Use of transoesophageal echocardiography during cardiac arrest in patients undergoing elective non-cardiac surgery.
BACKGROUND
Sudden unexpected intraoperative cardiac arrests in patients undergoing elective non-cardiac operations are rare but catastrophic complications. The efficacy and utility of transoesophageal echocardiography (TOE) in the diagnosis and management of these events have not been reported earlier.


METHODS
Unexpected intraoperative cardiac arrests in patients undergoing elective non-cardiac operations were prospectively studied during a 6 yr period. In these patients, TOE was performed within 5 min after initiation of external chest compression to identify the causes of the cardiac arrests.


RESULTS
Among a total of 125 965 surgical operations, 10 patients who suffered intraoperative cardiac arrests were studied. The causes of the cardiac arrests including myocardial infarction in five, pulmonary embolism in two, and severe hypovolaemia and ventricular arrhythmia without specific pathology in the other two patients were correctly identified using TOE. Seven patients survived.


CONCLUSIONS
We conclude that TOE was useful in cardiac arrest during non-cardiac surgery for identifying or excluding pulmonary embolism and for directing investigations and treatment in those patients who had suffered myocardial infarction.
Lin
T
T
Department of Anesthesia, Far Eastern Memorial Hospital, Taipei, Taiwan.
Chen
Y
Y
Lu
C
C
Wang
M
M
D000328:Adult; D000368:Aged; D017548:Echocardiography, Transesophageal; D017558:Elective Surgical Procedures; D005260:Female; D006323:Heart Arrest / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D006336:Heart Massage; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D007431:Intraoperative Complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000150:complications / Q000000981:diagnostic imaging