Korean J Anesthesiol.  2002 Sep;43(3):309-313. 10.4097/kjae.2002.43.3.309.

The Effects of the Insertion of a Transesophageal Echocardiography Transducer Probe on Hemodynamics and Ventilation in Pediatric Patients with Congenital Heart Disease

• Han SH
• Kim CS

• KMID: 2238973
• DOI: http://doi.org/10.4097/kjae.2002.43.3.309

Abstract

BACKGROUND: Transesophageal echocardiography (TEE) is now a common part of intraoperative monitoring in cardiac surgery. Complications related to TEE have not been frequently reported, yet there have been some cases of hemodynamic compromise and interference with ventilation. We measured the changes of hemodynamic and ventilatory variables in associated with the insertion of TEE probe in pediatric cardic pateints.
METHODS
Twenty six patients (age = 11.0 +/- 5.1 months) weighing under 10 kg who scheduled for elective operations for congenital heart disease were studied prospectively. We measured heart rate, mean arterial pressure, central venous pressure, peak inspiratory pressure, end-tidal carbon dioxide pressure, pulse oxygen saturation and arterial blood gases. The variables were measured before and after each TEE probe insertion.
RESULTS
No significant changes in hemodynamic variables were noted after TEE probe insertion. Arterial carbon dioxide pressure increased significantly after TEE probe insertion. Peak inspiratory pressure increased markedly in three infants who weighed under 7 kg, which showed no statistical significance over all. In one patient, the endotracheal tube was extubated accidentally, and reintubated after reinstitution of partial cardiopulmonary bypass.
CONCLUSIONS
TEE is noninvasive monitoring and complications thereof are rare, but vigilance against hemodynamic and ventilatory compromise is highly needed especially for small infants. In addition the possibility of extubation should be kept in mind and should be detected early.

Keyword

Hemodynamic; infant; transesophageal echocardiography; ventilation

MeSH Terms

Arterial Pressure
Blood Pressure
Carbon Dioxide
Cardiopulmonary Bypass
Central Venous Pressure
Echocardiography, Transesophageal*
Gases
Heart Defects, Congenital*
Heart Rate
Hemodynamics*
Humans
Infant
Monitoring, Intraoperative
Oxygen
Prospective Studies
Thoracic Surgery
Transducers*
Ventilation*
Carbon Dioxide
Gases
Oxygen