An Approach to Standard Perioperative Transthoracic Echocardiography Practice for Anesthesiologists—Perioperative Transthoracic Echocardiography Protocols

Perioperative hemodynamic monitoring techniques: a narrative review

“…Medical pioneers emphasize the vast potential of ultrasound (US)-based imaging in anesthesiology, particularly in enhancing the safety and efficacy of several invasive procedures and the noninvasive monitoring of vital organ function and anatomy [66][67][68] . The mounting clinical evidence for the point-ofcare US (POCUS) value in the perioperative setting, growing affordability of US equipment, and a few associated perioperative US in everyday clinical practice [69][70][71] . Hemodynamic instability unresponsive to initial treatment is a class I indication for performing a timely echocardiographic examination for accurate assessment of cardiovascular therapy to maintain hemodynamic stability.…”

Logistics of perioperative diagnostic point-of-care ultrasound: nomenclature, scope of practice, training, credentialing/privileging, and billing

“…11 Similarly, PTTE is the use of echocardiography by anesthesiologists with advanced training (board certification or equivalent) in chest wall cardiac ultrasound to answer quantitative questions about cardiovascular function in perioperative patients. 13 Whereas a CCE provider may be more interested in using echocardiography to titrate inotropic support, a PTTE provider may be more likely to use echocardiography to quantify the precise severity of aortic stenosis when evaluating a patient preoperatively. But in both cases, to qualify as an "echo," the exam must meet all 3 of the following criteria: (1) be performed/ interpreted by providers with comprehensive training in image acquisition/interpretation (ie, board certification or equivalent);…”

“…CCE is the use of echocardiography by intensivists with advanced training (board certification or equivalent) in chest wall cardiac ultrasound to answer quantitative questions about cardiovascular function in critically ill patients 11. Similarly, PTTE is the use of echocardiography by anesthesiologists with advanced training (board certification or equivalent) in chest wall cardiac ultrasound to answer quantitative questions about cardiovascular function in perioperative patients 13. Whereas a CCE provider may be more interested in using echocardiography to titrate inotropic support, a PTTE provider may be more likely to use echocardiography to quantify the precise severity of aortic stenosis when evaluating a patient preoperatively.…”

Student Survey After Ten Years of Continuous Blended Teaching of Echocardiocraphy

“…was followed by a progressive increase in its application in various scenarios [6][7][8], being today a widespread practice and a standard of care in many cardiac surgeries and in many procedures of interventional cardiology [9][10][11]. Later its use was extended to the critical patient and emergency units [12][13][14][15][16][17][18][19] as well as to the perioperative period [20,21], being the transthoracic approach (TTE) the most widely used technique.…”

“…With these antecedents and based on our daily clinical practice, we started in 2011 an annual blended teaching program in echocardiography focused on perioperative and critical care scenarios, with the aim that students learn to interpret and use echocardiography for the clinical management of these patients, and that provides a level of knowledge and interpretation according to a Perioperative TTE and with a period of practice according to the FOCUS programs [20,21,26,29,32,35,36]. This teaching program, dictated by the Faculty of Medicine of the University of Chile via medichi (digital learning network, www.medichi.cl) and currently endorsed by the European Association of Cardiothoracic Anesthesiologists and Intensive Care (EACTAIC) (www.eactaic.org), was structured by an international and multidisciplinary faculty that includes anesthesiologists, cardiologists and intensivists with vast experience in echocardiography and with its directors certi ed in echocardiography by the European Association of Cardiovascular Imaging (EACVI).…”