![]() All views especially the deep transgastric are easier to attain in anaesthetized patients than in awake patients with TEE. Hence TEE gives better quality images than TTE. It can provide images even when the chest is open. 1, 2, 4-8 Ribs, obesity, pneumothorax do not produce artifacts when the TEE is being used. It provides detailed dynamic, real time information about cardiac anatomy and functioning by high quality cardiac monitoring from just a distance of 1-2mm posterior to the heart. TEE aptly resolves this important issue by opening a new window to the heart. It cannot be used intraoperatively when surgical site overlaps with the site of placement of standard ultrasound probe. Trans thoracic echocardiography (TTE) has been previously used as a clinical guide for treatment and follow-up in cases of septic, cardiogenic, anaphylactic, hypovolemic and spinal shock, cardiac and renal failure, pulmonary embolism, tension pneumothorax, myocardial infarction, and antihypertensive overdose. Most anaesthesiologists would be willingly to participate in an accreditation process that accredits what they actually do, namely, perioperative TEE 4, 5Advances in technology like high frequency linear transducers, harmonic imaging, digital display, left-sided contrast agents and three dimensional TEE 7 (specifically for mitral and aortic valve assessment and interventional procedures and for left ventricular volume and ejection fraction assessment) are revolutionizing. Obvious differences in training and accreditation reflecting these backgrounds have been incorporated by the American Society of Echocardiography (ASE)/Society of Cardiovascular Anesthesiologists (SCA) task force on training in perioperative echocardiography. Anaesthesiologists’ TEE skills complement those of cardiologists-neither identical nor competitive. We hope for a modification in this requirement as the TEE practitioners within non-cardiac anaesthesia prove the utility and scope of TEE in their field as well. TEE practitioners within non-cardiac anaesthesia and intensive care medicine who have not completed fellowship training in cardiovascular anaesthesia are unlikely to qualify for Board Certification in TEE, based on the current logbook requirement of 150 patients per annum in the 2 years immediately preceding their application. ![]() National Board of Echocardiography (NBE) of United States of America offers Board Certification in Transoesophageal Echocardiography but candidates who passed these TEE examinations are described as NBE-PTE ‘Testamurs’ (passed the NBE exam but not board certified). Training and skill retention is important to realize the full potential of TEE and to avoid complications, 3-6 not just for cardiac anaesthesiologists but more so for general anaesthesiologists and intensivists. ![]() 1, 2 We review here, the lesser studied and fast evolving use of TEE in patients undergoing non-cardiac surgery, concentrating on obtaining five basic views which can be rapidly reviewed to provide valuable information requisite for non cardiac surgery. TEE is a perioperative diagnostic tool of proven efficacy which can influence surgical and anaesthetic management in patients undergoing cardiac surgery. In intubated patients under general anaesthesia, TEE probe is introduced inside the oesophageal orifice under direct laryngoscopy and is less traumatic than when performed in awake patients. Trans esophageal echocardiography (TEE) is a semi invasive, real time, cardiac imaging modality which has come of age.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |