THE ROLE OF TRANSOESOPHAGEAL ECHOCARDIOGRAPHY IN THE DIAGNOSIS AND MANAGEMENT OF CRITICALLY ILL PATIENTS IN THE INTENSIVE CARE UNIT

Banu Sahin YILDIZ,Murat INNICE,Cetin GUL,Alparslan SAHIN,Mustafa YILDIZ,Mustafa YILDIZ

Abstract

Aim: Transesophageal echocardiogram is an alternative method to transthoracic echocardiogram. The advantage of this technique over transthoracic echocardiogram is usually clearer images, especially of structures that are difficult to view transthoracicly. In this study, we examined the role of transoesophageal echocardiography in the diagnosis and management of critically ill patients in the intensive care unit. Methods: The study was performed on 20 consecutive critically ill intensive care unit patients (12 men and 8 women; mean age 47.1±2.5 years) in whom transthoracic echocardiography was inadequate. Before inserting the probe, mild to moderate sedation was made with iv midazolam to the patients. Results: At the time of transesophageal echocardiography, 4 patients (%20) with prosthetic valve were being mechanically ventilated. Transesophageal echocardiography was performed without significant complications in all patients. The most frequent indications, in 13 (%65) patients, was prosthetic valvular thrombus including 10 patients with mitral and 3 patients with aortic prosthetic valve, in 5 (%25) patients was infective endocarditis, and in 2 (%10) patients was aortic dissection. Conclusions: Transesophageal echocardiography can be safely performed and has an important role in the diagnosis and management options of critically ill patients in the intensive care unit.

Özet

Aim: Transesophageal echocardiogram is an alternative method to transthoracic echocardiogram. The advantage of this technique over transthoracic echocardiogram is usually clearer images, especially of structures that are difficult to view transthoracicly. In this study, we examined the role of transoesophageal echocardiography in the diagnosis and management of critically ill patients in the intensive care unit.Methods: The study was performed on 20 consecutive critically illintensive care unit patients (12 men and 8 women; mean age 47.1±2.5years) in whom transthoracic echocardiography was inadequate. Beforeinserting the probe, mild to moderate sedation was made with ivmidazolam to the patients.Results: At the time of transesophageal echocardiography, 4 patients(%20) with prosthetic valve were being mechanically ventilated.Transesophageal echocardiography was performed without significantcomplications in all patients. The most frequent indications, in 13(%65) patients, was prosthetic valvular thrombus including 10 patientswith mitral and 3 patients with aortic prosthetic valve, in 5 (%25)patients was infective endocarditis, and in 2 (%10) patients was aorticdissection.Conclusions: Transesophageal echocardiography can be safelyperformed and has an important role in the diagnosis and managementoptions of critically ill patients in the intensive care unit.

Keywords: Transoesophageal echocardiography, critically ill patients, intensive care unit