Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital of Inje University, Busan, Republic of Korea.
Medicine (Baltimore). 2022 Aug 26;101(34):e30160. doi: 10.1097/MD.0000000000030160.
Although echocardiography is widely used for preoperative cardiac risk evaluation, few studies have analyzed the effect of performing preoperative echocardiography on intraoperative anesthetic management and postoperative outcomes. We investigated the effect of performing echocardiography on intraoperative anesthetic management and postoperative outcomes in patients with cardiovascular risk. We retrospectively evaluated patients who had undergone major abdominal surgery and satisfied 2 or more of the following criteria: hypertension, diabetes mellitus, age ≥70 years, and previous cardiac disease. Patients were categorized into a group in which preoperative echocardiography was performed (echo) and a group in which it was not (non-echo). The primary outcomes were postoperative 30-day mortality and incidence of cardiovascular complications. Secondary outcomes were length of hospital stay, intraoperative incidence of hypotension, use of vasopressors, and findings on intraoperative invasive hemodynamic monitoring. There were no differences in 30-day mortality, incidence of postoperative cardiovascular complications, length of hospital stay, and intraoperative events between the groups. Only the incidence of cardiac output monitoring was lower in the echo group than in the non-echo group (59.6% vs 73.9%). Preoperative echocardiography does not affect postoperative outcomes, but it has the potential to affect intraoperative anesthetic management such as invasive hemodynamic monitoring during surgery.
虽然超声心动图广泛用于术前心脏风险评估,但很少有研究分析术前进行超声心动图对术中麻醉管理和术后结果的影响。我们研究了在心血管风险患者中进行超声心动图对术中麻醉管理和术后结果的影响。我们回顾性评估了接受过主要腹部手术且符合以下 2 个或更多标准的患者:高血压、糖尿病、年龄≥70 岁和既往心脏病。患者分为术前进行超声心动图检查组(超声心动图组)和未进行超声心动图检查组(非超声心动图组)。主要结局为术后 30 天死亡率和心血管并发症发生率。次要结局为住院时间、术中低血压发生率、血管加压药使用情况以及术中有创血流动力学监测结果。两组间 30 天死亡率、术后心血管并发症发生率、住院时间和术中事件均无差异。只有超声心动图组的心脏指数监测发生率低于非超声心动图组(59.6% vs 73.9%)。术前超声心动图并不影响术后结果,但它可能会影响术中麻醉管理,如手术期间的有创血流动力学监测。