Perioperative hemodynamic monitoring with transesophageal Doppler technology.

Abstract:

:Invasive cardiac output (CO) monitoring, traditionally performed with transpulmonary thermodilution techniques, is usually reserved for high-risk patients because of the inherent risks of these methods. In contrast, transesophageal Doppler (TED) technology offers a safe, quick, and less invasive method for routine measurements of CO. After esophageal insertion and focusing of the probe, the Doppler beam interrogates the descending aortic blood flow. On the basis of the measured frequency shift between the emitted and received ultrasound frequency, blood flow velocity is determined. From this velocity, combined with the simultaneously measured systolic ejection time, CO and other advanced hemodynamic variables can be calculated, including estimations of preload, afterload, and contractility. Numerous studies have validated TED-derived CO against reference methods. Although the agreement of CO values between TED and the reference methods is limited (95% limits of agreement: median 4.2 L/min, interquartile range 3.3-5.0 L/min), TED has been shown to accurately follow changes of CO over time, making it a useful device for trend monitoring. TED can be used to guide perioperative intravascular volume substitution and therapy, with vasoactive or inotropic drugs. Various studies have demonstrated a reduced postoperative morbidity and shorter length of hospital stay in patients managed with TED compared with conventional clinical management, suggesting that it may be a valuable supplement to standard perioperative monitoring. We review not only the technical basis of this method and its clinical application but also its limitations, risks, and contraindications.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Schober P,Loer SA,Schwarte LA

doi

10.1213/ane.0b013e3181aa0af3

subject

Has Abstract

pub_date

2009-08-01 00:00:00

pages

340-53

issue

2

eissn

0003-2999

issn

1526-7598

pii

109/2/340

journal_volume

109

pub_type

杂志文章,评审
  • The ability of stroke volume variations obtained with Vigileo/FloTrac system to monitor fluid responsiveness in mechanically ventilated patients.

    abstract:BACKGROUND:Respiratory variations in arterial pulse pressure (DeltaPP) are accurate predictors of fluid responsiveness in mechanically ventilated patients. The aim of our study was to assess the ability of a novel algorithm for automatic estimation of stroke volume variation (SVV) to predict fluid responsiveness in mec...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e318192a36b

    authors: Cannesson M,Musard H,Desebbe O,Boucau C,Simon R,Hénaine R,Lehot JJ

    更新日期:2009-02-01 00:00:00

  • A Comparison of Measurements of Change in Respiratory Status in Spontaneously Breathing Volunteers by the ExSpiron Noninvasive Respiratory Volume Monitor Versus the Capnostream Capnometer.

    abstract:BACKGROUND:Current respiratory monitoring technologies such as pulse oximetry and capnography have been insufficient to identify early signs of respiratory compromise in nonintubated patients. Pulse oximetry, when used appropriately, will alert the caregiver to an episode of dangerous hypoxemia. However, desaturation l...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000001395

    authors: Williams GW 2nd,George CA,Harvey BC,Freeman JE

    更新日期:2017-01-01 00:00:00

  • The addition of bupivacaine to intrathecal sufentanil for labor analgesia.

    abstract::We designed a prospective, randomized, double-blind study to evaluate the efficacy of the combination of intrathecal sufentanil with a low dose of local anesthetic in an attempt to prolong analgesia in labor. Fifty-two patients received one of the following intrathecal study solutions: 2.5 mg of bupivacaine; 10 microg...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199508000-00017

    authors: Campbell DC,Camann WR,Datta S

    更新日期:1995-08-01 00:00:00

  • The effectiveness of a perioperative smoking cessation program: a randomized clinical trial.

    abstract:BACKGROUND:Cigarette smoking by surgical patients is associated with increased complications, particularly perioperative respiratory problems and poor wound healing. In this study, we sought to determine whether a pragmatic perioperative smoking cessation intervention designed for a busy preadmission clinic would be su...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0b013e318298a6b0

    authors: Lee SM,Landry J,Jones PM,Buhrmann O,Morley-Forster P

    更新日期:2013-09-01 00:00:00

  • Hydroxyethyl starch: the effect of molecular weight and degree of substitution on intravascular retention in vivo.

    abstract:BACKGROUND:Hydroxyethyl starch (HES) solution is characterized by its mean molecular weight (MW), concentration, and degree of substitution (DS). This character varies worldwide. METHODS:After binding fluorescein-isothiocyanate (FITC-HES), we evaluated the retention rate of three types of 6% HES in the A2 and V2 blood...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000275198.84094.ad

    authors: Hitosugi T,Saito T,Suzuki S,Kubota I,Shoda E,Shimizu T,Oi Y

    更新日期:2007-09-01 00:00:00

  • Recurrence of cardiotoxicity after lipid rescue from bupivacaine-induced cardiac arrest.

