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European Journal of Echocardiography 2004 5(6):403; doi:10.1016/j.euje.2004.10.002
© 2004 by European Society of Cardiology
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Copyright © 2004, The European Society of Cardiology

The intensivist's view

D. Poldermans, Professor in Perioperative Care and J. Klein, Professor in Anesthesiology

Erasmus MC

Dr. Sloth raises several interesting points in his letter concerning a more widespread use of Transthoracic Echocardiography (TTE).

Although traditionally anesthesiologists and intensivists have not considered TTE within the scope of their practice and the availability of Hand-Carried Ultrasound devices (HCU) should not be decisive, there is growing evidence for the usefulness of TTE in minimal preoperative testing. TTE confirms or rules out cardiac pathology such as aortic stenosis, left ventricular hypertrophy, diastolic dysfunction and cardiomyopathy, all of which represent major clinical predictors of cardiac risk.1–3 For anesthesiologists to become effective perioperative physicians, anesthesia training needs to be adjusted and instruction in TTE should be included.

In the setting of the ICU however, further studies are needed to validate the use of TTE and HCU, since these techniques have failed so far to provide adequate imaging in a considerable number of critically ill patients.4,5


   References
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 References
 

  1. Rohde L.E., Polanczyk C.A., Goldman L., Cook E.F., Lee R.T., Lee T.H. Usefulness of transthoracic echocardiography as a tool for risk stratification of patients undergoing major noncardiac surgery. Am J Cardiol (1 March 2001) 87(5):505–509.[CrossRef]
  2. Filipovic M., Seeberger M.D., Schneider M.C., Schmid M., Pargger H., Hunziker P., et al. Transthoracic echocardiography for perioperative haemodynamic monitoring. Br J Anaesth (2000) 84(6):800–803.[Abstract/Free Full Text]
  3. Hadi A., Vloka M.E., Vloka J.D., Koorn R., Krasnow N., Hillel Z. Perioperative echocardiography in the ambulatory anesthesia setting. Anesth Analg (1998) 86:S9.[CrossRef]
  4. Cook C.H., Praba A.C., Beery P.R., Martin L.C. Transthoracic echocardiography is not cost effective in critically ill surgical patients. J Trauma (2002) 52(2):280–284.[Web of Science][Medline]
  5. Vignon P., Frank M.B., Lerage J., Muche F., Francois B., Normand S., et al. Hand-held echocardiography with Doppler capability for the assessment of critically-ill patients: is it reliable. Intensive Care Med (2004) 30(4):718–723.[CrossRef][Web of Science][Medline]

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This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
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Right arrow Articles by Poldermans, D.
Right arrow Articles by Klein, J.
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PubMed
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Right arrow Articles by Poldermans, D.
Right arrow Articles by Klein, J.
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What's this?