Markin Nicholas W, Gmelch Benjamin S, Griffee Matthew J, Holmberg Timothy J, Morgan David E, Zimmerman Joshua M
Department of Anesthesiology, University of Utah, Salt Lake City, UT.
Department of Anesthesiology, University of Utah, Salt Lake City, UT.
J Cardiothorac Vasc Anesth. 2015 Feb;29(1):82-8. doi: 10.1053/j.jvca.2014.07.004. Epub 2014 Nov 7.
Review the findings and use of rescue echocardiography performed by the Division of Perioperative Echocardiography and its impact on patient management.
Retrospective observational study.
Single institution, tertiary care hospital.
Three hundred sixty-four consecutive rescue echocardiograms in the perioperative setting.
Rescue transesophageal or rescue transthoracic echocardiography.
Of a total of 1,675 perioperative echocardiograms performed in a 28-month period, 364 (21.8%) were rescue studies. Of these, 95.9% were transesophageal and 4.1% were transthoracic. Location at time of rescue echocardiography was intraoperative (55.5%), postoperative (44.2%), and preoperative (0.3%). No single diagnosis predominated the intraoperative or postoperative environment, and the frequency of common etiologies did not allow for assumption. There was a change in management for 214 patients (59%) as the result of findings. The methods used in performing rescue echocardiography at the authors' institution are reported.
The heterogeneity of diagnoses and the frequency with which rescue echocardiography changed management further supports the growing body of evidence that the hemodynamically unstable perioperative patient benefits from its use.
回顾围手术期超声心动图科进行的急救超声心动图检查的结果、应用情况及其对患者管理的影响。
回顾性观察研究。
单一机构的三级护理医院。
围手术期连续364例急救超声心动图检查。
急救经食管或急救经胸超声心动图检查。
在28个月内共进行了1675例围手术期超声心动图检查，其中364例（21.8%）为急救检查。其中，95.9%为经食管检查，4.1%为经胸检查。急救超声心动图检查时的位置为术中（55.5%）、术后（44.2%）和术前（0.3%）。术中或术后环境中没有单一诊断占主导地位，常见病因的频率也无法进行推测。214例患者（59%）的管理因检查结果而改变。报告了作者所在机构进行急救超声心动图检查所采用的方法。
诊断的异质性以及急救超声心动图改变管理的频率进一步支持了越来越多的证据，即血流动力学不稳定的围手术期患者可从其应用中获益。
