Intraoperative Transesophageal Echocardiography for the Evaluation and Management of Diastolic Dysfunction in Patients Undergoing Cardiac Surgery: A Survey of Current Practice.
J Cardiothorac Vasc Anesth
; 30(2): 389-97, 2016 Apr.
Article
em En
| MEDLINE
| ID: mdl-26811270
ABSTRACT
OBJECTIVES:
To characterize existing practice patterns for intraoperative evaluation and grading of diastolic dysfunction in patients undergoing cardiac surgery.DESIGN:
A 14-question, multiple-choice survey of current practice for patients with diastolic dysfunction and the use of intraoperative transesophageal echocardiography (TEE) to evaluate, grade, and monitor changes in diastolic function.SETTING:
Online survey.PARTICIPANTS:
Members of the Society of Cardiovascular Anesthesiologists.INTERVENTIONS:
None. MEASUREMENTS AND MAINRESULTS:
Of 515 respondents, there was a near-even spread between those based in an academic setting (53%) and those based in private practice (43%). Most respondents (81%) had completed training with certification in TEE. Most respondents (86%) currently modified their intraoperative management, at least some of the time, if they believed a patient was experiencing diastolic dysfunction, with 72% varying the nature of any modification according to the identified grade of diastolic dysfunction. Although 62% of respondents usually evaluated diastolic dysfunction in the pre-bypass period, only 59% of those evaluating diastolic dysfunction typically graded the dysfunction, with a variety of algorithms used for this purpose. The majority of respondents (62%) typically did not re-evaluate diastolic function using TEE in the post-bypass period. In 2 sample patients with Doppler data provided, there was marked variation in grading of diastolic dysfunction by respondents; this variation remained marked even within subgroups of respondents who typically used the same grading algorithm.CONCLUSIONS:
Marked variation currently exists in how intraoperative TEE is used to evaluate, grade, and monitor diastolic function during cardiac surgery. This suggests clinically important knowledge gaps that should be addressed.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ecocardiografia Transesofagiana
/
Testes de Função Cardíaca
/
Procedimentos Cirúrgicos Cardíacos
/
Complicações Intraoperatórias
Tipo de estudo:
Evaluation_studies
Limite:
Humans
Idioma:
En
Revista:
J Cardiothorac Vasc Anesth
Assunto da revista:
ANESTESIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2016
Tipo de documento:
Article