Ischämische hämodynamische Instabilität bei Intensivpatienten

Autor: H. Schmidt, Karl K. Haase, A. Wisbar, J. Haas, M. H. Hust, F. Al-Shajlawi
Rok vydání: 2005
Předmět:
Zdroj: Intensivmedizin und Notfallmedizin. 42:517-529
ISSN: 1435-1420
0175-3851
DOI: 10.1007/s00390-005-0642-5
Popis: Hemodynamic instability due to ischemia in post-myocardial infarction patients remains a great challenge in intensive care medicine. The high mortality rates in these patients can be effectively reduced by bedside diagnostic procedures and subsequent therapy. The first choice of non-invasive imaging is transthoracic echocardiography (TTE), providing information about systolic and diastolic heart function, volume status, and typical complications following myocardial infarction. Moreover, TTE is very important to rule out non-ischemic pathophysiological conditions. In these patients, TTE may be limited by tachycardia, mechanical ventilation using positive end-expiratory pressure and other conditions. Transesophageal echocardiography (TEE) overcomes these problems by using an esophageal or gastric window. Thus, TTE and TEE have to be considered as complementary tools. An experienced investigator will be able to obtain valid information in most cases using TTE only, since newer echocardiographic systems include second harmonic imaging. Therefore, TEE as a semi-invasive and more time consuming method can be reserved for patients presenting with poor imaging conditions, or in whom a diagnosis could not be established by TTE alone. Both, TTE and TEE should be routinely available in modern intensive care units.
Databáze: OpenAIRE
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