    abstract::Accidental intravascular administration of bupivacaine during performance of a brachial block precipitated convulsions followed by asystole. The patient was rapidly resuscitated using cardiopulmonary resuscitation, supplemented by 150 mL of 20% lipid emulsion. Nonetheless, cardiac toxicity reappeared 40 min after comp...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e3181979e17

    authors: Marwick PC,Levin AI,Coetzee AR

    更新日期:2009-04-01 00:00:00

  • Obturator versus femoral nerve block for analgesia after total knee arthroplasty.

    abstract:BACKGROUND:Both femoral and obturator nerve blocks have been suggested to be useful in relieving pain after total knee arthroplasty (TKA). We sought to compare their efficacy. METHODS:Sixty patients undergoing elective unilateral TKA under spinal anesthesia received in a randomized, double-blind manner a femoral, obtu...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/01.ane.0000278158.36843.f7

    authors: Kardash K,Hickey D,Tessler MJ,Payne S,Zukor D,Velly AM

    更新日期:2007-09-01 00:00:00

  • Postoperative hypoxemia after nonabdominal surgery: a frequent event not caused by nitrous oxide.

    abstract::We tested whether anesthesia that includes nitrous oxide (N2O) results in the development of intraoperative and postoperative pulmonary complications, including hypoxemia. We also tested whether aging contributes to the development of such complications, particularly when anesthesia includes N2O. We randomly allocated...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Lampe GH,Wauk LZ,Whitendale P,Way WL,Kozmary SV,Donegan JH,Eger EI 2nd

    更新日期:1990-12-01 00:00:00

  • Spinal anesthesia with hyperbaric levobupivacaine and ropivacaine for outpatient knee arthroscopy: a prospective, randomized, double-blind study.

    abstract::To compare unilateral spinal block produced with small doses of hyperbaric ropivacaine with that produced by 2 doses of hyperbaric levobupivacaine, we randomly allocated 91 ASA physical status I-II outpatients undergoing knee arthroscopy to receive unilateral spinal anesthesia with 7.5 mg of hyperbaric ropivacaine 0.5...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ANE.0000155265.79673.56

    authors: Cappelleri G,Aldegheri G,Danelli G,Marchetti C,Nuzzi M,Iannandrea G,Casati A

    更新日期:2005-07-01 00:00:00

  • Inadvertent aortic cannulation with a pulmonary artery catheter detected by transesophageal echocardiography.

    abstract::Attempted pulmonary artery catheterization via the left internal jugular vein resulted in a misdiagnosis of pulmonary hypertension before transesophageal echocardiography revealed the catheter positioned in the ascending aorta. Inadvertent aortic cannulation through an unusual type of partial anomalous pulmonary venou...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000296459.51820.64

    authors: Siegmueller C,Bell A,Mittal T,George S

    更新日期:2008-01-01 00:00:00

  • Single-injection percutaneous peribulbar anesthesia with a short needle as an alternative to the double-injection technique for cataract extraction.

    abstract:BACKGROUND:We evaluated the efficacy of a single-injection technique for percutaneous peribulbar anesthesia with a short needle as an alternative to the double-injection technique for cataract extraction. METHODS:We included 200 patients who underwent elective cataract surgery randomized into 2 equal groups. They rece...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0b013e3181c293bd

    authors: Ghali AM,Hafez A

    更新日期:2010-01-01 00:00:00

  • Resistance to atracurium-induced neuromuscular blockade in patients with intractable seizure disorders treated with anticonvulsants.

    abstract::Previous studies have demonstrated that, with the exception of atracurium, resistance to the neuromuscular blocking effects of various muscle relaxants develops in patients receiving anticonvulsant therapy. We studied the effects of 0.5 mg/kg IV atracurium in 53 neurosurgical patients: 21 nonepileptic patients receivi...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199012000-00015

    authors: Tempelhoff R,Modica PA,Jellish WS,Spitznagel EL

    更新日期:1990-12-01 00:00:00

  • Neostigmine Versus Sugammadex for Reversal of Neuromuscular Blockade and Effects on Reintubation for Respiratory Failure or Newly Initiated Noninvasive Ventilation: An Interrupted Time Series Design.

    abstract:BACKGROUND:Pulmonary complications related to residual neuromuscular blockade lead to morbidity and mortality. Using an interrupted time series design, we tested whether proportions of reintubation for respiratory failure or new noninvasive ventilation were changed after a system-wide transition of the standard reversa...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/ANE.0000000000004505

    authors: Krause M,McWilliams SK,Bullard KJ,Mayes LM,Jameson LC,Mikulich-Gilbertson SK,Fernandez-Bustamante A,Bartels K

