There is growing evidence both in the perioperative period and in the field of intensive care (ICU) on the association between left ventricular diastolic dysfunction (LVDD) and worse outcomes in patients. The recent American Society of Echocardiography and European Association of Cardiovascular Imaging joint recommendations have tried to simplify the diagnosis and the grading of LVDD. However, both an often unknown pre-morbid LV diastolic function and the presence of several confounders—i.e., use of vasopressors, positive pressure ventilation, volume loading—make the proposed parameters difficult to interpret, especially in the ICU. Among the proposed parameters for diagnosis and grading of LVDD, the two tissue Doppler imaging-derived variables e′ and E/e′ seem most reliable. However, these are not devoid of limitations. In the present review, we aim at rationalizing the applicability of the recent recommendations to the perioperative and ICU areas, discussing the clinical meaning and echocardiographic findings of different grades of LVDD, describing the impact of LVDD on patients’ outcomes and providing some hints on the management of patients with LVDD.

Practical approach to diastolic dysfunction in light of the new guidelines and clinical applications in the operating room and in the intensive care / Sanfilippo, F.; Scolletta, S.; Morelli, A.; Vieillard-Baron, A.. - In: ANNALS OF INTENSIVE CARE. - ISSN 2110-5820. - 8:1(2018). [10.1186/s13613-018-0447-x]

Practical approach to diastolic dysfunction in light of the new guidelines and clinical applications in the operating room and in the intensive care

Morelli, A.;
2018

Abstract

There is growing evidence both in the perioperative period and in the field of intensive care (ICU) on the association between left ventricular diastolic dysfunction (LVDD) and worse outcomes in patients. The recent American Society of Echocardiography and European Association of Cardiovascular Imaging joint recommendations have tried to simplify the diagnosis and the grading of LVDD. However, both an often unknown pre-morbid LV diastolic function and the presence of several confounders—i.e., use of vasopressors, positive pressure ventilation, volume loading—make the proposed parameters difficult to interpret, especially in the ICU. Among the proposed parameters for diagnosis and grading of LVDD, the two tissue Doppler imaging-derived variables e′ and E/e′ seem most reliable. However, these are not devoid of limitations. In the present review, we aim at rationalizing the applicability of the recent recommendations to the perioperative and ICU areas, discussing the clinical meaning and echocardiographic findings of different grades of LVDD, describing the impact of LVDD on patients’ outcomes and providing some hints on the management of patients with LVDD.
2018
critical care; diastolic function; sepsis; systolic function; weaning failure; critical care and intensive care medicine
01 Pubblicazione su rivista::01g Articolo di rassegna (Review)
Practical approach to diastolic dysfunction in light of the new guidelines and clinical applications in the operating room and in the intensive care / Sanfilippo, F.; Scolletta, S.; Morelli, A.; Vieillard-Baron, A.. - In: ANNALS OF INTENSIVE CARE. - ISSN 2110-5820. - 8:1(2018). [10.1186/s13613-018-0447-x]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1187301
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