Hemodynamic monitoring using a single-use indwelling transesophageal echocardiography probe in an unstable patient after open-heart surgery

作者：Begot Emmanuelle; Clavel Marc; Piccardo Alessandro; Bellier Remi; Francois Bruno; Pichon Nicolas; Vignon Philippe^*

来源：BMC Medical Imaging, 2015, 15(1): 31.

DOI：10.1186/s12880-015-0070-3

• Monitoring
• Transesophageal echocardiography
• Patent foramen ovale
• Tamponade
• Mediastinal hematoma

Background:
Hemodynamic monitoring is frequently needed in ventilated patients with unstable hemodynamics after open-heart surgery. Novel miniaturized single-use transesophageal echocardiographic probe has been scarcely used in this clinical setting.
Case presentation:
A patient who underwent a scheduled open-heart surgery developed a ventilator-associated pneumonia and was referred to the intensive care unit for post-operative acute respiratory distress syndrome. Hemodynamic monitoring was performed with a single-use indwelling transesophageal echocardiography probe during 50 h. Initially, a contrast study depicted a patent foramen ovale with a right-to-left shunt. Nitric oxide was administered and positive end-expiration pressure was reduced. Subsequently, the patient became hemodynamically unstable and the identification of a localized tamponade due to compressive left atrial hematoma prompted reoperation.
Conclusions:
The novel hemodynamic monitoring device described here appears valuable to help identifying severe post-operative complications and guide acute care.

• 出版日期2015-8-14