What is the role of echocardiography in the diagnosis of acute respiratory distress syndrome (ARDS)?

Updated: Mar 27, 2020
  • Author: Eloise M Harman, MD; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

As part of the workup, patients with ARDS should undergo two-dimensional echocardiography for the purpose of screening. If findings are suggestive of patent foramen ovale shunting, two-dimensional echocardiography should be followed up with transesophageal echocardiography. [19] Routine screening with transthoracic echocardiography also provides information about right ventricular function. Right ventricular dysfunction is present in 22-50% of patients with ARDS and is associated with increased mortality. [20] Being aware of the presence and severity of right ventricular dysfunction may guide therapy with reduced fluid volume administration and application of pulmonary artery vasodilators or vasoactive support.

Because patients with severe ARDS often require prolonged prone positioning due to refractory hypoxemia, a study assessed the use of transesophageal echocardiography (TEE) in patients in the prone position. [21] The study determined that TEE can be safely and efficiently performed in patients with severe ARDS in the prone position.


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