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

BMC Medical Imaging

Case Report

Alessandro Piccardo¹  Emmanuelle Begot²  Rémi Bellier²  Nicolas Pichon³  Marc Clavel³  Bruno François³  Philippe Vignon⁴ 

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

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

DOI  :  10.1186/s12880-015-0070-3

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

来源: Springer

【 摘 要 】

BackgroundHemodynamic 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 presentationA 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.ConclusionsThe novel hemodynamic monitoring device described here appears valuable to help identifying severe post-operative complications and guide acute care.

【 授权许可】

CC BY   
© Begot et al. 2015