Hypotension Publications

Ultrasound Algorithms for Undifferentiated Hypotension

Jones AE, Tayal VS, Sullivan DM, Kline JA. Randomized, controlled trial of immediate versus delayed goal-directed ultrasound to identify the cause of nontraumatic hypotension in emergency department patients. Crit Care Med. 2004 Aug;32(8):1703-8. doi: 10.1097/01.ccm.0000133017.34137.82. PMID: 15286547.

Perera P, Mailhot T, Riley D, Mandavia D. The RUSH exam: Rapid Ultrasound in SHock in the evaluation of the critically lll. Emerg Med Clin North Am. 2010 Feb;28(1):29-56, vii. doi: 10.1016/j.emc.2009.09.010. PMID: 19945597.

Velocity time integral (VTI) and fluid responsiveness

Blanco P. Rationale for using the velocity-time integral and the minute distance for assessing the stroke volume and cardiac output in point-of-care settings. Ultrasound J. 2020 Apr 21;12(1):21. doi: 10.1186/s13089-020-00170-x. PMID: 32318842; PMCID: PMC7174466.

• An increase > 15% in the VTI after a treatment indicates a concrete response to this therapy

• A > 12% increase in the VTI after a passive leg raise has demonstrated a good accuracy for differentiating fluid responders from non-responders

• Limitations: VTI not reliable for estimating the SV/ CO when there is a moderate-to-severe aortic regurgitation and/or a subaortic obstruction

‍

‍