    更新日期:2020-07-01 00:00:00

  • Analgesia before performing a spinal block in the sitting position in patients with femoral shaft fracture: a comparison between femoral nerve block and intravenous fentanyl.

    abstract::We conducted this prospective, randomized study to compare the analgesic effect of femoral nerve block and IV fentanyl administration when given to facilitate the sitting position for spinal anesthesia in patients undergoing surgery for femoral shaft fracture. Five minutes before the placement of spinal block, group F...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ANE.0000134812.00471.44

    authors: Sia S,Pelusio F,Barbagli R,Rivituso C

    更新日期:2004-10-01 00:00:00

  • The effect of a perioperative clinical pathway for knee replacement surgery on hospital costs.

    abstract:UNLABELLED:Clinical pathways are being introduced by hospitals to reduce costs and control unnecessary variation in care. We studied 766 inpatients to measure the impact of a perioperative clinical pathway for patients undergoing knee replacement surgery on hospital costs. One hundred twenty patients underwent knee rep...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199805000-00012

    authors: Macario A,Horne M,Goodman S,Vitez T,Dexter F,Heinen R,Brown B

    更新日期:1998-05-01 00:00:00

  • The influence of chronic administration of hypnotics and analgesics on rate of recovery from inhalation anesthesia in rats.

    abstract::A series of groups of Sprague-Dawley rats were given either secobarbital, phenobarbital, morphine, pentazocine, diazepam, methotrimeprazine, or saline (control) intraperitoneally on 4 consecutive days and then, on day 5, anesthetized with chloroform, trichlorethylene, fluroxene, halothane, methoxyflurane, enflurane, i...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-197501000-00020

    authors: Dobkin AB,Borgstedt HH,Rohner RF,KURLAN RM,Fein AB

    更新日期:1975-01-01 00:00:00

  • Is dexamethasone associated with recurrence of ovarian cancer?

    abstract:BACKGROUND:Basic science studies suggest that perioperative immune impairment may augment the risk of cancer recurrence after otherwise potentially curative surgery. Despite its immunosuppressant properties, dexamethasone is commonly given to oncologic patients in an effort to reduce postoperative nausea and vomiting. ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3182a5d656

    authors: De Oliveira GS Jr,McCarthy R,Turan A,Schink JC,Fitzgerald PC,Sessler DI

    更新日期:2014-06-01 00:00:00

  • Hemodynamic dose-responses to halothane and isoflurane are different in swine with and without critical coronary artery stenosis.

    abstract::This study examined global hemodynamic responses to increasing concentrations of halothane and isoflurane in pigs with an acute critical coronary stenosis (CCS) on the left anterior descending coronary artery (LAD). The CCS was caused by graded inflation of an hydraulic occluder to the point where no hyperemic respons...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Gilbert M,Mori M,Myhre ES

    更新日期:1989-06-01 00:00:00

  • Induction of anesthesia with ketamine reduces the magnitude of redistribution hypothermia.

    abstract:UNLABELLED:Hypothermia after induction of general anesthesia results largely from core-to-peripheral redistribution of body heat. Both central inhibition of tonic thermoregulatory vasoconstriction in arteriovenous shunts and anesthetic-induced arteriolar and venous dilation contribute to this redistribution. Ketamine, ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200110000-00027

    authors: Ikeda T,Kazama T,Sessler DI,Toriyama S,Niwa K,Shimada C,Sato S

    更新日期:2001-10-01 00:00:00

  • Lecture practices in United States anesthesiology residencies.

    abstract::We obtained data on lecture practices from 100 of the 110 university-affiliated anesthesiology residency programs certified in the United States in 1988. Of these residency programs, 36% had a majority of their lectures before the operating room schedule began, 57% had no lectures at all in this early time slot, and 7...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199201000-00018

    authors: Landers DF,Becker GL,Newland MC,Peters KR

    更新日期:1992-01-01 00:00:00

  • A simple method for detecting plasma propofol.

    abstract:IMPLICATIONS:We measured plasma propofol levels by head space-gas chromatography analysis using solid-phase microextraction. This method saves time, and does not require elimination of interfering substances in the plasma. The coefficient variation was +/-5% to +/-30%. The detection limit was 10 ng/mL. ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200006000-00038

    authors: Fujita A,Higuchi J,Nagai T,Tokudome S,Sakio H

    更新日期:2000-06-01 00:00:00

  • Multiple casualty terror events: the anesthesiologist's perspective.

    abstract:UNLABELLED:In a 28-mo period 14 multiple-casualty terror events occurred in Jerusalem, challenging the Department of Anesthesiology and Critical Care Medicine of the city's sole Level 1 trauma center. We performed a retrospective review of the response of the department to evaluate staff activities, resource use (emerg...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000121307.33776.84

    authors: Shamir MY,Weiss YG,Willner D,Mintz Y,Bloom AI,Weiss Y,Sprung CL,Weissman C

