Repeated Monitoring With Transthoracic Echocardiography and Lung Ultrasound After Cardiac Surgery: Feasibility and Impact on Diagnosis
| Autor: | David Canty, Fayez El Shaer, Mohammed Fouda, Alistair Royse, Hanan Albackr, Abdulelah F. Al Mobeirek, Ahmed A. Alsaddique, Colin Royse |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Pleural effusion 030204 cardiovascular system & hematology Pericardial effusion law.invention 03 medical and health sciences 0302 clinical medicine Postoperative Complications law Internal medicine medicine Humans Prospective Studies Cardiac Surgical Procedures Prospective cohort study Lung Aged Monitoring Physiologic Ultrasonography business.industry 030208 emergency & critical care medicine Middle Aged medicine.disease Intensive care unit Cardiac surgery Stenosis Anesthesiology and Pain Medicine medicine.anatomical_structure Pneumothorax Echocardiography Cardiology Female Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of cardiothoracic and vascular anesthesia. 30(2) |
| ISSN: | 1532-8422 |
| Popis: | Objectives Cardiorespiratory complications are common after cardiac surgery and current monitors used to diagnose these are invasive and have limitations. Transthoracic echocardiography and lung ultrasound are noninvasive and frequently improve diagnosis in critically ill patients but have not been reported for routine postoperative monitoring after coronary, valve, and aortic surgery. The aim was to determine whether both repeated postoperative transthoracic echocardiography and lung ultrasound revealed or excluded clinically important cardiac and respiratory disorders compared to conventional monitoring and chest x-ray. Design Prospective observational study. Setting Tertiary university hospital. Participants Ninety-one patients aged older than 18 undergoing cardiac surgery Interventions Postoperative clinical patient assessment for significant cardiac and respiratory disorders by the treating physician was recorded at 3 time points (day after surgery, after extubation and removal of chest drains and at discharge) using conventional monitoring and chest x-ray. After each assessment, transthoracic echocardiography and lung ultrasound were performed, and differences in diagnosis from conventional assessment were recorded. Measurements and Main Results Transthoracic echocardiography was interpretable in at least 1 echocardiographic window in 99% of examinations. Transthoracic echocardiography and/or lung ultrasound changed the diagnosis of important cardiac and/or respiratory disorders in 61 patients (67%). New cardiac findings included cardiac dysfunction (38 patients), pericardial effusion (5), mitral regurgitation (2), and hypovolemia (1). New respiratory findings included pleural effusion (30), pneumothorax (4), alveolar interstitial syndrome (3) and consolidation (1). Conclusions Routine repeated monitoring with cardiac and lung ultrasound after cardiac surgery is feasible and frequently alters diagnosis of clinically important cardiac and respiratory pathology. |
| Databáze: | OpenAIRE |
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