Cardiac ultrasound: a true haemodynamic monitor?

Cardiac ultrasound has been used in the critically ill for more than thirty years. The technology has made enormous progression with respect to image quality and quantity, various Doppler techniques, as well as connectivity, the transfer of data and offline calculations. Some consider cardiac ultrasound as the stethoscope of the Twenty-first century. The potential of eye-balling moving cardiac structures gives undeniable power to this diagnostic and monitoring tool. The main shortcoming is the discontinuous mode of monitoring and the fact that optimal information acquisition can only be obtained when one is well-trained and experienced. Cardiac ultrasound has become an indispensable tool, especially in haemodynamically unstable patients. This review summarizes some important aspects of cardiac ultrasound with use of Doppler monitoring for assessment of the three most important pillars of haemodynamics, namely cardiac preload, afterload and contractile function.