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Echocardiography-Based Hemodynamic Management in the Cardiac Surgical Intensive Care Unit

Published:December 16, 2013DOI:https://doi.org/10.1053/j.jvca.2013.08.006
      INTRAOPERATIVE TRANSESOPHAGEAL echocardiography (TEE) is well established within the cardiac operating room. Confirmation of the preoperative diagnosis is sought and additional relevant information is communicated to the surgeon. Following the procedure, the results of surgery are examined together with any complications, and information from echocardiography is used to optimize hemodynamic status. As the patient moves to the cardiac critical care unit and the TEE probe is removed, this information is no longer available. Echocardiography is indicated to troubleshoot unstable patients in the immediate postoperative phase, but compared with intraoperative use, postoperative use may occur less frequently. In comparison with some other types of surgery, cardiac surgery has a low mortality, but complications are common and costly.

      Society for Cardiothoracic Surgery in Great Britain and Ireland. Blue Book Online, 2013. http://bluebook.scts.org/

      • Lawson E.H.
      • Hall B.L.
      • Louie R.
      • et al.
      Association between occurrence of a postoperative complication and readmission: Implications for quality improvement and cost savings.
      • Iribarne A.
      • Burgener J.D.
      • Hong K.
      • et al.
      Quantifying the incremental cost of complications associated with mitral valve surgery in the United States.
      Good hemodynamic management should seek to reduce the incidence and impact of such complications. There have been considerable developments in critical care monitoring and echocardiography in recent years, and the authors review the implications for adult cardiac critical care management.

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