[Critical care echocardiography].

Critical care echocardiography (CCE) using the transthoracic approach is a noninvasive imaging tool at the bedside and is of great value in the intensive care setting because of its portability, widespread availability, and rapid diagnostic capability. Time-dependent scenarios occur during shock and during cardiopulmonary resuscitation. Potentially treatable causes of shock or cardiac arrest including hypovolemia, cardiac tamponade, left ventricular failure, or massive pulmonary embolism should be detected or excluded as soon as possible. Basic CCE is assessed by means of "focused" or "goal-directed". Performance of such focused or goal-directed echocardiography by intensive care unit (ICU) physicians has been shown to provide new information not assessable by physical examination, and often leads to change in therapeutic management. Competence in basic CCE includes qualitative assessment of left ventricular cavity size, left ventricular systolic function, right ventricular cavity size and function, identification of pericardial fluid, and measurement of inferior vena cava diameter. Basic CCE should be a required part of the training of every ICU physician. This review discusses the application of basic CCE performed by the emphasis on focused or goal-directed assessment.