Key result
Intraoperative transoesophageal echocardiography during liver surgery showed a significant correlation with PiCCO2 for cardiac output measurements (r = 0.83, P < 0.001).
Why the study?
Does intraoperative transoesophageal echocardiography (TEE) monitoring provide reliable hemodynamic assessment compared to standard methods in patients undergoing liver surgery?
Observational (n=21)
Does intraoperative transoesophageal echocardiography (TEE) monitoring provide reliable hemodynamic assessment compared to standard methods in patients undergoing liver surgery?
Effect estimate: r = 0.83
p-value: p=< 0.001
Intraoperative TEE is a feasible monitoring tool during liver surgery that correlates well with PiCCO2 for cardiac output measurement and can detect early hemodynamic changes like acute blood loss.
May support TEE consideration for liver surgery monitoring; leaves open need for randomized outcome validation.
A pilot study aimed to introduce intraoperative monitoring of liver surgery using transoesophageal echocardiography (TEE) is described. A set of TEE measurements was established as a protocol, consisting of left atrial (LA) dimension at the aortic valve plane; mitral velocity flow integral, calculation of stroke volume and cardiac output (CO); mitral annular plane systolic excursion; finally, right atrial area. A total of 165 measurements (on 21 patients) were performed, 31 occurring during hypotension. The conclusions reached were during acute blood loss LA dimension changed earlier than CVP, and, in one patient, a dynamic left ventricular (LV) obstruction was observed; in 3 patients a transient LV systolic dysfunction was documented. The comparison between 39 CO paired measurements obtained by TEE and PiCCO2 revealed a statistically significant correlation (P < 0.001, r = 0.83). In this pilot study TEE successfully answered the questions raised by the anesthesiologists. Larger cohort studies are needed to address this issue.
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Pissarra et al. (2012) conducted an observational in Liver surgery (n=21). Transoesophageal echocardiography (TEE) vs. PiCCO2 was evaluated on Correlation between cardiac output measurements obtained by TEE and PiCCO2 (r = 0.83, p=< 0.001). Intraoperative transoesophageal echocardiography during liver surgery showed a significant correlation with PiCCO2 for cardiac output measurements (r = 0.83, P < 0.001).
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