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El Tahan MM, Cheng DC, Szegedi L, Mellin-Olsen J, Zdravkovic M, Lineburger EB, Filipescu D, Tritapepe L, Guarracino F, Neto CN, Garcia PC, Ángel Rodenas Monteagudo M, Granell MG, Guillén RV, Gaudard P, Abdulmomen A, Eldawlatly AA, Bubenek-Turconi SI, Stoica R, Licker M, Erdoes G, Mauermann E, Kirov M, Lomivorotov V, Saldien V, Momeni M, Huang J. A Multi-Country Survey on the Availability of Intraoperative Use of Echocardiography for Noncardiac Surgery. Semin Cardiothorac Vasc Anesth 2024; 28:135-146. [PMID: 38842145 DOI: 10.1177/10892532241256020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
BACKGROUND This survey aimed to explore the availability and accessibility of echocardiography during noncardiac surgery worldwide. METHODS An internet-based 45-item survey was sent, followed by reminders from August 30, 2021, to August 20, 2022. RESULTS 1189 responses were received from 62 countries. Nearly seventy-one percent of respondents had intraoperatively used transesophageal or transthoracic echocardiography (TEE and TTE, respectively) for monitoring or examination. The unavailability of echocardiography machines (30.3%), lack of trained personnel (30.2%), and absence of clinical indications (22.6%) were the top 3 reasons for not using intraoperative echocardiography in noncardiac surgery. About 61.5% of participants had access to at least one echocardiography machine. About 41% had access to at least 1 TEE probe, and 62.2% had access to at least 1 TTE probe. Seventy-four percent of centers had a procedure to request intraoperative echocardiography if needed for noncardiac cases. Intraoperative echocardiography service was immediately available in 58% of centers. CONCLUSIONS Echocardiography machines and skilled echocardiographers are still unavailable at many centers worldwide. National societies should aim to train a critical mass of certified TEE/TTE anesthesiologists and provide all anesthesiologists access to perioperative TEE/TTE machines in anesthesiology departments, considering the increasing number of older and sicker surgical patients scheduled for noncardiac surgery.
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Affiliation(s)
- Mohamed M El Tahan
- Anesthesiology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Davy C Cheng
- School of Medicine, The Chinese University of Hong Kong, Shenzhen, China
- Department of Anesthesia & Perioperative Medicine, Western University, London, ON, Canada
- Department of Anesthesia & Pain Medicine, University of Toronto, Toronto, ON, Canada
| | - Laszlo Szegedi
- Department of Anesthesiology, Université Libre de Bruxelles (U.L.B.), H.U.B Hôpital Erasme, Brussels, Belgium
| | - Jannicke Mellin-Olsen
- Past President World Federation of Societies of Anaesthesiologists, Consultant Anesthesiologist, Bærum Hospital, Drammen, Norway
| | - Marko Zdravkovic
- Department of Anesthesiology, Intensive Care and Pain Management, University Medical Centre Maribor, Maribor, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Daniela Filipescu
- Department of Cardiac Anesthesia and Intensive Care, Emergency Institute of Cardiovascular Diseases, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Luigi Tritapepe
- Anesthesia and Intensive Care, San Camillo-Forlanini Hospital, Rome, Italy
- Anesthesia and Intensive Care, Sapienza University of Rome, Rome, Italy
| | - Fabio Guarracino
- Department of Anesthesia and Critical Care Medicine, Cardiothoracic and Vascular Anesthesia and Intensive Care, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Caetano Nigro Neto
- Anesthesia Section, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil
| | - Paula Camona Garcia
- Cardiovascular-Anesthesia and Intensive Care, University Hospital La Fe, Valencia, Spain
| | | | - Manuel Gil Granell
- Department of Surgery (Anesthesiology Unit), University of Valencia, Valencia, Spain
- Consortium Hospital General University of Valencia, Valencia, Spain
| | - Rosario Vicente Guillén
- Cardiothoracic Anaesthesia & Surgical Intensive Care, La Fe University Hospital, Valencia, Valencia, Spain; University of Valencia, Valencia, Spain
| | - Philippe Gaudard
- Department of Anesthesiology and Critical Care Medicine, CHU Montpellier, PhyMedExp, INSERM, CNRS, Montpellier University, Montpellier, France
| | - Ahmed Abdulmomen
- Department of Anesthesia, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Serban-Ion Bubenek-Turconi
- Prof. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
- "Carol Davila" The University of Medicine and Pharmacy, Bucharest, Romania
- Romanian Society of Anesthesia and Intensive Care (SRATI), Bucharest, Romania
| | - Radu Stoica
- Department of Thoracic Anesthesia, Memorial Hospital Bucharest, Bucharest, Romania
| | - Marc Licker
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Gabor Erdoes
