrasound in the Critically Ill. In: Ferrada, P. (eds) Ultrasonography in the ICU. Springer, Cham. https://doi.org/10.1007/978-3-319-11876-5_4

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