Evaluation of Transesophageal Echocardiography as a Diagnostic and Therapeutic Aid in a Critical Care Setting

Poelaert, Jan; Everaert, Jan A.; Colardyn, Francis; Trouerbach, Jan; Buyzere, Marc De

doi:10.1378/chest.107.3.774

Cited by 168 publications

(76 citation statements)

References 16 publications

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“…Transoesophageal echocardiography (TOE) has been applied widely in ventilated patients with haemodynamic instability [1,2]. For more than 25 years, pulmonary artery catheterisation has been the clinical standard in the management of the haemodynamically unstable patient and, in particular, for determining cardiac output.…”

mentioning

confidence: 99%

A comparison of transoesophageal echocardiographic Doppler across the aortic valve and the thermodilution technique for estimating cardiac output

Poelaert¹,

Schmidt²,

Aken³

et al. 1999

Anaesthesia

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SummaryThis study was undertaken in order to elucidate the differences between various planes of measurement and Doppler techniques (pulsed-vs. continuous-wave Doppler) across the aortic valve to estimate cardiac output. In 45 coronary artery bypass patients, cardiac output was measured each time using four different Doppler techniques (transverse and longitudinal plane, pulsed-and continuous-wave Doppler) and compared with the thermodilution technique. Measurements were performed after induction of anaesthesia and shortly after arrival in the intensive care unit. Optimal imaging was obtained in 91% of the patients, in whom a total of 82 measurements of cardiac output were performed. The respective mean (SD) areas of the aortic valve were 3.77 (0.71) cm 2 in the transverse plane and 3.86 (0.89) cm 2 in the longitudinal plane. A correlation of 0.87 was found between pulsed-wave Doppler cardiac output and the thermodilution technique in either transverse or longitudinal plane. Correlation coefficients of 0.82 and 0.84 were found between thermodilution cardiac output and transverse and longitudinal continuous-wave Doppler cardiac output, respectively. Although thermodilution cardiac output is a widely accepted clinical standard, transoesophageal Doppler echocardiography across the aortic valve offers adequate estimations of cardiac output. In particular, pulsed-wave Doppler cardiac output in both the transverse and longitudinal plane provides useful data.

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mentioning

confidence: 99%

A comparison of transoesophageal echocardiographic Doppler across the aortic valve and the thermodilution technique for estimating cardiac output

Poelaert¹,

Schmidt²,

Aken³

et al. 1999

Anaesthesia

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“…In various clinical situations, therapy is the answer to the occurring hemodynamic changes. The ability to predict the deterioration of hemodynamic conditions resulting from disease progression or surgical injury and the ability to detect unfavorable changes constitute a key factor in preventing hemodynamic "crises" [23,24].…”

Section: Kardiochirurgia I Torakochirurgia Polska 2013; 10 (4)mentioning

confidence: 99%

Anaesthesiology and intensive care Hemodynamic consequences of different ventilation methods used in lung surgery

Misiołek¹,

Budziński²,

Karpe³

et al. 2013

kitp

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StreszczenieTechniki znieczulenia i wentylacji do operacji torakochirurgicznych są zdecydowanie odmienne od stosowanych w chirurgii ogólnej. Standardową metodą wentylacji podczas dużych zabiegów torakochirurgicznych dotyczących miąższu płucnego oraz innych narządów klatki piersiowej jest wentylacja jednego płuca (one lung ventilation -OLV). Najczęściej zabiegi przeprowadza się w ułożeniu pacjenta na boku przeciwnym do operowanego z równoczesnym otwarciem klatki piersiowej (odma otwarta). To wszystko implikuje zaburzenia mechaniki oddychania, hemodynamiki oraz utlenowania krwi. Alternatywną metodą jest wentylacja wysokimi częstotliwościami (high-frequency jet ventilation -HFJV). Obie metody wentylacji zapewniają całkowite lub częściowe unieruchomienie pola operacyjnego, ale odmienne skutki hemodynamiczne. Porównując obie techniki wentylacji ze względu na zachowanie się parametrów układu sercowo-naczyniowego, można zdecydowanie stwierdzić, że HFJV zapewniając lepsze utlenowanie i prawidłową wentylację, utrzymuje stabilność hemodynamiczną w porównaniu z wentylacją OLV. Słowa kluczowe: wentylacja jednym płucem, wentylacja wysokimi częstotliwościami, układ sercowo-naczyniowy. ANAESTHESIOLOGY AND INTENSIVE CARE AbstractAnesthesia techniques used in thoracic surgery are completely different from those used in general surgery, because thoracic surgery requires both effective ventilation and immobilization of the operating area. One lung ventilation (OLV) remains the standard ventilation method used during thoracic surgery procedures. The most frequent position of the patient during thoracotomy is the lateral decubitus position opposite to the operated side. The abovementioned conditions lead to several respiratory, hemodynamic, and oxygenation disturbances. However, high-frequency jet ventilation (HFJV) may be used as an alternative way of ventilation during lung resection. Both ventilation methods provide full or partial immobilization of the operative field, but they result in different hemodynamic effects. Comparing the cardiovascular parameters during OLV and HFJV we can definitely say that HFJV provides better oxygenation and ventilation in comparison to OLV, while maintaining hemodynamic stability. Key words: one lung ventilation, high frequency jet ventilation, cardiovascular system. DOI: 10.5114/kitp.2013.39743 One lung ventilation (OLV) remains the standard method of providing ventilation during anesthesia before thoracic surgery procedures. The procedures are usually conducted with the patient in a lateral decubitus position opposite to the operated side, with concurrent opening of the chest (open pneumothorax), which allows for complete or partial immobilization of the operating field. Employing this method of ventilation, however, implies a change in the mechanics of breathing, hemodynamics, and blood oxygenation [1]. Hemodynamic consequences of different ventilation methods used in lung surgeryDuring one lung ventilation, the priority for the anesthesiologist is to protect the patient from hypoxia, caus...

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“…Die TEE hat sich in der Kardioanästhe-sie als ein unverzichtbares perioperatives diagnostisches Verfahren etabliert [9]: So konnte gezeigt werden, dass die echokardiographische Evaluation der Interpretation des in der Regel mit dem Swan-GanzKatheter ermittelten hämodynamischen Profils bei postoperativer hämodyna-mischer Instabilität überlegen war [2] und in einem hohen Prozentsatz zu einer Therapieänderung führte [7].…”

Section: üBerflüssiger Luxus Oder Unerlässliches Diagnostikum?unclassified

Transösophageale Echokardiographie bei nichtkardiochirurgischen Intensivpatienten

et al. 2006

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Transesophageal echocardiography provides additional information in critically ill non-cardiac patients with unexplained hemodynamic instability. In the majority of cases a clinical diagnosis is confirmed or improvement of volume resuscitation and catecholamine therapy can be achieved. In the minority of patients the results of TEE lead to distinct changes in medical management. Whether this improved diagnostic accuracy favours outcome, still needs to be evaluated.

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Evaluation of Transesophageal Echocardiography as a Diagnostic and Therapeutic Aid in a Critical Care Setting

Cited by 168 publications

References 16 publications

A comparison of transoesophageal echocardiographic Doppler across the aortic valve and the thermodilution technique for estimating cardiac output

A comparison of transoesophageal echocardiographic Doppler across the aortic valve and the thermodilution technique for estimating cardiac output

Anaesthesiology and intensive care Hemodynamic consequences of different ventilation methods used in lung surgery

Transösophageale Echokardiographie bei nichtkardiochirurgischen Intensivpatienten

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