Contrast-enhanced ultrasound in critical care: a problem-solving approach

Area of Science:

• Critical care medicine
• Medical imaging
• Physiology

Background:

• Critical illness presents with respiratory and circulatory dysfunction, leading to organ damage.
• Microcirculatory hypoperfusion and inflammation cause severe complications like acute kidney injury and ICU-acquired weakness.
• Early identification of organ dysfunction is crucial for managing critical illness.

Purpose of the Study:

• To highlight the role of contrast-enhanced ultrasound (CEUS) in evaluating perfusion-related pathophysiological processes in critical illness.
• To emphasize CEUS applications in assessing hemodynamics in vulnerable organs within the ICU.
• To discuss CEUS-guided interventions and their impact on patient outcomes.

Main Methods:

• Utilizing contrast-enhanced ultrasound (CEUS) for sensitive detection of tissue-level perfusion changes.
• Applying CEUS for bedside assessment of hemodynamics in the kidney, gastrointestinal tract, and skeletal muscle.
• Reviewing recent advances and clinical experience in CEUS for critical care.

Main Results:

• CEUS enables sensitive detection of microcirculatory hypoperfusion and tissue-level perfusion changes.
• CEUS provides crucial insights for early recognition of organ dysfunction and disease progression.
• CEUS facilitates CEUS-guided percutaneous interventions and optimizes thrombus-related therapeutic decisions.

Conclusions:

• CEUS is a valuable non-invasive tool for monitoring microcirculation in critical illness.
• CEUS applications in the ICU can lead to more precise interventions.
• Optimized CEUS use holds potential for improved patient outcomes in critical care settings.