Microsphere contrast echocardiography in the critical care complex
1 Department of Echocardiography, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD 4032, Australia
2 Critical Care Unit, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD 4032, Australia
3 Critical Care and Anaesthesia, School of Medicine, University of Queensland, Georges Street, Brisbane, QLD 4072, Australia
Critical Care 2011, 15:417 doi:10.1186/cc10122
See related research by Saranteas et al., http://ccforum.com/content/15/1/R54 and see related letter by Barreiro Pardal et al., http://ccforum.com/content/15/3/431Published: 6 April 2011
First paragraph (this article has no abstract)
The paper by Saranteas and colleagues  in the previous issue of Critical Care describes the use of transthoracic echocardiography (TTE) for detection of ventricular thrombus in postoperative patients in the critical care unit. While we agree that TTE is a fundamental diagnostic imaging tool that enhances detection of anatomic and physiologic abnormalities within the critical care complex, we would like to make several comments regarding its utility in this clinical setting. In up to 25% of TTE scans performed in the critical care complex, the images are nondiagnostic despite operator excellence, and this fact can have a significant impact on patient diagnosis and management . We agree with the authors that, owing to the suboptimal spatial orientation of the transducer in relation to the left ventricular apex, transoesophageal echocardiography may not help in these cases.