THE ROLE OF TRANSOESOPHAGEAL ECHOCARDIOGRAPHY IN THE DIAGNOSIS AND MANAGEMENT OF CRITICALLY ILL PATIENTS IN THE INTENSIVE CARE UNIT

Öz

Aim: Transesophageal echocardiogram is an alternative method to transthoracic echocardiogram. The advantage of this technique over transthoracic echocardiogram is usually clearer images, especially of structures that are difficult to view transthoracicly. In this study, we examined the role of transoesophageal echocardiography in the diagnosis and management of critically ill patients in the intensive care unit. Methods: The study was performed on 20 consecutive critically ill intensive care unit patients (12 men and 8 women; mean age 47.1±2.5 years) in whom transthoracic echocardiography was inadequate. Before inserting the probe, mild to moderate sedation was made with iv midazolam to the patients. Results: At the time of transesophageal echocardiography, 4 patients (%20) with prosthetic valve were being mechanically ventilated. Transesophageal echocardiography was performed without significant complications in all patients. The most frequent indications, in 13 (%65) patients, was prosthetic valvular thrombus including 10 patients with mitral and 3 patients with aortic prosthetic valve, in 5 (%25) patients was infective endocarditis, and in 2 (%10) patients was aortic dissection. Conclusions: Transesophageal echocardiography can be safely performed and has an important role in the diagnosis and management options of critically ill patients in the intensive care unit.

Anahtar Kelimeler

• Transoesophageal echocardiography, critically ill patients, intensive care unit

THE ROLE OF TRANSOESOPHAGEAL ECHOCARDIOGRAPHY IN THE DIAGNOSIS AND MANAGEMENT OF CRITICALLY ILL PATIENTS IN THE INTENSIVE CARE UNIT

Öz

Aim: Transesophageal echocardiogram is an alternative method to transthoracic echocardiogram. The advantage of this technique over transthoracic echocardiogram is usually clearer images, especially of structures that are difficult to view transthoracicly. In this study, we examined the role of transoesophageal echocardiography in the diagnosis and management of critically ill patients in the intensive care unit.
Methods: The study was performed on 20 consecutive critically ill
intensive care unit patients (12 men and 8 women; mean age 47.1±2.5
years) in whom transthoracic echocardiography was inadequate. Before
inserting the probe, mild to moderate sedation was made with iv
midazolam to the patients.
Results: At the time of transesophageal echocardiography, 4 patients
(%20) with prosthetic valve were being mechanically ventilated.
Transesophageal echocardiography was performed without significant
complications in all patients. The most frequent indications, in 13
(%65) patients, was prosthetic valvular thrombus including 10 patients
with mitral and 3 patients with aortic prosthetic valve, in 5 (%25)
patients was infective endocarditis, and in 2 (%10) patients was aortic
dissection.
Conclusions: Transesophageal echocardiography can be safely
performed and has an important role in the diagnosis and management
options of critically ill patients in the intensive care unit.

Anahtar Kelimeler

• Transoesophageal echocardiography,critically ill patients,intensive care unit

Kaynakça

1. 1. Costachescu T, Denault A, Guimond JG, Couture P, Carignan S, Sheridan P, Hellou G, Blair L, Normandin L, Babin D, Allard M, Harel F, Buithieu J. The hemodynamically unstable patient in the intensive care unit: hemodynamic vs. transesophageal echocardiographic monitoring. Crit Care Med 2002;30(6):1214-23.
2. 2. Brown JM. Use of echocardiography for hemodynamic monitoring. Crit Care Med. 2002;30(6):1361-4.
3. 3. Colreavy FB, Donovan K, Lee KY, Weekes J. Transesophageal echocardiography in critically ill patients. Crit Care Med 2002;30(5):989- 96.
4. 4. Vignon P, Mentec H, Terré S, Gastinne H, Guéret P, Lemaire F. Diagnostic accuracy and therapeutic impact of transthoracic and transesophageal echocardiography in mechanically