Echocardiographic Applications of M-Mode Ultrasonography in Anesthesiology and Critical Care

Gabriel Prada, Antoine Vieillard-Baron, Archer K. Martin, Antonio Hernandez, Farouk Mookadam, Harish Ramakrishna, Jose L. Diaz-Gomez

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Proficiency in echocardiography and lung ultrasound has become essential for anesthesiologists and critical care physicians. Nonetheless, comprehensive echocardiography measurements often are time-consuming and technically challenging, and conventional 2-dimensional images do not permit evaluation of specific conditions (eg, systolic anterior motion of the mitral valve, pneumothorax), which have important clinical implications in the perioperative setting. M-mode (motion-based) ultrasonographic imaging, however, provides the most reliable temporal resolution in ultrasonography. Hence, M-mode can provide clinically relevant information in echocardiography and lung ultrasound–driven approaches for diagnosis, monitoring, and interventional procedures performed by anesthesiologists and intensivists. Although M-mode is feasible, this imaging modality progressively has been abandoned in echocardiography and is often underutilized in lung ultrasound. This article aims to comprehensively illustrate contemporary applications of M-mode ultrasonography in the anesthesia and critical care medicine practice. Information presented for each clinical application will include image acquisition and interpretation, evidence-based clinical implications in the critically ill and surgical patient, and limitations. The present article focuses on echocardiography and reviews left ventricular function (mitral annular plane systolic excursion, E-point septal separation, fractional shortening, and transmitral propagation velocity); right ventricular function (tricuspid annular plane systolic excursion, subcostal echocardiographic assessment of tricuspid annulus kick, outflow tract fractional shortening, ventricular septal motion, wall thickness, and outflow tract obstruction); volume status and responsiveness (inferior vena cava and superior vena cava diameter and respiratory variability [collapsibility and distensibility indexes]); cardiac tamponade; systolic anterior motion of the mitral valve; and aortic dissection.

Original languageEnglish (US)
JournalJournal of Cardiothoracic and Vascular Anesthesia
DOIs
StateAccepted/In press - Jan 1 2018

Keywords

  • anesthesia
  • critical care
  • echocardiography
  • lung ultrasound
  • M-mode
  • ultrasonography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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    Prada, G., Vieillard-Baron, A., Martin, A. K., Hernandez, A., Mookadam, F., Ramakrishna, H., & Diaz-Gomez, J. L. (Accepted/In press). Echocardiographic Applications of M-Mode Ultrasonography in Anesthesiology and Critical Care. Journal of Cardiothoracic and Vascular Anesthesia. https://doi.org/10.1053/j.jvca.2018.06.019