| Autor: |
Kolev, N, Brase, R, Swanevelder, J, Oppizzi, M, Riesgo, MJ, van der Maaten, JMAA, Abiad, MG, Guarracino, F, Zimpfer, M |
| Jazyk: |
angličtina |
| Rok vydání: |
1998 |
| Předmět: |
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| Zdroj: |
Anaesthesia, 53(8), 767-773. Wiley |
| ISSN: |
0003-2409 |
| Popis: |
The role of transoesophageal echocardiography (TOE) in anaesthesia remains controversial because it is a rapidly evolving technique with few proven benefits and considerable cost. Recently, the Society of Cardiovascular Anaesthesiologists has published practice guidelines for the use of peri-operative TOE. To determine the current role of transoesophageal echocardiography and the relative impact of category-based transoesophageal echocardiographic indications the present study investigated its use in seven Western European countries. The study sample was taken from a prospective cohort of 224 patients with acute or chronic haemodynamic disturbances or at risk of myocardial ischaemia. All patients were monitored with two-lead electrocardiography and radial and pulmonary artery catheters, as well as biplane or multiplane transoesophageal echocardiography. A total of 2232 clinical interventions were made in these patients. The most frequently observed intervention was the administration of a fluid bolus (45% of all interventions). Overall, transoesophageal echocardiography was the most important guiding factor in 560 (25%) interventions. It was the most important monitor in guiding the following therapeutic interventions: anti-ischaemic therapy - 207 of 372 interventions (56%); fluid administration 275 of 996 (28%) interventions; vasopressor or inotrope administration - 56 of 316 (16%) interventions; vasodilator therapy - six of 142 (4%) interventions and depth of anaesthesia four of 211 (2%) interventions. We found that transoesophageal echocardiography is frequently influential in guiding clinical decision making and is used most frequently for category II indications but category I indications were associated with more frequent change in management. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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