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

BMC Medical Imaging

Philippe Vignon⁴  Nicolas Pichon²  Bruno François²  Rémi Bellier¹  Alessandro Piccardo³  Marc Clavel²  Emmanuelle Begot¹ 

[1] Medical-surgical intensive care unit, Dupuytren University Hospital, 2 Ave. Martin Luther King, Limoges, 87042, France;Inserm, CIC-1435, Limoges, F-87000, France;Department of Thoracic and Cardiovascular Surgery, Dupuytren University Hospital, Limoges, France;Université de Limoges, Limoges, F-87000, France

关键词: Mediastinal hematoma;    Tamponade;    Patent foramen ovale;    Transesophageal echocardiography;    Monitoring;   

Others  :  1222829
DOI  :  10.1186/s12880-015-0070-3

 received in 2014-08-13, accepted in 2015-07-09,  发布年份 2015

【 摘 要 】

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.

【 授权许可】

   
2015 Begot et al.

【 图 表 】

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