Anästhesiol Intensivmed Notfallmed Schmerzther 2022; 57(05): 344-358
DOI: 10.1055/a-1713-3088
CME-Fortbildung
Topthema

Perioperative Echokardiografie der rechts- und linksventrikulären Funktion

Echocardiographic Assessment of Perioperative Right and Left Ventricular Function
Michael Koeppen
,
Marius Keller

Zusammenfassung

Die Echokardiografie erlaubt eine präzise und minimalinvasive Charakterisierung der rechtsventrikulären (RV) und linksventrikulären (LV) Funktion chirurgischer Patientinnen und Patienten. Eine korrekte Handhabung und ein fundiertes Verständnis der Messungen sind unabdingbar für eine valide echokardiografische Untersuchung. Im folgenden Beitrag werden die gängigsten, aber auch einige neue Parameter der RV- und LV-Funktion vorgestellt.

Abstract

The perioperative quantification of left and right ventricular function is cornerstone to provide optimal patient care. Echocardiography has emerged as the most important cardiac imaging modality in this setting, mainly due to its rapid availability, non-invasiveness and cost-efficiency. Both the transthoracic and the transesophageal acoustic windows offer manifold modes, e.g., doppler-based measurements or M-mode display, to assess systolic and diastolic ventricular function. An association with patient outcome and corresponding prognostic implications could be demonstrated for the majority of those parameters. Hence, a profound understanding of these measurements is key to delineate sufficient from failing left or right ventricular function and guide treatment decisions. This article gives the reader an overview over the most important measurements, reference values and pitfalls.

Kernaussagen
  • Die perioperative Bestimmung der LV- und RV-Funktion mittels Echokardiografie ist ein wichtiger Bestandteil einer optimalen Patientenversorgung.

  • Die erhobenen Parameter helfen bei der Einschätzung des perioperativen Outcomes und der Identifikation von Risikopatienten.

  • Die meisten Verfahren sind in der Regel bettseitig anwendbar, um zügig einen orientierenden Eindruck über die hämodynamische Situation der Patientinnen und Patienten zu erhalten.

  • Die Kenntnis der einzelnen Messverfahren ist essenziell, um durch deren Anwendung präzise Ergebnisse zu erhalten, welche die systolische und diastolische Funktion von LV und RV widerspiegeln.

  • Durch technische Innovationen und wissenschaftliche Validierungen nimmt der Stellenwert der perioperativen Echokardiografie stetig zu.



Publication History

Article published online:
18 May 2022

© 2022. Thieme. All rights reserved.

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