ECHO 2013 / Perioperative Echocardiography Decision Making in the Surgical Patient
.pdf
When Should TEE Change
Your Management During
Cardiac Surgery?
When the outcome is improved!
In situations where the outcome has been shown to be improved!
Studies clearly demonstrating improved outcome in cardiac surgery due to intraoperative TEE…
BMJ 327: 1459-61, 2003
“No matter how bad things are, you can always make them worse.”
JS Shanewise
Spahn et al.
Anesthesiology 82:581-583, 1995
TEE: Laryngeal dysfunction
•JTCVS 1995, Hogue et al, Wash U
–869 pts retrospective review
–4% swallowing dysfunction (Ba swallow)
–Multivariate independent predictors
•age, IOTEE, length of intubation
•ATS 2000, Rousou et al BSM, MA
–838 pts, retrospective review
–TEE pts 7.8x more likely to have dysphagia
Other possible risks of TEE
•Decreased vigilance
•False positive findings
Pulmonary
Artery
Catheter
