title: Three years' experience of focused cardiovascular ultrasound in the peri-operative period.
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.
authors.affiliation: Department of Anaesthesia, St. Vincent's Hospital, Melbourne, Australia. brian.cowie@svhm.org.au
authors.forename: B
authors.initials: B
authors.lastname: Cowie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging*; D005260:Female; D006337:Heart Murmurs / Q000000981:diagnostic imaging; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms; D019990:Perioperative Care / Q000379:methods*; D019095:Point-of-Care Systems; D014463:Ultrasonography; D018754:Ventricular Dysfunction / Q000000981:diagnostic imaging; D055815:Young Adult