Why and How to Use Echocardiography in Acute Respiratory Distress Syndrome

Abstract

In addition to excluding hydrostatic edema and monitoring the patient with septic shock or trauma, which are the leading causes of acute respiratory distress syndrome (ARDS), echocardiography is useful as it may detect some specific hemodynamic alterations related to the disease or its therapy, and this may have marked influence on ARDS management. Pulmonary hypertension is frequent in ARDS patients. Though it is usually mild and often accompanied by some degree of right ventricular dysfunction, it ordinarily does not lead to right ventricular failure. However, in some cases, especially when heavy ventilatory conditions are applied - high positive end-expiratory pressure (PEEP) or decreased expiratory time - acute cor pulmonale may develop. Detecting this condition may help in better adjusting ventilatory settings. A patent foramen ovale with a right-to-left shunt should always be considered, as it may contribute to hypoxemia and mandates decrease in respiratory pressures. © 2011 Springer-Verlag Berlin Heidelberg.