Daniel Bolliger1, Corsin Poltera1, Albert T Cheung2, Pierre Couture3, Isabelle Michaux4, Jan Poelaert5, Sergey Preisman6, Karl Skarvan1, Giovanna Lurati Buse1, Manfred D Seeberger7. 1. Department of Anesthesiology, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, Switzerland. 2. Department of Anesthesia, University of Pennsylvania, Philadelphia, USA. 3. Department of Anesthesiology, Montreal Heart Institution, University of Montréal, Montréal, Quebec, Canada. 4. Department of Intensive Care Medicine, Mont-Godinne University Hospital, Université Catholique de Louvain, Yvoir, Belgium. 5. Department of Anesthesiology and Perioperative Medicine, University Hospital-Free University of Brussels, Brussels, Belgium. 6. Department of Anesthesiology and Intensive Care, Sheba Medical Center, Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel. 7. University of Basel, Medical School, Basel, Switzerland; and Institute for Anesthesiology and Intensive Care Medicine, Klinik Hirslanden, Zurich, Switzerland.
Abstract
OBJECTIVE: Normative values of left ventricular (LV) end-diastolic area and diameter (EDA and EDD) for intraoperative transoesophageal echocardiography (TEE) have not been established. We aimed to define the ranges of LV EDA and EDD for intraoperative TEE examinations in patients undergoing coronary artery bypass graft (CABG) surgery. METHODS: A MEDLINE search for studies reporting LV EDA and EDD in CABG patients was performed. Individual-level dataset from 333 anaesthetised and mechanically ventilated patients with preserved LV function (study population) were received from 8 studies. EDA and calculated EDD values in the study population were compared with summary mean EDD values obtained by transthoracic echocardiography (TTE) in 2 studies of 500 awake patients with coronary artery disease (CAD). Further, the influence of prespecified factors on EDD was evaluated through a multivariate regression model. RESULTS: LV EDA and EDD values measured by TEE in anaesthetised CABG patients were 16.7±4.7 cm2 and 4.6±0.6 cm, respectively. EDD values measured by TEE in anaesthetised patients were 10% to 13% less those measured by TTE in 2 studies of awake patients (p<0.001). Body surface area, age and fractional area change but not sex were factors that affected LV EDD. CONCLUSION: LV EDD values measured by intraoperative TEE in anaesthetised and mechanically ventilated CABG patients were 10% to 13% less than those measured by TTE in awake CAD patients. This finding indicates that independent normative values specific for intraoperative TEE should be established for guiding intraoperative clinical decisions.
OBJECTIVE: Normative values of left ventricular (LV) end-diastolic area and diameter (EDA and EDD) for intraoperative transoesophageal echocardiography (TEE) have not been established. We aimed to define the ranges of LV EDA and EDD for intraoperative TEE examinations in patients undergoing coronary artery bypass graft (CABG) surgery. METHODS: A MEDLINE search for studies reporting LV EDA and EDD in CABG patients was performed. Individual-level dataset from 333 anaesthetised and mechanically ventilated patients with preserved LV function (study population) were received from 8 studies. EDA and calculated EDD values in the study population were compared with summary mean EDD values obtained by transthoracic echocardiography (TTE) in 2 studies of 500 awake patients with coronary artery disease (CAD). Further, the influence of prespecified factors on EDD was evaluated through a multivariate regression model. RESULTS: LV EDA and EDD values measured by TEE in anaesthetised CABG patients were 16.7±4.7 cm2 and 4.6±0.6 cm, respectively. EDD values measured by TEE in anaesthetised patients were 10% to 13% less those measured by TTE in 2 studies of awake patients (p<0.001). Body surface area, age and fractional area change but not sex were factors that affected LV EDD. CONCLUSION: LV EDD values measured by intraoperative TEE in anaesthetised and mechanically ventilated CABG patients were 10% to 13% less than those measured by TTE in awake CAD patients. This finding indicates that independent normative values specific for intraoperative TEE should be established for guiding intraoperative clinical decisions.
Authors: Rebecca T Hahn; Theodore Abraham; Mark S Adams; Charles J Bruce; Kathryn E Glas; Roberto M Lang; Scott T Reeves; Jack S Shanewise; Samuel C Siu; William Stewart; Michael H Picard Journal: Anesth Analg Date: 2014-01 Impact factor: 5.108
Authors: M E van Daele; A Trouwborst; L C van Woerkens; R Tenbrinck; A G Fraser; J R Roelandt Journal: Anesthesiology Date: 1994-09 Impact factor: 7.892