Ultrasound-Guided Goal-Directed Therapy in the Critically Ill Patient

Purpose of Review This review highlights the current clinical use of ultrasound-guided goal-directed therapy in critically ill patients with an attention to most up-to-date evidence. Recent Findings Current ultrasound-guided therapy uses whole-body ultrasound to assess causes of shock as well as optimize management in an integrative manner. Echocardiography literature recognizes the limitations of left ventricular ejection fraction and focuses on cardiac output assessment to optimize forward flow in relation to systemic status. Lung ultrasound can determine the precise cause of acute respiratory failure and be used for optimization of ventilator settings during acute and weaning phases. Organ congestion can be assessed through integrated cardiac, lung ultrasound and splanchnic organ ultrasound and has limited but promising evidence for volume management. Summary The field of ultrasound-guided goal-directed therapy has good evidence to support improved outcomes in the use of ultrasound to optimize patient’s hemodynamic and ventilatory management.