title: Repeated Monitoring With Transthoracic Echocardiography and Lung Ultrasound After Cardiac Surgery: Feasibility and Impact on Diagnosis.
abstract: OBJECTIVE
  Cardiorespiratory complications are common after cardiac surgery and current monitors used to diagnose these are invasive and have limitations. Transthoracic echocardiography and lung ultrasound are noninvasive and frequently improve diagnosis in critically ill patients but have not been reported for routine postoperative monitoring after coronary, valve, and aortic surgery. The aim was to determine whether both repeated postoperative transthoracic echocardiography and lung ultrasound revealed or excluded clinically important cardiac and respiratory disorders compared to conventional monitoring and chest x-ray.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Tertiary university hospital.
  
  
  METHODS
  Ninety-one patients aged older than 18 undergoing cardiac surgery
  
  
  METHODS
  Postoperative clinical patient assessment for significant cardiac and respiratory disorders by the treating physician was recorded at 3 time points (day after surgery, after extubation and removal of chest drains and at discharge) using conventional monitoring and chest x-ray. After each assessment, transthoracic echocardiography and lung ultrasound were performed, and differences in diagnosis from conventional assessment were recorded.
  
  
  RESULTS
  Transthoracic echocardiography was interpretable in at least 1 echocardiographic window in 99% of examinations. Transthoracic echocardiography and/or lung ultrasound changed the diagnosis of important cardiac and/or respiratory disorders in 61 patients (67%). New cardiac findings included cardiac dysfunction (38 patients), pericardial effusion (5), mitral regurgitation (2), and hypovolemia (1). New respiratory findings included pleural effusion (30), pneumothorax (4), alveolar interstitial syndrome (3) and consolidation (1).
  
  
  CONCLUSIONS
  Routine repeated monitoring with cardiac and lung ultrasound after cardiac surgery is feasible and frequently alters diagnosis of clinically important cardiac and respiratory pathology.
authors.affiliation: King Fahad Cardiac Center and College of Medicine, King Saud University, Riyadh, Saudi Arabia;
authors.forename: Ahmed
authors.initials: A
authors.lastname: Alsaddique
authors.affiliation: Department of Surgery, University of Melbourne, Royal Parade, Parkville, Australia; Royal Melbourne Hospital, Grattan Street, Parkville, Australia.
authors.forename: Alistair G
authors.initials: AG
authors.lastname: Royse
authors.affiliation: Department of Surgery, University of Melbourne, Royal Parade, Parkville, Australia; Royal Melbourne Hospital, Grattan Street, Parkville, Australia.
authors.forename: Colin F
authors.initials: CF
authors.lastname: Royse
authors.affiliation: King Fahad Cardiac Center and College of Medicine, King Saud University, Riyadh, Saudi Arabia;
authors.forename: Abdulelah
authors.initials: A
authors.lastname: Mobeirek
authors.affiliation: King Fahad Cardiac Center and College of Medicine, King Saud University, Riyadh, Saudi Arabia;
authors.forename: Fayez
authors.initials: F
authors.lastname: El Shaer
authors.affiliation: King Fahad Cardiac Center and College of Medicine, King Saud University, Riyadh, Saudi Arabia;
authors.forename: Hanan
authors.initials: H
authors.lastname: AlBackr
authors.affiliation: King Fahad Cardiac Center and College of Medicine, King Saud University, Riyadh, Saudi Arabia;
authors.forename: Mohammed
authors.initials: M
authors.lastname: Fouda
authors.affiliation: Department of Surgery, University of Melbourne, Royal Parade, Parkville, Australia; Royal Melbourne Hospital, Grattan Street, Parkville, Australia. Electronic address: dj_canty@hotmail.com.
authors.forename: David J
authors.initials: DJ
authors.lastname: Canty
mesh_terms: D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D004452:Echocardiography; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011183:Postoperative Complications / Q000175:diagnosis*; D011446:Prospective Studies; D014463:Ultrasonography
keywords: echocardiography; lung; postoperative care; surgery complications; ultrasound