title: A review of 364 perioperative rescue echocardiograms: findings of an anesthesiologist-staffed perioperative echocardiography service.
abstract: OBJECTIVE
  Review the findings and use of rescue echocardiography performed by the Division of Perioperative Echocardiography and its impact on patient management.
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  Single institution, tertiary care hospital.
  
  
  METHODS
  Three hundred sixty-four consecutive rescue echocardiograms in the perioperative setting.
  
  
  METHODS
  Rescue transesophageal or rescue transthoracic echocardiography.
  
  
  RESULTS
  Of a total of 1,675 perioperative echocardiograms performed in a 28-month period, 364 (21.8%) were rescue studies. Of these, 95.9% were transesophageal and 4.1% were transthoracic. Location at time of rescue echocardiography was intraoperative (55.5%), postoperative (44.2%), and preoperative (0.3%). No single diagnosis predominated the intraoperative or postoperative environment, and the frequency of common etiologies did not allow for assumption. There was a change in management for 214 patients (59%) as the result of findings. The methods used in performing rescue echocardiography at the authors' institution are reported.
  
  
  CONCLUSIONS
  The heterogeneity of diagnoses and the frequency with which rescue echocardiography changed management further supports the growing body of evidence that the hemodynamically unstable perioperative patient benefits from its use.
authors.affiliation: Department of Anesthesiology, University of Utah, Salt Lake City, UT. Electronic address: nmarkin@unmc.edu.
authors.forename: Nicholas W
authors.initials: NW
authors.lastname: Markin
authors.affiliation: Department of Anesthesiology, University of Utah, Salt Lake City, UT.
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Gmelch
authors.affiliation: Department of Anesthesiology, University of Utah, Salt Lake City, UT.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Griffee
authors.affiliation: Department of Anesthesiology, University of Utah, Salt Lake City, UT.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Holmberg
authors.affiliation: Department of Anesthesiology, University of Utah, Salt Lake City, UT.
authors.forename: David E
authors.initials: DE
authors.lastname: Morgan
authors.affiliation: Department of Anesthesiology, University of Utah, Salt Lake City, UT.
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Zimmerman
mesh_terms: D000328:Adult; D000368:Aged; D000776:Anesthesiology / Q000379:methods* / Q000592:standards; D017548:Echocardiography, Transesophageal / Q000379:methods* / Q000592:standards; D057286:Electronic Health Records / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods* / Q000592:standards; D010820:Physicians / Q000592:standards; D012189:Retrospective Studies
keywords: hemodynamic instability; intraoperative hypotension; rescue echocardiography; transesophageal echocardiography; transthoracic echocardiography