Abstract:
:Although intraoperative transoesophageal echocardiography (TOE) has an established role in the management of some cardiac surgical procedures, there is little data on its impact on coronary artery bypass graft (CABG) cases that are stratified for clinical risk. This is a retrospective review of the surgical impact of intraoperative TOE on 2,343 unselected cardiac cases. The surgical impact of TOE findings were rated E (essential)--resulted in changes to the proposed surgical procedure or V (valuable)--the surgical technique for the planned surgery was altered. The surgical impact that routine TOE had on low-, medium- and high-risk CABG cases was also examined. The surgical impact of TOE for the total study population (E + V) was 4.5%. The impact was greatest in combined CABG + mitral valve procedures (18%). The impact in CABG cases was 3.5% overall, with an estimated impact in low-risk patients of 2.8% (95% CI. 2.7-3.0%) versus 6.7% (95% CI. 5.9-7.7%) in high-risk cases. The commonest E-impact in CABG patients was unscheduled valve surgery (2.6% of high-risk patients). The complication rate attributable to TOE was 0.09%. These findings provide indirect evidence for a potential patient benefit from the routine use of TOE in cardiac surgery.
journal_name
Anaesth Intensive Carejournal_title
Anaesthesia and intensive careauthors
Forrest AP,Lovelock ND,Hu JM,Fletcher SNdoi
10.1177/0310057X0203000603keywords:
subject
Has Abstractpub_date
2002-12-01 00:00:00pages
734-41issue
6eissn
0310-057Xissn
1448-0271pii
2002102journal_volume
30pub_type
杂志文章abstract::Patients with a presumptive diagnosis of an acute anaphylactoid reaction to anaesthesia were investigated to determine the cause of the reaction and the drug responsible by intradermal testing, patch and prick testing, sequential complement measurement, passive transfer testing and challenge. The most valuable informa...
journal_title:Anaesthesia and intensive care
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journal_title:Anaesthesia and intensive care
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journal_title:Anaesthesia and intensive care
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journal_title:Anaesthesia and intensive care
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journal_title:Anaesthesia and intensive care
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journal_title:Anaesthesia and intensive care
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journal_title:Anaesthesia and intensive care
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