- President Swiss Association of Cardiovascular and Thoracic Anesthesia, Head Adult and Pediatric Cardiovascular Anesthesia, Inselspital, University Hospital Bern, University Department of Anesthesiology and Pain Medicine, Bern, Switzerland
| | - Eckhard Mauermann
- Department of Anesthesiology, Zurich City Hospital, Zurich, Switzerland
| | - Mikhail Kirov
- Department of Anesthesiology and Intensive Care Medicine, Northern State Medical University, Arkhangelsk, Russia
| | - Vladimir Lomivorotov
- Department of Anesthesiology and Perioperative Medicine, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
| | - Vera Saldien
- Anesthesiology Department, University Hospital Antwerp, Edegem, Belgium
- University of Antwerp, Antwerp, Belgium
| | - Mona Momeni
- Department of Anesthesiology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Institut de Recherche Expérimentale et Clinique, Brussels, Belgium
| | - Jiapeng Huang
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USA
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Zhang S, Yu M, Xu X, Jin P, Jia J. Transesophageal Ultrasound in Perioperative Hemodynamic Analysis of Off-Pump Coronary Artery Bypass Grafting. JOURNAL OF MEDICAL IMAGING AND HEALTH INFORMATICS 2021. [DOI: 10.1166/jmihi.2021.3594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Transesophageal echocardiography (TEE) can directly, real-time, and visually monitor cardiac structure, function, and volume status, and effectively guide perioperative volumetric therapy and vasoactive drug use in critically ill patients to improve rehabilitation treatment and prognosis.
Therefore, TEE is considered to be the most comprehensive monitoring technology. The characteristics of reliability, continuity, and repeatability of TEE-guided perioperative hemodynamic management make it have obvious advantages in clinical application, and have gradually developed into a
technology that anesthesiologists must master. In this article, we carried out the application of transesophageal echocardiography in perioperative hemodynamic management, with a view to providing clinical research evidence for further promoting the clinical application of TEE and optimizing
the quality of perioperative hemodynamic management in critical patients. The experimental results show that before and after cardiopulmonary bypass, there is a decrease after cardiopulmonary bypass, but it is not reflected in invasive pressure monitoring. It is considered that the volume
change is small, and it has not yet caused the pressure change. In other words, the pressure is estimated to some extent. The load state sensitivity is poor and can not really reflect the change of the front load. Compared to the large number of applications to assess systolic function, there
are few studies using estimated left ventricular diastolic function. In addition to the complexity of the diastolic process itself, the area curve is susceptible to clutter interference, and the poor readability of the time differential curve is directly related.
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Affiliation(s)
- Shuangyin Zhang
- Department of Anesthesiology, Lanzhou University Second Hospital, LanZhou, 730030, China
| | - Min Yu
- Department of Anesthesiology, Lanzhou University Second Hospital, LanZhou, 730030, China
| | - Xu Xu
- Department of Anesthesiology, Lanzhou University Second Hospital, LanZhou, 730030, China
| | - Ping Jin
- Department of Anesthesiology, Lanzhou University Second Hospital, LanZhou, 730030, China
| | - Juan Jia
- Department of Anesthesiology, Lanzhou University Second Hospital, LanZhou, 730030, China
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Zhao Y, Yuan ZY, Zhang HY, Yang X, Qian D, Lin JY, Zhu T, Song HB. Simulation-based training following a theoretical lecture enhances the performance of medical students in the interpretation and short-term retention of 20 cross-sectional transesophageal echocardiographic views: a prospective, randomized, controlled trial. BMC MEDICAL EDUCATION 2021; 21:336. [PMID: 34107936 PMCID: PMC8191119 DOI: 10.1186/s12909-021-02753-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/17/2021] [Indexed: 02/08/2023]
Abstract
