Prof Anthony McLean from the Nepeam in Sydney delivered this excellent masterclass using a case from his unit as an example.
Assessing RV function using echocardiography is not easy- the gold standard is MRI https://t.co/CcJ0nBrDTP
There are a number of tools available to us as echocardiographers to monitor RV function:
RV:LV ratio https://t.co/d3eskf2N5n
Spectral Doppler through the right ventricular outflow tract
Fractional area change https://t.co/EerYxVytB0
myocardial performance index (Tei index) https://t.co/IEGrCMdkdk
Tissue Doppler imaging
Tricuspid annular plane systolic excursion (TAPSE)
And indirectly using the tricuspid regurgitation jet and IVC size/collapsibility.
The American society of Echocardiography has excellent guidelines on full assessment of RV function https://t.co/1llzJSBszL which are reviewed and simplified by Cardioserv here https://t.co/Mz49Il1Oq0
ARDS has its own set of challenges and RV function needs to be assessed in conjunction with LV function https://t.co/JUkxw8HNN4
Prof McLean’s advice: measurements are all well and good but can be misleading in practice…
RV assessment is complex. Both subjective and objective parameters are necessary to quantify its function. Be careful with patients on inotropes as they confound things.
Prof McLean’s daily “go-tos” are TAPSE, TR/PASP. If still unsure, he adds FAC and TDI (S’).
Prof reckons if you have a machine in your unit that currently measures strain, you should start using it as it will become mainstream in a few years time…
— #hellomynameis Segun (@iceman_ex) September 24, 2017