    更新日期:2004-06-01 00:00:00

  • Low-dose synthetic narcotic infusions for cerebral relaxation during craniotomies.

    abstract::Thirty patients undergoing craniotomies were given infusions of fentanyl 1 microgram X kg-1 X hr-1, sufentanil 0.1 microgram X kg-1 X hr-1, or normal saline in a double-blind study of cerebral relaxation. Significantly better relaxation scores were achieved in patients given a narcotic infusion, but there was no diffe...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/00000539-198705000-00007

    authors: Bristow A,Shalev D,Rice B,Lipton JM,Giesecke AH Jr

    更新日期:1987-05-01 00:00:00

  • Continuous gastric decompression for postoperative nausea and vomiting after coronary revascularization surgery.

    abstract::Postoperative nausea and vomiting is common after cardiac surgery and may contribute to significant morbidity. Gastric decompression during anesthesia has been used for postoperative nausea and vomiting prophylaxis in shorter duration noncardiac surgery with conflicting results. We tested the hypothesis that gastric d...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ANE.0000143567.51304.1A

    authors: Burlacu CL,Healy D,Buggy DJ,Twomey C,Veerasingam D,Tierney A,Moriarty DC

    更新日期:2005-02-01 00:00:00

  • Perioperative beta-blockers for preventing surgery-related mortality and morbidity: a systematic review and meta-analysis.

    abstract:BACKGROUND:Perioperative beta-blockers are suggested to reduce cardiovascular mortality, myocardial-ischemia/infarction, and supraventricular arrhythmias after surgery. We reviewed the evidence regarding the effectiveness of perioperative beta-blockers for improving patient outcomes after cardiac and noncardiac surgery...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000247805.00342.21

    authors: Wiesbauer F,Schlager O,Domanovits H,Wildner B,Maurer G,Muellner M,Blessberger H,Schillinger M

    更新日期:2007-01-01 00:00:00

  • Educating Patients Regarding Pain Management and Safe Opioid Use After Surgery: A Narrative Review.

    abstract::In recent years, there have been escalating concerns related to the opioid epidemic. With a steadily increasing opioid supply, it is critical to provide proper education to patients who are prescribed these medications. Education should be emphasized as a means of ensuring safe use and potentially as a strategy for cu...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000004436

    authors: Lee BH,Wu CL

    更新日期:2020-03-01 00:00:00

  • Clinical pharmacokinetics of carbonated local anesthetics. II: Interscalene brachial block model.

    abstract::A double-blind comparison of 1.1% lidocaine carbonate and 1.0% lidocaine hydrochloride was carried out in 30 healthy adult patients undergoing upper-extremity surgery under interscalene brachial plexus block. Epinephrine (1:200,000) was added to both solutions just before injection. As compared to lidocaine hydrochlor...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:

    authors: Sukhani R,Winnie AP

    更新日期:1987-12-01 00:00:00

  • The time-dependent effects of midazolam on regional cerebral glucose metabolism in rats.

    abstract:BACKGROUND:Midazolam has hypnotic and sedative activities, which may be mediated by different neuronal structures. We investigated the time course effect of a hypnotic dose of midazolam on conscious motor behavior and on patterns of brain metabolism. METHODS:Loss of nociceptive reflexes and impairment of spontaneous l...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e31816a64a8

    authors: Freo U,Dam M,Ori C

    更新日期:2008-05-01 00:00:00

  • Intracranial pressure effects of dexmedetomidine in rabbits.

    abstract::The alpha 2-adrenergic receptor agonist dexmedetomidine produces an anesthetic state in a variety of species. Although its effects on cerebral blood flow and the electroencephalogram have been investigated, the effect of this drug on intracranial pressure (ICP) has not been reported previously. Dexmedetomidine therefo...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199208000-00014

    authors: Zornow MH,Scheller MS,Sheehan PB,Strnat MA,Matsumoto M

    更新日期:1992-08-01 00:00:00

  • Prevalence and characteristics of pain induced by percutaneous liver biopsy.

    abstract:UNLABELLED:Percutaneous needle liver biopsy is an important procedure for the diagnosis and evaluation of liver disease and is frequently associated with pain. In this prospective study, we investigated the prevalence and characteristics of this pain syndrome. Fifty-four subjects, who underwent liver biopsy under ultra...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/01.ane.0000060453.74744.17

    authors: Eisenberg E,Konopniki M,Veitsman E,Kramskay R,Gaitini D,Baruch Y

    更新日期:2003-05-01 00:00:00