Intraoperative Diagnosis and Treatment of Pleural Effusion Based on Transesophageal Echocardiographic Findings

Swenson, Jeffrey D.; Bull, David A.

doi:10.1213/00000539-199908000-00011

Cited by 12 publications

(4 citation statements)

References 7 publications

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“…As shown in Fig. 5a and online resource 1, a tight and significant correlation (r = 0.95, p \ 0.001) was found between PEV CT and calculated PEV using the previously recommended formula: PE length multiplied by maximal PE effusion area (A CTmax 9 L CT ) [18,19]. The formula, however, systematically overestimated PEV CT , and the wide limits of agreement indicated limited accuracy.…”

Section: Ct Assessment Of the Accuracy Of Previous Methods Of Pev Mea...mentioning

confidence: 74%

“…As a consequence, simple mathematical modeling was impossible. Two different formulas have been previously proposed to estimate PEV: (1) PEV = maximal PE depth squared 9 PE length [17]; (2) PEV = PE maximal crosssectional area 9 PE length [18,19]. In our study, the PE maximal area level was unpredictable, and because the acoustic window was restricted to intercostals spaces, its localization at bedside with ultrasound may have had poor accuracy (these formulas have been validated in CT or in transesophageal echocardiography).…”

Section: Discussionmentioning

confidence: 87%

“…As shown in Fig. 6a and online resource 2, a highly significant correlation was found between PEV US and PEV CT (r = 0.90, p \ 0.001) with a mean bias of -53 ml Figure 5a shows graphics concerning PEV measured on CT (PEV CT ) and PEV calculated by the formula: PE length 9 maximal PE cross-sectional area [18,19]. Figure 5b shows graphics concerning PEV CT and PEV calculated by the formula: PE length 9 (maximal paravertebral PE depth) 2 [17].…”

Section: Accuracy Of Multiplane Ultrasound For Measuring Pev: Pev Us ...mentioning

confidence: 81%

“…In a first series of investigations, all available CT scans were analyzed with two objectives: (1) to describe the spatial distribution of PE cross-sectional area between apical and caudal limits of PE, and (2) to compare the accuracy of the new formula PEV = A CT 9 L CT with the accuracy of previous methods using different formulas validated in CT [17] or in transesophageal echocardiography [18,19]:…”

Section: Study Protocolmentioning

confidence: 99%

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Multiplane ultrasound approach to quantify pleural effusion at the bedside

et al. 2010

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Section: Ct Assessment Of the Accuracy Of Previous Methods Of Pev Mea...mentioning

confidence: 74%

Section: Discussionmentioning

confidence: 87%

Section: Accuracy Of Multiplane Ultrasound For Measuring Pev: Pev Us ...mentioning

confidence: 81%

Section: Study Protocolmentioning

confidence: 99%

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Multiplane ultrasound approach to quantify pleural effusion at the bedside

et al. 2010

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Transesophageal lung ultrasonography: a novel technique for investigating hypoxemia

Cavayas

Girard

Desjardins

et al. 2016

Can J Anesth/J Can Anesth

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Background Acute deterioration in respiratory status commonly occurs in patients who cannot be transported for imaging studies, particularly during surgical procedures and in critical care settings. Transthoracic lung ultrasonography has been developed to allow rapid diagnosis of respiratory conditions at the bedside. Nevertheless, the thorax is not always accessible, especially in the perioperative setting. Transesophageal lung ultrasonography (TELU) can be used to circumvent this problem. Purpose The aim of this narrative review is to provide a complete description of the TELU technique by summarizing the existing literature on the subject and describing our own experience that extrapolates from transthoracic lung ultrasonography. Principal findings The use of TELU can provide point-ofcare real-time information for quickly establishing the etiology of acute hypoxemia. The transesophageal probe is placed in close proximity to the posterior regions of the lungs where lung consolidation and pleural effusions are most often seen; however, most of the artefacts relied on by transthoracic ultrasound have yet to be validated with TELU. Moreover, the relative invasiveness of TELU compared with transthoracic ultrasonography may limit its use to specific situations when the probe is already in place, as during cardiac anesthesia or when the anterior thorax is inaccessible. The main advantage of TELU may lie in the ability to integrate both cardiac and pulmonary assessments in one single examination. Conclusion Anesthesiologists and intensivists who already use transesophageal echocardiography on a regular basis should consider adding TELU to their clinical assessment of hypoxemia and related pulmonary pathologies. Nevertheless, the literature specifically supporting TELU is relatively limited, and further validation studies are needed. RésuméContexte Des détériorations aiguës de l'état respiratoire de patients qui ne peuvent être transportés pour des examens d'imagerie sont fréquentes, particulièrement lors d'interventions chirurgicales ainsi que dans le contexte des soins intensifs. L'échographie pulmonaire transthoracique a été mise au point afin de permettre de diagnostiquer rapidement la cause d'une détérioration respiratoire au chevet du patient. Or, le thorax n'est pas toujours accessible, particulièrement dans un contexte périopératoire.L'échographie transoesophagienne pulmonaire (ETOP) peut alors être utilisée pour pallier ce problème.

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