Three years' experience of focused cardiovascular ultrasound in the peri-operative period

Anaesthesia. 2011 Apr;66(4):268-73. doi: 10.1111/j.1365-2044.2011.06622.x. Epub 2011 Feb 24.

Abstract

Ultrasound applications in peri-operative medicine have become common place in modern anaesthesia practice. Anaesthetists have performed transoesophageal echocardiography in cardiac and selected non-cardiac surgery for over two decades. We aimed to assess the indications, impact on clinical management and accuracy of focused cardiovascular ultrasound performed by anaesthetists in the peri-operative period. One hundred and seventy patients over a 3-year period had a focused transthoracic echocardiogram. Adequate images to answer the clinical question were obtained in 167 out of 170 patients (98%). The undifferentiated systolic murmur was the commonest indication (98 out of 170, 58%). Some degree of aortic stenosis was present in 47 out of 170 (26%) of patients; mitral valve disease (30 out of 170 (18%)) and pulmonary hypertension (25 out of 170 (14%)) were also common. Changes in peri-operative management occurred in 140 out of 170 (82%) patients and major findings correlated with a formal cardiology transthoracic echocardiogram in 52 out of 57 (92%) patients. Focused cardiovascular ultrasound performed by anaesthetists in the peri-operative period accurately detects major cardiac pathology and significantly alters peri-operative management.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases / diagnostic imaging*
  • Female
  • Heart Murmurs / diagnostic imaging
  • Heart Valve Diseases / diagnostic imaging
  • Humans
  • Hypertension, Pulmonary / diagnostic imaging
  • Male
  • Middle Aged
  • Operating Rooms
  • Perioperative Care / methods*
  • Point-of-Care Systems
  • Ultrasonography
  • Ventricular Dysfunction / diagnostic imaging
  • Young Adult