BACKGROUND: We hypothesized that transoesophageal echocardiography (TOE) performed by the anaesthesiologists would be beneficial for monitoring purposes during paediatric cardiac surgery. We present the results for the first 5 years in 532 consecutive children. METHODS: The probe was successfully inserted in 99% of cases and remained in the oesophagus for 211 min on average (range 10-555 min). RESULTS: Insignificant valve leak, single- or biventricular failure and volume depletion were the most common new findings due to TOE. Changes in inotropic strategy and volume replacement were the most frequent interventions. In 45% of the cases, new information was disclosed and, in a total of 8% of cases, decisive information was provided. Except for tracheal extubation in one child who was uneventfully reintubated, no severe complications were identified. CONCLUSIONS: These data stress the safety and ease of performing TOE in children undergoing cardiac surgery. There is evidence for benefit from TOE findings to potentially enhance the therapeutic basis.
BACKGROUND: We hypothesized that transoesophageal echocardiography (TOE) performed by the anaesthesiologists would be beneficial for monitoring purposes during paediatric cardiac surgery. We present the results for the first 5 years in 532 consecutive children. METHODS: The probe was successfully inserted in 99% of cases and remained in the oesophagus for 211 min on average (range 10-555 min). RESULTS: Insignificant valve leak, single- or biventricular failure and volume depletion were the most common new findings due to TOE. Changes in inotropic strategy and volume replacement were the most frequent interventions. In 45% of the cases, new information was disclosed and, in a total of 8% of cases, decisive information was provided. Except for tracheal extubation in one child who was uneventfully reintubated, no severe complications were identified. CONCLUSIONS: These data stress the safety and ease of performing TOE in children undergoing cardiac surgery. There is evidence for benefit from TOE findings to potentially enhance the therapeutic basis.
Authors: Joe Brierley; Joseph A Carcillo; Karen Choong; Tim Cornell; Allan Decaen; Andreas Deymann; Allan Doctor; Alan Davis; John Duff; Marc-Andre Dugas; Alan Duncan; Barry Evans; Jonathan Feldman; Kathryn Felmet; Gene Fisher; Lorry Frankel; Howard Jeffries; Bruce Greenwald; Juan Gutierrez; Mark Hall; Yong Y Han; James Hanson; Jan Hazelzet; Lynn Hernan; Jane Kiff; Niranjan Kissoon; Alexander Kon; Jose Irazuzta; Jose Irazusta; John Lin; Angie Lorts; Michelle Mariscalco; Renuka Mehta; Simon Nadel; Trung Nguyen; Carol Nicholson; Mark Peters; Regina Okhuysen-Cawley; Tom Poulton; Monica Relves; Agustin Rodriguez; Ranna Rozenfeld; Eduardo Schnitzler; Tom Shanley; Saraswati Kache; Sara Skache; Peter Skippen; Adalberto Torres; Bettina von Dessauer; Jacki Weingarten; Timothy Yeh; Arno Zaritsky; Bonnie Stojadinovic; Jerry Zimmerman; Aaron Zuckerberg Journal: Crit Care Med Date: 2009-02 Impact factor: 7.598