Case ConferenceVictor C. Baum, MDSection Editors?>| Volume 29, ISSUE 6, P1702-1711, December 2015

CASE 11–2015

Intraoperative Transthoracic Cardiac and Pulmonary Ultrasonography
Published:August 19, 2015DOI:
      I NTRAOPERATIVE ULTRASONOGRAPHY, especially transesophageal echocardiography (TEE), commonly is used by anesthesiologists in the setting of cardiovascular instability. Several different causes of hypotension, such as hypovolemia, systolic ventricular failure, pericardial tamponade, and valvular problems can be detected within a matter of minutes. Subsequent emergent management can be monitored and guided easily using TEE. However, a TEE probe may not be available readily. In addition, the patient must tolerate sedation or intubation for the procedure. In contrast to TEE, transthoracic ultrasound offers an alternative modality for the nonintubated, awake patient, yet is reported less commonly in the anesthesia literature. In addition to providing cardiac imaging, transthoracic ultrasound can be applied to the lungs to yield further diagnostic clues, such as the presence of pleural effusion, pneumothorax, or pulmonary edema.
      • Volpicelli G.
      • Elbarbary M.
      • Blaivas M.
      • et al.
      International evidence-based recommendations for point-of-care lung ultrasound.
      In the case presented here, intraoperative transthoracic cardiac and pulmonary ultrasound played a key role in the timely management of sudden cardiopulmonary decompensation.

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