Echocardiography as an imaging method in anaesthesia and intensive care medicine has enabled a new dimension of hemodynamic monitoring: the direct visualization of the cardiac function and its disruptions. Preconditions for a broad application in this area was the development of mobile, high-definition ultrasonic devices and the origination of focused examination techniques. A successful application of this method requires the respective know-how of the examiner, in order to take relevant decisions and avoid misdiagnoses. The following article shows the advantages and limitations of echocardiography in the diagnosis of hemodynamic instability. For TTE and TEE focused examination techniques are illustrated and evaluated with regards to their applicability to hemodynamic monitoring. Furthermore, the requirements on devices and education of the examiner are discussed.
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