Feasibility and influence of hTEE monitoring on postoperative management in cardiac surgery patients.
Monoplane hemodynamic TEE (hTEE) monitoring (ImaCor(®) ClariTEE(®)) might be a useful alternative to continuously evaluate cardiovascular function and we aimed to investigate the feasibility and influence of hTEE monitoring on postoperative management in cardiac surgery patients. After IRB approval...
| Publicado en: | International Journal of Cardiovascular Imaging Vol. 31; no. 7; pp. 1327 - 1336 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | diagnostic images pictorial research tables/charts Journal Article |
| Publicado: |
Springer Nature
Oct2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109473935&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109473935 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15695794 1HHY jtl: International Journal of Cardiovascular Imaging issn: 15695794 maglogo: N pubinfo: dt: Oct2015 vid: 31 iid: 7 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 109473935 109473935 NLM26047772 109473935 10.1007/s10554-015-0689-8 NLM26047772 109473935 ppf: 1327 ppct: 9 formats: tig: atl: Feasibility and influence of hTEE monitoring on postoperative management in cardiac surgery patients. aug: au: Treskatsch, S. Balzer, F. Knebel, F. Habicher, M. Braun, J. Kastrup, M. Grubitzsch, H. Wernecke, K.-D. Spies, C. Sander, M. Braun, J P affil: Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Charitéplatz 1 10117 Berlin Germany sug: subj: Hemodynamics Echocardiography, Doppler, Color Methods Postoperative Care Methods Cardiac Surgery Adverse Effects Echocardiography, Transesophageal Methods Monitoring, Physiologic Methods Postoperative Care Equipment and Supplies Postoperative Care Education Male Pilot Studies Aged, 80 and Over Education, Medical Internship and Residency Echocardiography, Transesophageal Equipment and Supplies Predictive Value of Tests Middle Age Cardiac Tamponade Ultrasonography Cardiac Tamponade Etiology Retrospective Design Treatment Outcomes Heart Failure Ultrasonography Monitoring, Physiologic Equipment and Supplies Heart Failure Etiology Cardiovascular Agents Administration and Dosage Intensive Care Units Time Factors Heart Failure Therapy Transducers Female Germany Aged Heart Failure Physiopathology Cardiac Tamponade Therapy Equipment Design Cardiac Tamponade Physiopathology Echocardiography, Doppler, Color Equipment and Supplies Human Aged, 80 & over Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Monoplane hemodynamic TEE (hTEE) monitoring (ImaCor(®) ClariTEE(®)) might be a useful alternative to continuously evaluate cardiovascular function and we aimed to investigate the feasibility and influence of hTEE monitoring on postoperative management in cardiac surgery patients. After IRB approval we reviewed the electronic data of cardiac surgery patients admitted to our intensive care between 01/01/2012 and 30/06/2013 in a case-controlled matched-pairs design. Patients were eligible for the study when they presented a sustained hemodynamic instability postoperatively with the clinical need of an extended hemodynamic monitoring: (a) hTEE (hTEE group, n = 18), or (b) transpulmonary thermodilution (control group, n = 18). hTEE was performed by ICU residents after receiving an approximately 6-h hTEE training session. For hTEE guided hemodynamic optimization an institutional algorithm was used. The hTEE probe was blindly inserted at the first attempt in all patients and image quality was at least judged to be adequate. The frequency of hemodynamic examinations was higher (ten complete hTEE examinations every 2.6 h) in contrast to the control group (one examination every 8 h). hTEE findings, including five unexpected right heart failure and one pericardial tamponade, led to a change of current therapy in 89% of patients. The cumulative dose of epinephrine was significantly reduced (p = 0.034) and levosimendan administration was significantly increased (p = 0.047) in the hTEE group. hTEE was non-inferior to the control group in guiding norepinephrine treatment (p = 0.038). hTEE monitoring performed by ICU residents was feasible and beneficially influenced the postoperative management of cardiac surgery patients. pubtype: Academic Journal doctype: diagnostic images pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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