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[术中经食管超声心动图在非心脏手术患者中的监测应用]

[Intraoperative transesophageal echocardiography as monitoring procedure in noncardiac surgery patients].

作者信息

Umrath V, Dumps C, Rupprecht B, Schimpf J, Benak J

机构信息

Klinik für Anästhesie, Intensivmedizin und Notfallmedizin, Klinikum Kempten, Robert-Weixler-Str. 50, 87439, Kempten, Deutschland.

Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Augsburg, Augsburg, Deutschland.

出版信息

Anaesthesist. 2021 Dec;70(12):1059-1072. doi: 10.1007/s00101-021-01035-1. Epub 2021 Nov 11.

Abstract

Transesophageal echocardiography (TEE) is firmly established in cardiac surgery for diagnostics, hemodynamic monitoring and as a guiding tool. Dynamic and (patho)physiological processes of the heart can be immediately depicted. Ideally, therapeutic changes can be derived. For this reason, TEE is increasingly used in high-risk non-cardiac surgery interventions and in the interventional setting. In the first part of this advanced training series, general aspects regarding TEE examinations as well as indications and contraindications are presented. Clinical fields of application, where TEE can play a role in hemodynamic monitoring are outlined. The second part focusses on an emergency examination pathway and differential diagnoses, which can be made in the event of intraoperative hemodynamic instability or unexplained hypoxemia using TEE. The article concludes with an outlook on the use of computer-aided evaluation of TEE images.

摘要

经食管超声心动图(TEE)在心脏外科手术中已被广泛应用于诊断、血流动力学监测及作为指导工具。心脏的动态和(病理)生理过程能够即刻呈现。理想情况下,可据此得出治疗方案的调整依据。因此,TEE在高风险非心脏手术干预及介入治疗中应用越来越广泛。在本高级培训系列的第一部分,介绍了TEE检查的一般情况以及适应证和禁忌证。概述了TEE在血流动力学监测中发挥作用的临床应用领域。第二部分重点介绍了急诊检查流程以及在术中血流动力学不稳定或出现不明原因低氧血症时使用TEE进行鉴别诊断的方法。文章最后展望了TEE图像计算机辅助评估的应用前景。

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