Transoesophageal echocardiography in cardiac and vascular surgery: implications and observer variability.

Transoesophageal echocardiography (TOE) has gained widespread acceptance among cardiac anaesthetists as a tool to facilitate peri-operative decision-making. This observational study analyses the impact of TOE and its inter-observer variability on intra-operative patient management during cardiac and major vascular surgery. From June 1996 to December 1998, standardized reports were obtained from 11 anaesthetists in 1891 adult cardiac and vascular surgery patients undergoing routine biplane or multiplane TOE.

Inhaled nitric oxide versus intravenous vasodilators in severe pulmonary hypertension after cardiac surgery.

Unlabelled: Inhaled nitric oxide (iNO) is superior to i.v. vasodilators for treatment of pulmonary hypertension (PH) after cardiac surgery, but iNO is a potentially toxic gas, and patient subsets who benefit from iNO are not yet clearly defined.

Continuous thermodilution cardiac output: clinical validation against a reference technique of known accuracy.

Objective: To evaluate the accuracy and precision of continuous thermodilution (CCO) by using a validated bolus thermodilution (BCO) reference technique as criterion standard.

Design: Under circulatory steady state conditions, a CCO system (Vigilance, software versions 4.35 and 4.

Reliability of a new generation transesophageal Doppler device for cardiac output monitoring.

A new generation continuous-wave transesophageal Doppler (TED) device for cardiac output (CO) monitoring (Accucom 2, Datascope), which displays aortic blood flow velocity in real time, was evaluated by 140 simultaneous comparisons with thermodilution (TD) in 16 patients early after coronary artery bypass surgery. The aim was to determine whether this technologic advancement improves the accuracy of COTED assessment. Absolute COTED values showed a considerable scatter as compared to COTD [COTED = 1.