Diagnostic Accuracy and Therapeutic Impact of Transthoracic and Transesophageal Echocardiography in Mechanically Ventilated Patients in the ICU

Localized Cardiac Tamponade after Open-Heart Surgery

“…Invasive hemodynamic monitoring was not performed in our patients with surgically proven localized tamponade since echocardiography is routinely used for the assessment of patients with cardiorespiratory compromise in our ICU. 14) Nevertheless, authors previously reported that right-heart catheterization was not commonly contributive in these patients. 1,9) Although the small sample size did not allow us to use a multivariate analysis in order to determine independent risk factors of death, the present case series of localized tamponade after open-heart surgery is currently the largest published to the best of our knowledge.…”

“…During the first week following open-heart surgery, Flynn et al 13) showed that TTE provides adequate visualization of cardiac ventricles in only 58% of patients, since numerous factors are known to interfere with image quality in ventilated ICU patients. 14) In addition, localized tamponade predominantly involve the right or left atrium, 15,16) which are best imaged by TEE. 6,8,17) Although TTE has allowed the depiction of localized cardiac tamponade in ventilated patients after open-heart surgery, 1,15,16) TEE must be obtained since a false positive or false negative result may have major consequences in this clinical setting.…”

Des diagnostics cliniques et échocardiographiques contradictoires dans des cas d’instabilité hémodynamique inexpliquée à la suite d’une intervention en cardiochirurgie

“…3,4 Both the potential of superior imaging quality and its reproducibility provide a more accurate diagnosis or allow exclusion of suspected pathological changes. 5 Both the American Society of Anesthesiologists and Society of Cardiovascular Anesthetists, and the American College of Cardiology and the American Heart Association have published guidelines on the use of TEE.…”

Ten good reasons why everybody can and should perform cardiac ultrasound in the ICU

“…In a clinical study of 128 transthoracic procedures, Vignon et al reported quality that was good in 55% of cases, suboptimal in 23%, and poor in 22% [17]. In the event of TTE failure, TEE was very efficient [17].…”