Chest
Clinical Investigations in Critical Care: ArticlesEvaluation of Transesophageal Echocardiography as a Diagnostic and Therapeutic Aid in a Critical Care Setting
Section snippets
Patient Selection
All critically ill patients in a 33-bed ICU who underwent a TEE during a 7-month period between January and July 1991 were included. Excluded were patients after cardiac surgery. The patient population was assorted into patients who did and who did not have a PAC at the time of the TEE. Moreover, in the two groups, three subgroups were made depending on the primary disease on admission to the ICU. When cardiac disease was the foremost indication of admittance, patients were assorted within a
Patient Characteristics and Subgroup Identification
Of 982 patients admitted to the ICU during the study period, 108 patients underwent a TEE (Table 1). The mean age was 62 years (range, 8 to 83 years; 32 women, 76 men). Sixty patients (56%) were ventilated at the time of the TEE.
The cardiac subgroup consisted of 63 patients and the septic group consisted of 37 patients. In a third subgroup (n=3) the primary indication was assessment of extracardiac abnormalities. Five patients with mixed abnormalities could not be asserted in either the septic
Discussion
The clinical application of TEE has been studied in many conditions1, 2, 3, 4,8 and gradually this technique has been validated in the critical care setting. Some studies claim the importance of TEE in the postoperative follow-up after cardiac surgery.9, 10 In the noncardiac surgery ICU, several authors have shown the additional value of TEE in decision making.11, 12, 13, 14, 15, 16 We particularly studied the potential role of TEE in the ICU in patients instrumented with a PAC concerning
References (23)
- et al.
Transesophageal echocardiography: technique, anatomic correlations, implementation and clinical applications
Mayo Clin Proc
(1988) - et al.
Biplanar transesophageal echocardiography: anatomic correlations, image orientation and clinical applications
Mayo Clin Proc
(1990) - et al.
Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis
Chest
(1992) Transesophageal echocardiography for assessing cause of hypotension after cardiac surgery
Am J Cardiol
(1988)- et al.
Prognostic value of biventricular function in hypotensive patients after cardiac surgery as assessed by transesophageal echocardiography
J Cardiothorac Vasc Anesth
(1992) - et al.
Transesophageal echocardiography in critically ill patients
Am J Cardiol
(1990) - et al.
The role of transesophageal echocardiography in critical care: UCSF Experience
J Am Soc Echocardiogr
(1992) - et al.
Echocardiography in serial evaluation of left ventricular systolic and diastolic function: importance of image acquisition, quantitation and physiologic variability in clinical and investigational applications
J Am Soc Echo
(1991) - et al.
Accuracy of cardiac output estimation with biplane transesophageal echocardiography
J Am Soc Echocardiogr
(1993) - et al.
Traumatic tricuspid insufficiency: an underdiagnosed disease
Chest
(1987)
Transesophageal echocardiography: technique and clinical applications
J Cardiothorac Anesth
Cited by (177)
Impact of Focused Intraoperative Transthoracic Echocardiography by Anesthesiologists on Management in Hemodynamically Unstable High-Risk Noncardiac Surgery Patients
2017, Journal of Cardiothoracic and Vascular Anesthesia