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BJA Advance Access published online on December 16, 2005
British Journal of Anaesthesia, doi:10.1093/bja/aei303
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Accepted November 20, 2005

Clinical Investigation

Use of transoesophageal echocardiography during cardiac arrest in patients undergoing elective non-cardiac surgery

T. Lin 1, Y. Chen 2, C. Lu 1, and M. Wang 3 *

1 Department of Anesthesia, Far Eastern Memorial Hospital, Taipei, Taiwan
2 Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
3 Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

* To whom correspondence should be addressed.
M. Wang, E-mail: canon{at}ha.mc.ntu.edu.tw


  Abstract

Background. Sudden unexpected intraoperative cardiac arrests in patients undergoing elective non-cardiac operations are rare but catastrophic complications. The efficacy and utility of transoesophageal echocardiography (TOE) in the diagnosis and management of these events have not been reported earlier.

Methods. Unexpected intraoperative cardiac arrests in patients undergoing elective non-cardiac operations were prospectively studied during a 6 yr period. In these patients, TOE was performed within 5 min after initiation of external chest compression to identify the causes of the cardiac arrests.

Results: Among a total of 125 965 surgical operations, 10 patients who suffered intraoperative cardiac arrests were studied. The causes of the cardiac arrests including myocardial infarction in five, pulmonary embolism in two, and severe hypovolaemia and ventricular arrhythmia without specific pathology in the other two patients were correctly identified using TOE. Seven patients survived.

Conclusion. We conclude that TOE was useful in cardiac arrest during non-cardiac surgery for identifying or excluding pulmonary embolism and for directing investigations and treatment in those patients who had suffered myocardial infarction.

Keywords: complications, cardiac arrest; equipment, transoesophageal echocardiography; surgery, non-cardiac.
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E-letters:

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TOE during cardiac arrest
Malcolm A Broom
British Journal of Anaesthesia, 10 Feb 2006 [Full text]
Reply
Ming-Jiuh Wang
British Journal of Anaesthesia, 6 Mar 2006 [Full text]
Appropriateness of TOE during cardiac arrest
saurabh nagpaul
British Journal of Anaesthesia, 13 Mar 2006 [Full text]
Reply
Ming-Jiuh Wang
British Journal of Anaesthesia, 14 Mar 2006 [Full text]

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