Cardiac Arrest upon Induction of General Anesthesia: Transesophageal Echocardiography-assisted Diagnosis of Impending Paradoxical Embolus

Younker, Dirk; Reeves-Viets, J.; Gopinath, Shankar P.; Tsai, Peter I.; Moon, Teresa; Cuzick, Leslie M.

doi:10.1097/aln.0b013e3181b27a85

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…Operacijos metu kylanti veninė oro embolija yra seniai nustatytas reiškinys pacientams, operuojamiems sėdimoje pozicijoje. Oro burbuliukai doplerio režimu nustatomi maždaug 12% atvejų, kai paciento padėtis ne sėdima (gulintiems ant pilvo, nugaros, šono arba kniūbstiems) (24). Svarbiausi veiksniai, kurie lemia sergamumą ir mirštamumą, susijusį su oro embolizacija, galėtų būti laiku diagnozuojami ir tinkamai gydomi, ištiriant širdies anatomines struktūras ir panaudojant doplerį (24).…”

Section: Darbo Objektas Ir Metodasunclassified

“…Oro burbuliukai doplerio režimu nustatomi maždaug 12% atvejų, kai paciento padėtis ne sėdima (gulintiems ant pilvo, nugaros, šono arba kniūbstiems) (24). Svarbiausi veiksniai, kurie lemia sergamumą ir mirštamumą, susijusį su oro embolizacija, galėtų būti laiku diagnozuojami ir tinkamai gydomi, ištiriant širdies anatomines struktūras ir panaudojant doplerį (24). TEE pagalba neurochirurgijoje galėtume nustatyti atvirąją ovaliają angą, smegenų vandenės atveju nustatyti šunto, jungiančio smegenų vandentiekio sistemą su tuščiosios venos ir prieširdžio jungtimi, distalinio galo padėtį (25).…”

Section: Darbo Objektas Ir Metodasunclassified

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Perioperacinės Perstemplinės Echokardiografijos Panaudojimo Galimybės Neširdinių Operacijų Metu

Macas

Bilskienė

2014

Sveikatos Mokslai

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Section: Darbo Objektas Ir Metodasunclassified

Perioperacinės Perstemplinės Echokardiografijos Panaudojimo Galimybės Neširdinių Operacijų Metu

Macas

Bilskienė

2014

Sveikatos Mokslai

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Emergent limited perioperative transesophageal echocardiography: should new guidelines exist for limited echocardiography training for anesthesiologists?

Peng

Janelle

2012

Front. Med.

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Bedside limited echocardiography, or focused cardiac ultrasound, continues to gain popularity in many emergency rooms, intensive care units, and operating rooms as a rapid method of assessing unstable patients. Effective monitoring of cardiovascular function in conditions like cardiac arrest or near-arrest is the crucial step to guide successful resuscitative efforts. Transesophageal echocardiography (TEE) has emerged as one of the preferred cardiac diagnostic and monitoring modalities in the intraoperative setting due to the fact that it is less invasive than many other monitors, is immediately accessible, and allows for continuous real-time monitoring of cardiac function. However, the minimum training requirements needed for the anesthesia provider to obtain the competency, knowledge, and skills for basic certification in perioperative TEE far exceed those developed for other medical specialties. We believe there is an urgent need to develop (1) practical guidelines for emergent perioperative TEE use for anesthesiologists and (2) a requisite educational curriculum to teach the basic skills necessary to aid in the diagnosis and treatment of cardiac arrest or near-arrest scenarios. The measures elucidated in this report summarize the efforts of the Department of Anesthesiology at the University of Florida in establishing the necessary steps to make this process not only practical, but accessible to all trainees.We hope that these collective efforts will provide more trainees the confidence in utilizing TEE to aid in establishing a diagnosis in critical situations.

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Large serpiginous thrombus straddling the patent foramen ovale and traversing through mitral and tricuspid valves into both ventricles: a therapeutic dilemma of impending paradoxical embolism and recurrent pulmonary embolism.

et al. 2014

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A 51-year-old male with history of resected renal cell carcinoma and prior pulmonary embolism presented with tachypnea, tachycardia and progressive dyspnea on exertion. Chest computed tomography revealed bilateral acute pulmonary embolism. Transthoracic echocardiogram showed severe pulmonary hypertension with severe cor-pulmonale and presence of a large worm-like thrombus extending across the foramen ovale, entering both ventricles through the mitral and tricuspid valves. The risks of anti-coagulation, pharmacologic thrombolysis, and surgical thrombectomy, in a hemodynamically stable patient, posed a significant therapeutic dilemma. Ultimately, a collective decision was made to start anticoagulation, without incident. At 1 month follow up, complete resolution of the intracardiac thrombus, pulmonary hypertension, and cor-pulmonale were observed with full clinical recovery of the patient.

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Cardiac Arrest upon Induction of General Anesthesia: Transesophageal Echocardiography-assisted Diagnosis of Impending Paradoxical Embolus

Cited by 3 publications

References 7 publications

Perioperacinės Perstemplinės Echokardiografijos Panaudojimo Galimybės Neširdinių Operacijų Metu

Perioperacinės Perstemplinės Echokardiografijos Panaudojimo Galimybės Neširdinių Operacijų Metu

Emergent limited perioperative transesophageal echocardiography: should new guidelines exist for limited echocardiography training for anesthesiologists?

Large serpiginous thrombus straddling the patent foramen ovale and traversing through mitral and tricuspid valves into both ventricles: a therapeutic dilemma of impending paradoxical embolism and recurrent pulmonary embolism.

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