Echocardiographic approach to shock

Daniel De Backer, Simone Giglioli


Echocardiography can be used to evaluate the full hemodynamic pattern of patients with shock. Accordingly, echocardiography can rapidly identify the type of shock, helping to guide therapeutic interventions aiming at treat its cause. But echocardiography also provides important information on preload responsiveness, right and left filling pressures, function of the left and right ventricle (RV). Thank to this comprehensive hemodynamic evaluation, echocardiography is nowadays the preferred hemodynamic tool to initially assess a patient with shock, and is thus recommended for this purpose in several consensus documents. Interestingly, echocardiography also allows to perform serial measurements, which is particularly useful to evaluate changes over time as well as the response to therapy. Implementation of echocardiography as a guide to therapy in patients with shock seems to be associated with improved outcomes in observational studies. In this narrative review, we will report on how echocardiography can be used for the management of patients with circulatory failure.