Usage of peroperative transoesophageal echocardiography (TOE) during cardiac surgery in the Czech Republic by anaesthetists
Authors:
Kunstýř Jan; Lipš Michal; Romaniv Severyn; Dobiáš Miloš; Rulíšek Jan; Matias Michal; Pořízka Michal; Šachl Robert; Jindrová Barbora; Balík Martin
Authors place of work:
Klinika anesteziologie, resuscitace a intenzivní medicíny, 1. LF UK v Praze a Všeobecná fakultní nemocnice v Praze
Published in the journal:
Anest. intenziv. Med., 22, 2011, č. 4, s. 200-203
Category:
Anaesthesiology - Original Paper
Summary
Objective:
The aim of the study was to ascertain the usage of perioperative transoesophageal echocardiography (TOE) by anaesthetists during cardiac surgery in the Czech Republic.
Design:
Nationwide questionnaire survey.
Setting:
All twelve adult cardiac centres in the Czech Republic, mostly parts of University hospitals.
Materials and methods:
An electronic questionnaire was sent to chief cardiac anaesthetists in all centres. All of them responded. Methods of descriptive statistics were used for statistical analysis.
Results:
Only a minority (13%) of all cardiac anaesthetists have passed or are currently in the process of TOE accreditation. Therefore TOE is performed by cardiologists only at most centres (67 %). There is no cardiothoracic centre in Czech Republic where TOE is performed for the full range of procedures. However, it is available 24 hours every day in every centre. TOE is mostly used during valve repair procedures (100 % centres) and septum defect procedures (83 % centres). TOE is used less frequently before weaning off the cardiopulmonary bypass (58 % centres), in valve replacements (8 % centres), and in patients with left ventricular dysfunction (8 % centres). Lack of trained doctors and adequate equipment are the major obstacles of routine usage of TOE by anaesthetists. An absolute majority of respondents (92 %) are interested in education in echocardiography.
Conclusion:
The survey showed that TOE is a technique available in all cardiac surgical centres in the Czech Republic, though still mostly used by cardiologists. There is a lack of cardiac anaesthetists with TOE accreditation. Establishment of a national system of education for anaesthetists guaranteed by scientific societies is strongly required.
Keywords:
transoesophageal echocardiography – cardiac surgery – postgraduate education
Zdroje
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3. Cheitlin, M. D., Armstrong, W. F., Aurigemma, G. P. et al. ACC ⁄ AHA ⁄ ASE 2003 guideline update for the clinical application of echocardiography: summary article: a report of the American College of Cardiology ⁄ American Heart Association Task Force on Practice Guidelines (ACC ⁄ AHA ⁄ ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography). JACC, 2003, 42, 5, p. 954–970.
4. Thys, D. M., Abel, M., Bollen, B. A. et al. Practice Guidelines for Perioperative Transesophageal Echocardiography: a Report by the American Society of Anethesiologists and the Society of Cardiovascular Anesthesiologists Task Force on Transesophageal Echocardiography. Anesthesiology, 1996, 84, p. 986–1006.
5. Flachskampf, F. A., Decoodt, P., Fraser, A. G., Daniel, W. G., Roelandt, J. R. Guidelines from the Working Group. Recommendations for performing transesophageal echocardiography. Eur. J. Echocardiogr., 2001, 2, p. 8–21.
6. Thys, D. M. et al. Practice Guidelines for Perioperative Transesophageal Echocardiography. Anesthesiology, 2010, 112, p. 1084 –1096.
7. Mathew, J. P., Glas, K., Troianos, C. A., Sears-Rogan, P., Savage, R., Shanewise, J., Kisslo, J., Aronson, S., Shernan, S. ASE/SCA Recommendations and Guidelines for Continuous Quality Improvement in Perioperative Echocardiography. Anesth. Analg., 2006, 103, 6, p. 1416–1425.
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Štítky
Anaesthesiology, Resuscitation and Inten Intensive Care MedicineČlánok vyšiel v časopise
Anaesthesiology and Intensive Care Medicine
2011 Číslo 4
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