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An Approach to Standard Perioperative Transthoracic Echocardiography Practice for Anesthesiologists—Perioperative Transthoracic Echocardiography Protocols

Published:September 07, 2021DOI:https://doi.org/10.1053/j.jvca.2021.08.100

      Abstract

      The use of intraoperative transesophageal echocardiography (TEE) has become the standard of care for most cardiac surgical procedures. There are guidelines established for training, practice, and quality improvement in perioperative TEE by the joint efforts of the American Society of Echocardiography and Society of Cardiovascular Anesthesiologists. Cardiac point-of-care ultrasound (POCUS) increasingly is being incorporated into anesthesiologists’ training and practice. While a special “certification in Critical Care Echocardiography” was created by the National Board of Echocardiography in 2019, there currently exist no guidelines for training, certification, and practice of perioperative TTE by anesthesiologists. In this review, the authors describe the categories, indications and applications of perioperative TTE and provide a recommended sequence for performing an examination tailored to the evaluation of perioperative patients. Although the authors describe a protocol utilized at their institution, there are no standards described in the literature for PTTE. Cardiac anesthesiologists and cardiac anesthesia societies (Society of Cardiovascular Anesthesiologists, European Association of Cardiothoracic Anesthesiologists) must come forward to establish standards working in collaboration with echocardiography societies (American Society of Echocardiography, European Society of Cardiology).

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      Linked Article

      • Perioperative Transthoracic Echocardiography—Thoughtful Design and Delivery of Standardized Imaging Protocols for Anesthesiology Teams
        Journal of Cardiothoracic and Vascular AnesthesiaVol. 36Issue 2
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          The continued and ever-increasing incorporation of transthoracic echocardiography in perioperative practice has revolutionized point-of-care hemodynamic diagnosis and management.1 The applications of this diagnostic modality are a natural extension of current cardiac anesthesia practice and facilitate clinical triage throughout the perioperative setting including the preoperative clinic, the operating room, the postanesthesia care unit, and/or the intensive care unit.1,2 The importance of education, competence, and certification in this practice domain has been highlighted recently in the journal.
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