Guidelines for the Use of Echocardiography as a Monitor for Therapeutic Intervention in Adults

Porter, Thomas R.; Shillcutt, Sasha K.; Adams, Mark; Desjardins, Georges; Glas, Kathryn E.; Olson, Joan; Troughton, Richard W.

doi:10.4103/2543-1463.282192

Cited by 67 publications

(106 citation statements)

References 93 publications

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“…It is also recommended that TEE operators, commonly anesthesiologists with expertise in cardiothoracic cases and/or management of complex vascular surgical cases, have specific TEE training in order to appropriately guide clinical decision-making. 38 To further enhance the use of TEE, having the same operator throughout case is valuable in detecting dynamic changes, as even quantitative measures demonstrate intra-operator variability, and can require subjective judgment and case familiarity. 38 While there is extensive literature published on the role of TEE in treating RCC with IVC thrombus, no study has demonstrated definitively superior outcomes with its use.…”

Section: Discussionmentioning

confidence: 99%

“…38 To further enhance the use of TEE, having the same operator throughout case is valuable in detecting dynamic changes, as even quantitative measures demonstrate intra-operator variability, and can require subjective judgment and case familiarity. 38 While there is extensive literature published on the role of TEE in treating RCC with IVC thrombus, no study has demonstrated definitively superior outcomes with its use. This is a potential area of further investigation, which would help to validate future guidelines that may advocate for its use.…”

Section: Discussionmentioning

confidence: 99%

“…[35][36][37] However, its use remains primarily as a rescue procedure in these settings. 38 Techniques for intraoperative use of TEE have been previously described, which allow for direct, continuous visualization of the IVC. From a mid-esophageal four-chamber view of the heart, the probe may be rotated to view the right atrium (RA) and from there advanced distally to identify the RA/IVC junction.…”

Section: Intr Aoper Ative Imag Ing With Teementioning

confidence: 99%

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The role of transesophageal echocardiography in the management of renal cell carcinoma with venous tumor thrombus

et al. 2018

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We reviewed the role of transesophageal echocardiography (TEE) in the management of renal cell carcinoma (RCC) with associated tumor thrombus. Many consider intraoperative TEE as imperative in cases of Level 4 thrombi with atrial involvement, as well as in cases that require the use of cardiopulmonary bypass (CPB). However, the role of TEE in the surgical management of RCC with associated inferior vena cava (IVC) thrombus may expand beyond this subset. When performed after induction, TEE provides updated information regarding tumor thrombus staging, which is essential for optimal surgical planning. Furthermore, TEE provides feedback regarding properties of the thrombus, such as fragility and adherence, which may alter surgical technique. TEE can also be used intraoperatively for central venous line placement, to monitor cardiovascular and fluid status, to guide vascular clamp placement, and to ensure complete removal of the tumor thrombus. In some cases, the use of TEE allows for less morbid procedures and safe avoidance of CPB. We therefore recommend the use of preoperative TEE in all cases with a known tumor thrombus with discretion as to what extent TEE is used throughout the remainder of the case. Further investigation is necessary to elucidate the effect of TEE on patient outcomes, including surgical complication rates, morbidity and mortality of procedures, and cancer control.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Intr Aoper Ative Imag Ing With Teementioning

confidence: 99%

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The role of transesophageal echocardiography in the management of renal cell carcinoma with venous tumor thrombus

et al. 2018

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“…well as TDI)34 were strongly dependent on the insonation angle and the specific location of the sample. Both the STE49,50 and the 3D 28,47 overcome this weakness of the Doppler-based techniques;(b) the LVOT-VTI values reflect a surrogate of the SV without providing additional information on regional or global motility, while the TDI,34,48 STE,49,50 and the 3DE 28,47 provide specific and sensitive information for quantification of global and regional LV contractile function; (c) the dependency from geometric assumptions about LV and LVOT shape33 (in contrast with STE 49,50 and 3DE techniques) 28,47.…”