Background Both simulation-based training and video-based training serve as educational adjuncts for learning TEE among medical students. In the present study, we hypothesized that simulation-based training would better enhance the performance of medical students in the interpretation of 20 cross-sectional views compared to video-based training. Methods A total of 120 4th-year undergraduate medical students were enrolled in the present study. The study began with a pre-test of all the participants, followed by a 90-min theoretical lecture and a post-test. Subsequently, the participants were randomly divided into the video-based group (Group V) and simulation-based group (Group S). Next, Group V received 60 min of TEE video learning, while Group S received 60 min of TEE simulator training. After the respective training, both the groups undertook the retention-test 1 and retention-test 2, 1 week and 1 month later, respectively. The performance for each test was evaluated by five views, which were selected randomly and, respectively, from a set of 20 cross-sectional views. The primary outcome was the performance of the retention-test 1. Secondary outcomes included: (1) comparison the performances of the pre-test, post-test, and retention-test 2 between two groups; (2) comparison the performances of pre-test and post-test in the same group; (3) comparison the performances of retention-test 1, and retention-test 2 in the same group. Results Better performances were observed in Group S in both retention-test 1 (Group V: 63.2 [52.6, 77.6] vs. Group S: 89.5 [68.4, 100.0], P < 0.001) and retention-test 2 (Group V: 58.0 [48.0, 72.0] vs. Group S: 74.0 [64.0, 80.0], P < 0.001) compared to Group V. No statistically significant differences were observed in the performances of pre-test (Group V: 8.3 [4.2, 12.5] vs. Group S: 8.3 [4.2, 12.5], P = 0.825) or post-test (Group V: 46.2 [38.5, 57.7] vs. Group S: 44.2 [38.5, 56.7], P = 0.694) between the two groups. The improvement had been observed in the post-test, compared with pre-test in the same group, respectively (Group V in post-test: 46.2 [38.5, 57.7] vs. Group V in pre-test: 8.3 [4.2, 12.5], P < 0.001; Group S in post-test: 44.2 [38.5, 56.7] vs. Group S in pre-test: 8.3 [4.2, 12.5], P < 0.001). However, the performance in retention-test 2 was significantly reduced, compared with retention-test 1 in the same group, respectively (Group V in retention-test 2: 58.0 [48.0, 72.0] vs. Group V in retention-test 1: 63.2 [52.6, 77.6] P = 0.005; Group S in retention-test 2: 74.0 [64.0, 80.0] vs. Group S in retention-test 1: 89.5 [68.4, 100.0], P < 0.001). Conclusions Following a 90-min theoretical lecture, simulation-based training better enhanced the performance of medical students in the interpretation and short-term retention of 20 cross-sectional views compared to video-based training. Trial registration http://www.chictr.org.cn (ChiCTR2000033519, 3/June/2020). Supplementary Information The online version contains supplementary material available at 10.1186/s12909-021-02753-1.
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Affiliation(s)
- Yang Zhao
- Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.,Department of Anesthesiology, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Zong-Yi Yuan
- Department of Oral and Maxillofacial, Nanchong Central Hospital, The Second Clinical Medical College of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Han-Ying Zhang
- Department of Anesthesiology, Pidu District People's Hospital, 156# East Street, Pitong Town, Pidu District, Chengdu, Sichuan, 611730, People's Republic of China
| | - Xue Yang
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Duo Qian
- Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.,Department of Anesthesiology, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Jing-Yan Lin
- Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.,Department of Anesthesiology, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Tao Zhu
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
| | - Hai-Bo Song
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
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Shah R, Gutsche JT, Patel PA, Fabbro M, Ochroch EA, Valentine EA, Augoustides JGT. CASE 6-2016Cardiopulmonary Bypass as a Bridge to Clinical Recovery From Cardiovascular Collapse During Graft Reperfusion in Liver Transplantation. J Cardiothorac Vasc Anesth 2015; 30:809-15. [PMID: 26738978 DOI: 10.1053/j.jvca.2015.08.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Indexed: 02/07/2023]
Affiliation(s)
- Ronak Shah
- Cardiovascular and Thoracic Section Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Jacob T Gutsche
- Cardiovascular and Thoracic Section Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Prakash A Patel
- Cardiovascular and Thoracic Section Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Michael Fabbro
- Cardiovascular and Thoracic Section Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Edward A Ochroch
- Liver Transplant Section, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Elizabeth A Valentine
- Liver Transplant Section, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - John G T Augoustides
- Cardiovascular and Thoracic Section Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
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Ramakrishna H, Kohl BA, Gutsche JT, Fassl J, Patel PA, Riha H, Ghadimi K, Vernick WJ, Andritsos M, Silvay G, Augoustides JGT. The year in cardiothoracic and vascular anesthesia: selected highlights from 2013. J Cardiothorac Vasc Anesth 2014; 28:1-7. [PMID: 24440007 DOI: 10.1053/j.jvca.2013.10.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Indexed: 12/16/2022]
