{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:05:38Z","timestamp":1790193938925,"version":"4.1.0"},"reference-count":77,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T00:00:00Z","timestamp":1735257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Heart and lung sharing the same anatomical space are influenced by each other. Spontaneous breathing induces dynamic changes in intrathoracic pressure, impacting cardiac function, particularly the right ventricle. In intensive care units (ICU), mechanical ventilation (MV) and therefore positive end-expiratory pressure (PEEP) are often applied, and this inevitably influences cardiac function. In ventilated patients, the use of positive pressures leads to an increase in intrathoracic pressure and, consequently, to a reduction in the right ventricular preload and thus cardiac output. The clinician working in the intensive care unit must be able to assess the effects MV has on the heart in order to set it up appropriately and to manage any complications. The echocardiographic evaluation of the ventilated patient has the main purpose of studying the right ventricle; in fact, they are the ones most affected by PEEP. It is therefore necessary to assess the size, thickness, and systolic function of the right ventricle. In the mechanically ventilated patient, it may be difficult to assess the volemic status and fluid responsiveness, in fact, the study of the inferior vena cava (IVC) is not always reliable in these patients. In patients with MV, it is preferable to assess fluid responsiveness with dynamic methods such as the end-expiration occlusion (EEO) test, passive leg raise (PLR), and fluid challenge (FC). The study of the diaphragm is also essential to identify possible complications, manage weaning, and provide important prognostic information. This review describes the basis for echocardiographic evaluation of the mechanically ventilated patient with the aim of supporting the clinician in managing the consequences of MV for heart\u2013lung interaction.<\/jats:p>","DOI":"10.3390\/jcm14010077","type":"journal-article","created":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T02:59:27Z","timestamp":1735268367000},"page":"77","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Echocardiography in the Ventilated Patient: What the Clinician Has to Know"],"prefix":"10.3390","volume":"14","author":[{"given":"Fiorella Chiara","family":"Delle Femine","sequence":"first","affiliation":[{"name":"Cardiology Unit, Department of Medical Translational Sciences, Monaldi Hospital, University of Campania \u201cLuigi Vanvitelli\u201d, 80136 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"D\u2019Arienzo","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Department of Medical Translational Sciences, Monaldi Hospital, University of Campania \u201cLuigi Vanvitelli\u201d, 80136 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biagio","family":"Liccardo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Monaldi Hospital, University of Campania \u201cLuigi Vanvitelli\u201d, 80136 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7223-141X","authenticated-orcid":false,"given":"Maria Concetta","family":"Pastore","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3885-5093","authenticated-orcid":false,"given":"Federica","family":"Ilardi","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, Division of Cardiology, Federico II University Hospital, Via S. Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3184-3006","authenticated-orcid":false,"given":"Giulia Elena","family":"Mandoli","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1699-5255","authenticated-orcid":false,"given":"Simona","family":"Sperlongano","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Department of Medical Translational Sciences, Monaldi Hospital, University of Campania \u201cLuigi Vanvitelli\u201d, 80136 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9119-4311","authenticated-orcid":false,"given":"Alessandro","family":"Malagoli","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Nephro-Cardiovascular Department, Baggiovara Hospital, 41126 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4591-2030","authenticated-orcid":false,"given":"Matteo","family":"Lisi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Disease\u2014AUSL Romagna, Division of Cardiology, Ospedale S. Maria Delle Croci, Viale Randi 5, 48121 Ravenna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5660-6162","authenticated-orcid":false,"given":"Giovanni","family":"Benfari","sequence":"additional","affiliation":[{"name":"Section of Cardiology, Department of Medicine, University of Verona, 37129 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9227-0360","authenticated-orcid":false,"given":"Vincenzo","family":"Russo","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Department of Medical Translational Sciences, Monaldi Hospital, University of Campania \u201cLuigi Vanvitelli\u201d, 80136 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3872-8964","authenticated-orcid":false,"given":"Matteo","family":"Cameli","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9698-9145","authenticated-orcid":false,"given":"Antonello","family":"D\u2019Andrea","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Umberto I Hospital, 84014 Nocera Inferiore, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,27]]},"reference":[{"key":"ref_1","first-page":"w14491","article-title":"Basic concepts of heart-lung interactions during mechanical ventilation","volume":"147","author":"Grbler","year":"2017","journal-title":"Swiss Med. 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