Rolle der Echokardiografie bei Notfällen und hämodynamischer Instabilität

Die transthorakale (TTE) und die transösophageale (TEE) Echokardiografie sind bei Notfällen etabliert – Verdachtsdiagnosen können bestätigt und die meisten Ursachen einer hämodynamischen Instabilität erkannt werden. Dieser Beitrag stellt die „fokussierten“ Untersuchungsabläufe der TTE und TEE vor: Sie erfassen die wesentlichen Befunde bei hämodynamisch instabilen Patienten im Notfall und beeinflussen so maßgeblich die Therapieentscheidungen.

Abstract

Echocardiography is an imaging method in anaesthesia and intensive care medicine which adds a new dimension to hemodynamic monitoring: the direct visualization of the cardiac function and its disruptions. The review article shows the advantages and limitations of recent transthoracic (TTE) and transesophageal (TEE) echocardiography in the diagnostic course of hemodynamic instability. For TTE and TEE focused examination techniques and sequences are illustrated with regards to their fast applicability to hemodynamic monitoring.

Kernaussagen

• Die meisten Entscheidungen in hämodynamischen Notfallsituationen hängen von Befunden der transthorakalen und der transösophagealen Echokardiografie ab.

• Die Echokardiografie ist die einzige Methode, die eine Darstellung kardialer Strukturen und ihrer Funktion in Echtzeit erlaubt.

• Eine fokussierte Echokardiografie ist eine zielgerichtete, schnelle, im Blickfeld begrenzte, vom Behandler durchführbare und wiederholbare, qualitative und semiquantitative Point-of-Care-Untersuchungsmethode.

• Ein modifizierter Untersuchungsablauf mit 8 Standardschnitten der transösophagealen Echokardiografie erlaubt mit wenigen Sondenbewegungen schnell eine Erfassung der wesentlichen Befunde bei hämodynamisch instabilen Notfallpatienten.

• Die fokussierte transthorakale Echokardiografie kann mit 5 standardisierten Schnitten (ohne Sonografie der Pleuren) die wesentlichen Ursachen der hämodynamischen Instabilität untersuchen.

Schlüsselwörter

Notfallechokardiografie - fokussierte Echokardiografie - transthorakale Echokardiografie - transösophageale Echokardiografie - hämodynamische Instabilität

Keywords

emergency echocardiography - focussed cardiac ultrasound - transthoracic echocardiography - hemodynamic instability - transesophageal echocardiography

Publication History

Article published online:
18 May 2022

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