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(Chest. 1995;107:774-779.)
© 1995 American College of Chest Physicians

Evaluation of Transesophageal Echocardiography as a Diagnostic and Therapeutic Aid in a Critical Care Setting

Jan I. Poelaert MD, FCCP1; Jan Trouerbach MD2; Marc De Buyzere BSc2; Jan Everaert RN1; and Francis A. Colardyn MD1

1 From the Department of Intensive Care, Ghent, Belgium
2 From the Department of Cardiology, Ghent, Belgium

Objectives: To assess the impact of transesophageal echocardiography (TEE) on therapeutic management in relation to pulmonary artery catheterization (PAC) in the ICU.

Design: Retrospective analysis of 108 consecutive TEE video and related patient files during a 7-month period.

Setting: A 33-bed medical and surgical ICU.

Methods: All critically ill patients with or without PAC in whom a TEE was performed, excluding postoperative cardiac surgical patients. Patients were divided in a cardiac and a septic group depending on the primary disease on admission to the ICU. The impact of TEE in relation to PAC on ICU management was evaluated in whether therapy changes were performed strictly on the basis of the TEE findings.

Main results: Of 64% of patients with a PAC, 44% underwent therapy changes after TEE:41% in the cardiac and 54% in the septic subgroup. In 41% of patients without a PAC, TEE led to a change in therapy.

Conclusions: TEE results in altered therapeutic management in at least one third of our (noncardiac surgery) ICU patient population independent of the presence of a PAC.

Key Words: cardiac failure • echocardiography • ICU management • pulmonary artery catheter • sepsis

Submitted on July 21, 1994
Accepted on October 11, 2007




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