© The Author [2009]. Published by Oxford University Press on behalf of The Board of Directors of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org
Perioperative echocardiography for non-cardiac surgery: what is its role in routine haemodynamic monitoring?
| The first 150 words of the full text of this article appear below. |
Perioperative echocardiography enables direct visualization of the chambers of the heart, its valves, and the major connecting vessels (aorta, pulmonary artery, pulmonary veins, and vena cavae). Many aspects of cardiac function may be measured and monitored by transoesophageal (TOE) and transthoracic (TTE) echocardiography. In cardiac anaesthesia, echocardiography has become an established imaging modality.1 With recent proposed changes in training, the goalposts for perioperative echocardiography appear to have extended to include non-cardiac surgery.2 This Editorial examines the feasibility of using perioperative echocardiography in routine non-cardiac practice. It adopts a framework similar to that for diagnostic tests in the laboratory,3 that is to say, clinical validity (the ability to detect presence or absence of disease), clinical usefulness (does the test lead to better patient outcomes?), safety, education, and economics.
The validity of TOE as a monitor may be illustrated using a model of infective endocarditis in which multiple structural abnormalities, for example,
1 Heart and Lung Centre
Royal Wolverhampton Hospitals
NHS Trust and University of Birmingham
West Midlands
UK
2 University Hospitals of Leicester NHS Trust
Glenfield Hospital
Leicester
UK
* E-mail: Alexander.Ng@rwh-tr.nhs.uk
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