Hasnain Shahbaz, Shenava Arpith, Garg Ipshita
Anaesthesiology, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, IND.
Cureus. 2024 Jul 10;16(7):e64256. doi: 10.7759/cureus.64256. eCollection 2024 Jul.
Background and objective While transesophageal echocardiography (TEE) is crucial in cardiac surgery, the probe insertion can be challenging. This observational study aimed to identify predictive factors associated with difficult TEE probe insertion in adult cardiac surgery patients. Methods A total of 119 adult patients undergoing cardiac surgery were included in the study. Demographic variables (age, gender, and BMI) and airway factors (modified Mallampati classification, modified Cormack-Lehane grading, and thyromental distance) were analyzed. The difficulty of TEE probe insertion was categorized into three grades, and various maneuvers were assessed for difficult insertions. Results Of note, 30.3% of insertions were difficult. Male gender (OR: 1.8), BMI ≥30 kg/m (OR: 2.5), Mallampati class III-IV (OR: 3.2), Cormack-Lehane grade IIb-IV (OR: 2.7), and thyromental distance <6.5 cm (OR: 1.9) were significantly associated with difficult insertion. Jaw thrust was the most effective maneuver (58.3%) for difficult cases. Conclusions Based on our findings, several demographic and airway factors predict difficulties in TEE probe insertion. Understanding these factors can help clinicians anticipate challenges and prepare appropriate strategies, potentially reducing complications associated with probe insertion.
背景与目的 虽然经食管超声心动图（TEE）在心脏手术中至关重要，但探头插入可能具有挑战性。本观察性研究旨在确定成年心脏手术患者中与TEE探头插入困难相关的预测因素。方法 共有119例接受心脏手术的成年患者纳入本研究。分析了人口统计学变量（年龄、性别和体重指数）和气道因素（改良Mallampati分级、改良Cormack-Lehane分级和颏下距离）。TEE探头插入的难度分为三个等级，并对困难插入的各种操作进行了评估。结果 值得注意的是，30.3%的插入操作存在困难。男性（比值比：1.8）、体重指数≥30 kg/m（比值比：2.5）、Mallampati III-IV级（比值比：3.2）、Cormack-Lehane IIb-IV级（比值比：2.7）和颏下距离<6.5 cm（比值比：1.9）与插入困难显著相关。下颌前推是困难病例中最有效的操作（58.3%）。结论 根据我们的研究结果，一些人口统计学和气道因素可预测TEE探头插入的困难。了解这些因素有助于临床医生预测挑战并制定适当策略，可能减少与探头插入相关的并发症。