Abstract
This article reviewed selected research highlights of 2013 that pertain to the specialty of cardiothoracic and vascular anesthesia. The first major theme is the commemoration of the sixtieth anniversary of the first successful cardiac surgical procedure with cardiopulmonary bypass conducted by Dr Gibbon. This major milestone revolutionized the practice of cardiovascular surgery and invigorated a paradigm of mechanical platforms for contemporary perioperative cardiovascular practice. Dr Kolff was also a leading contributor in this area because of his important contributions to the refinement of cardiopulmonary bypass and mechanical ventricular assistance. The second major theme is the diffusion of echocardiography throughout perioperative practice. There are now guidelines and training pathways to guide its generalization into everyday practice. The third major theme is the paradigm shift in perioperative fluid management. Recent large randomized trials suggest that fluids are drugs that require a precise prescription with respect to type, dose, and duration. The final theme is patient safety in the cardiac perioperative environment. A recent expert scientific statement has focused attention on this issue because most perioperative errors are preventable. It is likely that clinical research in this area will blossom because this is a major opportunity for improvement in our specialty. The patient care processes identified in these research highlights will further improve perioperative outcomes for our patients.
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Affiliation(s)
- Harish Ramakrishna
- Assistant Professor, Director of Cardiac Anesthesia, Mayo Clinic, Scottsdale, AZ
| | - Benjamin A Kohl
- Assistant Professor, Director of Critical Care, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Jacob T Gutsche
- Assistant Professor, Cardiovascular and Thoracic Section, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Jens Fassl
- Assistant Professor, Cardiovascular and Thoracic Section, Department of Anesthesia and Intensive Care Medicine, University of Basel, Basel, Switzerland
| | - Prakash A Patel
- Assistant Professor, Cardiovascular and Thoracic Section, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Hynek Riha
- Clinical Assistant Professor, Cardiothoracic Anesthesiology and Intensive Care, Department of Anesthesiology and Intensive Care Medicine Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Kamrouz Ghadimi
- Senior Fellow, Cardiovascular and Thoracic Section, Department of Anesthesiology and Critical Care,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - William J Vernick
- Assistant Professor, Cardiovascular and Thoracic Section, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Michael Andritsos
- Clinical Associate Professor, Director of Cardiothoracic and Vascular Anesthesiology, Department of Anesthesiology, Ohio State University, Columbus, OH
| | - George Silvay
- Professor, Anesthesiology and Critical Care, Icahn School of Medicine, Mount Sinai Hospital, New York, NY
| | - John G T Augoustides
- Assistant Professor, Cardiovascular and Thoracic Section, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
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Innovative transesophageal echocardiography training and competency assessment for Chinese anesthesiologists: role of transesophageal echocardiography simulation training. Curr Opin Anaesthesiol 2013; 25:686-91. [PMID: 23079579 DOI: 10.1097/aco.0b013e32835a10fb] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE OF REVIEW Transesophageal echocardiography (TEE) is playing an invaluable role in diagnosing and monitoring the patient's hemodynamics in both cardiac and noncardiac surgery. There have been many obstacles in TEE training. RECENT FINDINGS The TEE simulation provides an ideal environment for anesthesiologists to practice their echocardiography skills out of the operation room. It consists of a manikin and a dummy probe that enable the trainees to perform a hands-on operation with echocardiographic views and allow a virtual scene consisting of a three-dimensional cardiac model, probe tip and image plane be presented side by side simultaneously. SUMMARY The TEE simulator provides an easy comprehensive learning interface and a friendly environment without the psychological pressure and time limitation frequently experienced in the operation room. The simulator can also be used to assess and evaluate the trainees' manipulation skills, space thinking, and clinical judgment ability. TEE simulation-based training and testing can be an important part in TEE training curriculum before the trainees start their clinical training in the operation room.
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