A Review of 364 Perioperative Rescue Echocardiograms: Findings of an Anesthesiologist-Staffed Perioperative Echocardiography Service

• Published in: Journal of cardiothoracic and vascular anesthesia 2015-02, Vol.29 (1), p.82-88
• Main Authors: Markin, Nicholas W., MD, Gmelch, Benjamin S., MD, Griffee, Matthew J., MD, Holmberg, Timothy J., MD, Morgan, David E., MD, Zimmerman, Joshua M., MD, FASE
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anesthesia & Perioperative Care; Anesthesiology - methods; Anesthesiology - standards; Critical Care; Echocardiography, Transesophageal - methods; Echocardiography, Transesophageal - standards; Electronic Health Records - standards; Female; hemodynamic instability; Humans; intraoperative hypotension; Male; Middle Aged; Perioperative Care - methods; Perioperative Care - standards; Physicians - standards; rescue echocardiography; Retrospective Studies; transesophageal echocardiography; transthoracic echocardiography
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2014.07.004

Objective Review the findings and use of rescue echocardiography performed by the Division of Perioperative Echocardiography and its impact on patient management. Design Retrospective observational study. Setting Single institution, tertiary care hospital. Participants Three hundred sixty-four consecutive rescue echocardiograms in the perioperative setting. Interventions Rescue transesophageal or rescue transthoracic echocardiography. Measurements and Main Results Of a total of 1,675 perioperative echocardiograms performed in a 28-month period, 364 (21.8%) were rescue studies. Of these, 95.9% were transesophageal and 4.1% were transthoracic. Location at time of rescue echocardiography was intraoperative (55.5%), postoperative (44.2%), and preoperative (0.3%). No single diagnosis predominated the intraoperative or postoperative environment, and the frequency of common etiologies did not allow for assumption. There was a change in management for 214 patients (59%) as the result of findings. The methods used in performing rescue echocardiography at the authors’ institution are reported. Conclusions The heterogeneity of diagnoses and the frequency with which rescue echocardiography changed management further supports the growing body of evidence that the hemodynamically unstable perioperative patient benefits from its use.