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Die Anaesthesiologie

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01.09.2015 | Allgemeinanästhesie

Perioperative transösophageale Echokardiographie außerhalb der Kardiochirurgie

Update

verfasst von: D. Wally, PD Dr. C. Velik-Salchner

Erschienen in: Die Anaesthesiologie | Ausgabe 9/2015

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Zusammenfassung

Ziel der Arbeit

Die Vermittlung von Kenntnissen zur fokussierten transösophagealen Echokardiographie (TEE) als Diagnostikum bei nichtkardiochirurgischen Patienten ist das Ziel dieser Arbeit. Die transösophageale Echokardiographie (TEE) ist perioperativ sehr hilfreich, da sie eine rasche echokardiographische Untersuchung ohne Behinderung des Operationsfelds bzw. bei eingeschränkten transthorakalen Untersuchungsbedingungen ermöglicht. Neue Empfehlungen zur perioperativen TEE mit erweiterten Standardschnitten und dem daraus abgeleiteten verkürzten Untersuchungsgang als Grundlage für eine orientierende Basisuntersuchung waren ausschlaggebend für diese Arbeit.

Material und Methoden

Hintergrund ist die zu diesem Thema publizierte Literatur (Peer-Review-Arbeiten aus PubMed).

Ergebnisse

Die TEE bei nichtkardiochirurgischen Patienten hat im Wesentlichen 2 Einsatzgebiete: 1. die Abklärung der akuten perioperativen hämodynamischen Instabilität in OP, Schockraum und auf der Intensivstation, 2. die geplante intraoperative Überwachung, wenn aufgrund der Art des Eingriffs oder aufgrund bekannter oder vermuteter kardiovaskulärer Vorerkrankungen des/r Patienten/in mit schweren hämodynamischen, pulmonalen oder neurologischen Komplikationen gerechnet werden muss. Im Jahr 2013 wurden 11 relevante Standardschnitte als Grundlage für die Basisuntersuchung außerhalb der Herzchirurgie definiert. Die konsequente Einhaltung dieses verkürzten Untersuchungsgangs sollte bei jedem Patienten erfolgen. Bei speziellen Fragestellungen kann eine Erweiterung des Untersuchungsgangs nötig werden.

Diskussion

Die perioperative TEE ist auch bei nichtkardiochirurgischen Patienten mittlerweile unverzichtbar. Mithilfe der TEE ist es möglich, eine lebensbedrohliche perioperative hämodynamische Instabilität innerhalb weniger Minuten abzuklären. Weiterhin kann das hämodynamische Management von Hochrisikopatienten/innen erleichtert werden. Entsprechende Qualifikation und Weiterbildung sind notwendig, um die Kompetenz der Untersucher/innen sicherzustellen.

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Titel: Perioperative transösophageale Echokardiographie außerhalb der Kardiochirurgie
Update
verfasst von: D. Wally
PD Dr. C. Velik-Salchner
Publikationsdatum: 01.09.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Die Anaesthesiologie / Ausgabe 9/2015
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI: https://doi.org/10.1007/s00101-015-0066-y

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Perioperative transösophageale Echokardiographie außerhalb der Kardiochirurgie

Update

Zusammenfassung

Ziel der Arbeit

Material und Methoden

Ergebnisse

Diskussion

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