Disfunción del ventrículo derecho en el paciente crítico. Evaluación ecocardiográfica

The impairment of the right ventricle is a common condition in critically ill patients. Right ventricular dysfunction is associated with increased mortality, and its diagnosis remains challenging. In this review, we aim to outline the potential mechanisms underlying abnormal biomechanics of the right ventricle and different phenotypes of injury. A comprehensive understanding of the pathophysiology and natural history of right ventricular injury may be informative for the intensivist in the diagnosis and management of this condition, as well as contributing to the guidance of individualized treatment strategies.

We describe the main recommended parameters to assess right ventricular systolic and diastolic function. We also define how to evaluate cardiac output and pressures of the pulmonary circulation with echocardiography, with a focus on the diagnosis of acute cor pulmonale and relevant applications in critical illnesses such as distress, septic shock, and right ventricular infarction.