Document Detail


Perioperative use of transesophageal echocardiography by anesthesiologists: impact in noncardiac surgery and in the intensive care unit.
MedLine Citation:
PMID:  11861348     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The American Society of Anesthesiologists (ASA) has published practice guidelines for the use of perioperative transesophageal echocardiography (TEE) but the role and impact of TEE performed by anesthesiologists outside the cardiac operating room (OR) is still poorly explored. We report our experience in the use of TEE in the noncardiac OR, the recovery room and in the intensive care unit (ICU) in a university hospital, and analyze the impact of TEE on clinical decision making. METHODS: Two hundred fourteen patients were included and TEE indications were classified prospectively according to the ASA guidelines. The examinations and data sheets were reviewed by two anesthesiologists with advanced training in TEE. For each examination, it was noted if TEE altered the management according to five groups: 1) changing medical therapy; 2) changing surgical therapy; 3) confirmation of a diagnosis; 4) positioning of an intravascular device; and 5) TEE used as a substitute to a pulmonary artery catheter. RESULTS: Eighty-nine (37%), 67 (31%) and 58 (27%) patients had category I, II and III indications. The impact was more significant in category I where TEE altered therapy 60% of the time compared with 31% and 21% for categories II and III (P < 0.001). The most frequent reason for changing management was a modification in medical therapy in 53 instances (45%). CONCLUSION: Our results confirm a greater impact of TEE performed by anesthesiologists on clinical management for category I compared to category II and III indications in the noncardiac OR surgical setting and in the ICU.
Authors:
André Y Denault; Pierre Couture; Sylvie McKenty; Daniel Boudreault; François Plante; Roger Perron; Denis Babin; Jean Buithieu
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  49     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-03-07     Completed Date:  2002-06-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  287-93     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Montreal Heart Institute, Quebec, Canada. denault@videotron.ca
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MeSH Terms
Descriptor/Qualifier:
Anesthesiology* / education
Echocardiography, Transesophageal / utilization*
Humans
Intensive Care Units

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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