OBJECTIVE: To assess the effects of transesophageal echocardiography (TEE) on hemodynamic variables during cardiac surgery in small infants. DESIGN: A prospective clinical study. SETTING: A medical college-affiliated tertiary care children's hospital. PARTICIPANTS: Twenty-three infants weighing 2 to 5 kg undergoing cardiac surgery. INTERVENTIONS: Baseline heart rate, arterial pressure, and central venous pressure were recorded. A pediatric TEE probe was inserted, and the hemodynamic variables were again recorded. Postoperatively the hemodynamic measurements were measured again before and after probe removal, with the addition of left atrial pressure and pulmonary artery pressure when available. Hemodynamic parameters were carefully observed during all phases of the TEE examinations for any changes attributable to probe manipulation. MEASUREMENTS AND MAIN RESULTS: No statistically significant changes occurred in this group of patients during TEE. No clinically significant changes in any individual patient occurred during the measurement or during manipulation of the TEE probe for the complete examination. CONCLUSION: Although hemodynamic compromise can occur in small infants, this study suggests that it is infrequent. Fear of hemodynamic compromise should not prevent use of intraoperative TEE in small infants when otherwise indicated.
OBJECTIVE: To assess the effects of transesophageal echocardiography (TEE) on hemodynamic variables during cardiac surgery in small infants. DESIGN: A prospective clinical study. SETTING: A medical college-affiliated tertiary care children's hospital. PARTICIPANTS: Twenty-three infants weighing 2 to 5 kg undergoing cardiac surgery. INTERVENTIONS: Baseline heart rate, arterial pressure, and central venous pressure were recorded. A pediatric TEE probe was inserted, and the hemodynamic variables were again recorded. Postoperatively the hemodynamic measurements were measured again before and after probe removal, with the addition of left atrial pressure and pulmonary artery pressure when available. Hemodynamic parameters were carefully observed during all phases of the TEE examinations for any changes attributable to probe manipulation. MEASUREMENTS AND MAIN RESULTS: No statistically significant changes occurred in this group of patients during TEE. No clinically significant changes in any individual patient occurred during the measurement or during manipulation of the TEE probe for the complete examination. CONCLUSION: Although hemodynamic compromise can occur in small infants, this study suggests that it is infrequent. Fear of hemodynamic compromise should not prevent use of intraoperative TEE in small infants when otherwise indicated.
Authors: Sinai C Zyblewski; Girish S Shirali; Geoffrey A Forbus; Tain-Yen Hsia; Scott M Bradley; Andrew M Atz; Meryl S Cohen; Eric M Graham Journal: Ann Thorac Surg Date: 2010-06 Impact factor: 4.330