mentioning

confidence: 99%

“…Both the STE49,50 and the 3D 28,47 overcome this weakness of the Doppler-based techniques;(b) the LVOT-VTI values reflect a surrogate of the SV without providing additional information on regional or global motility, while the TDI,34,48 STE,49,50 and the 3DE 28,47 provide specific and sensitive information for quantification of global and regional LV contractile function; (c) the dependency from geometric assumptions about LV and LVOT shape33 (in contrast with STE 49,50 and 3DE techniques) 28,47. The Guidelines for the Use of Echocardiography as a Monitor for Therapeutic Intervention in Adults considered a single cutoff value (18 cm) for LVOT-VTI 34. That single cutoff value was established considering data from adults 42,51.…”

mentioning

confidence: 99%

Reference intervals and percentile curve for left ventricular outflow tract (LVOT), velocity time integral (VTI), and LVOT‐VTI‐derived hemodynamic parameters in healthy children and adolescents: Analysis of echocardiographic methods association and agreement

2018

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Background Echocardiographic reference intervals (RIs) for left ventricular outflow tract (LVOT) and velocity time integral (VTI) are scarce in pediatrics. Aims (a) to generate RIs and percentiles for LVOT, VTI, and hemodynamic variables in healthy children and adolescents from Argentina; (b) to analyze the equivalence between stroke volume (SV), cardiac output (CO), and cardiac index (CI) obtained from two‐dimensional echocardiography (2D) and LVOT‐VTI analysis with pulsed wave Doppler (PWD); and (c) to analyze the association between subjects’ characteristics and VTI and LVOT‐VTI‐derived parameters. Methods Two‐dimensional and PWD studies were done in 385 subjects (5–24 years). Mean and standard deviation age‐related and body surface area (BSA)‐related equations were obtained for VTI and LVOT‐VTI‐derived parameters (parametric regression methods based on fractional polynomials). BSA‐ and age‐specific percentiles were determined. Results Pulsed wave Doppler‐ and 2D‐derived parameters were positively correlated. However, PWD values were always lower than those from 2D. Specific RIs for PWD and 2D data were necessary. Covariance analysis showed that sex‐specific RIs were required for LVOT, but not for VTI, VTI‐derived CO and CI. Age‐related RIs were obtained for LVOT, LVOT‐VTI, and VTI‐derived CO and CI. BSA‐related RIs for VTI‐derived CO and CI were obtained. Conclusions Stroke volume, CO, and CI data from 2D and PWD are not equivalent. An accurate analysis of LVOT‐VTI‐derived parameters requires considering age and BSA. In this study, age‐ and BSA‐related RIs and percentiles for LVOT, VTI, and hemodynamic parameters in healthy children and adolescents were determined, discriminating data according to the methodological approach (2D or PWD).

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Paediatric point‐of‐care ultrasound in a resource‐limited Melanesian setting: A case series

Henry

2020

Australas J Ultrason Med

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Point‐of‐care ultrasound (POCUS) is an imaging modality with high potential impact on the practice of paediatric emergency medicine in resource‐limited settings. Aside from the obvious diagnostic utility, it facilitates safe procedural guidance at the bedside and provides haemodynamic information to guide resuscitation of shocked states. This five‐patient paediatric case series illustrates the range of POCUS modalities used while working in emergency medicine at a regional referral hospital in Vanuatu. Cases described include a teenager with meningococcaemia, femoral central line insertion in an infant, ventricular septal defect in an infant, a child with a leg abscess, and a child with rheumatic heart disease.

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Guidelines for the Use of Echocardiography as a Monitor for Therapeutic Intervention in Adults

Cited by 67 publications

References 93 publications

The role of transesophageal echocardiography in the management of renal cell carcinoma with venous tumor thrombus

The role of transesophageal echocardiography in the management of renal cell carcinoma with venous tumor thrombus

Reference intervals and percentile curve for left ventricular outflow tract (LVOT), velocity time integral (VTI), and LVOT‐VTI‐derived hemodynamic parameters in healthy children and adolescents: Analysis of echocardiographic methods association and agreement

Paediatric point‐of‐care ultrasound in a resource‐limited Melanesian setting: A case series

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