Author/Editor		Krivec, Bojan; Voga, Gorazd; Žuran, Ivan; Skale, Rafael; Parežnik, Roman; Podbregar, Matej
Title		Tansezofagealna ultrazvočna preiskava srca pri bolniku v intenzivni enoti
Translated title		Transesophageal echocardiography in the intensive care patient
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 66, št. 7-8
Publication year		1997
Volume		str. 371-4
Language		slo
Abstract		Background. The imperative for successful treatment of critically ill represents an expedient and accurate assessment of cardiac function hemodynamic state with recognition of ethiologic diagnosis. To estimate clinical application, indications and diagnostic value with therapeutic impact of transesophageal echocardiography (TEE) in patients treated in intensive care unit. Methods. Review of 159 TEE examinations performed in consecutive patients admitted to our intensive unit at General Hospital Celje in the period from January 1991 to February 1997. Resiuts. 158 examinations were successfully completed with the exception of one patient in whom we could not introduce the probe due to the aortic arch aneurysm. We separated three indication subgroups. The first group with indication to confirm directed diagnosis consisted of 71 patients (aortic dissection 34, vegetations 28, dysfunction of artificial valve 5 and thoracic trauma 4). We established the diagnosis in 23 (32%) excluded in 20 (28%) and abtained new additional diagnosis in 27 (36%) cases. In the second group of patients with critical state (shock with or without increased central vein pressure) we successfully evaluated ventricular function and filling status in all of them and ascertained causal morphologic diagnosis in 18 (50%) patients. In the third group of 51 patients we evaluated the state with previously recognised diagnosis acquired by transthoracic echocardiographic examination or right ventricular catheterization. Prior diagnosis was confirmed in 45 (88%) patients new etiologic diagnosis established in 15 patients (29%). Treatment was immediately changed in 73 (46%) patients solely upon diagnostic data abtained by TEE. Conclusions. TEE is an useful diagnostic tool in intensive care and can be performed in the majority of patients. (Abstract truncated at 2000 characters.)
Summary		Izhodišča. Osnovni pogoj za ustrezno zdravljenje kritično bolnih je hitra in natančna ocena srčne funkcije in hemodinamskih razmer ter postavitev vzročne diagnoze. Ocena klinične uporabnosti, indikacij in diagnostične ter terapevtske vrednosti transezofagealne ehokardiografije (TEE) pri bolnikih, zdravljenih v intenzivni enoti. Metode. Pregled opravljenih izvidov TEE pri 159 zaporednih bolnikih, sprejetih na Oddelek za intenzivno interno medicino Splošne bolnišnice Celje v času med januarjem 1991 in februarjem 1997. Rezultati. Uspešno smo opravili 158 pregledov, pri eni bolnici zaradi anevrizme aortnega loka sonde nismo mogli uvesti. Pri pregledanih bolnikih smo ločili 3 indikacijske skupine. Prvo skupino za potrditev določene diagnoze je sestavljalo 71 bolnikov (aortna disekcija 34, vegetacije 28, disfunkcija umetne zaklopke 5 in poškodba prsnega koša 4). Diagnozo smo potrdili v 23 (32%) primerih, izključili v 20 (28%) in pridobili novo v 27 (36%) primerih. V drugi skupini 36 bolnikov v kritičnem stanju (šok z zvišanjem centralnega tlaka ali brez) smo pri vseh opredelili funkcijo prekatov in polnitvene razmere ter v 18 primerih (50%) ugotovili novo vzročno morfološko diagnozo. V tretji skupini 51 bolnikov smo ocenili stanje z že znano diagnozo, pridobljeno s transtorakalno ehokardiografsko preiskavo (TEE) ali desnostransko srčno kateterizacijo. Napotno diagnozo smo potrdili pri 45 (88%) bolnikih in pridobili novo vzročno diagnozo pri 15 (29%). Glede na diagnostične podatke, dobljene s TEE, smo zdravljenje pri celotni skupini bolnikov neposredno spremenili v 73 primerih (46%). Zaključki. TEE je v intenzivni enoti uporabna metoda, ker jo lahko izvedemo pri večini bolnikov. (izvleček prekinjen pri 2000 znakih.)
Descriptors		INTENSIVE CARE ECHOCARDIOGRAPHY, TRANSESOPHAGEAL HEART DISEASES CRITICAL CARE