A review of 364 perioperative rescue echocardiograms: findings of an anesthesiologist-staffed perioperative echocardiography service

Objective: Review the findings and use of rescue echocardiography performed by the Division of Perioperative Echocardiography and its impact on patient management.

Design: Retrospective observational study.

Setting: Single institution, tertiary care hospital.

Participants: Three hundred sixty-four consecutive rescue echocardiograms in the perioperative setting.

Interventions: Rescue transesophageal or rescue transthoracic echocardiography.

Measurements and main results: Of a total of 1,675 perioperative echocardiograms performed in a 28-month period, 364 (21.8%) were rescue studies. Of these, 95.9% were transesophageal and 4.1% were transthoracic. Location at time of rescue echocardiography was intraoperative (55.5%), postoperative (44.2%), and preoperative (0.3%). No single diagnosis predominated the intraoperative or postoperative environment, and the frequency of common etiologies did not allow for assumption. There was a change in management for 214 patients (59%) as the result of findings. The methods used in performing rescue echocardiography at the authors' institution are reported.

Conclusions: The heterogeneity of diagnoses and the frequency with which rescue echocardiography changed management further supports the growing body of evidence that the hemodynamically unstable perioperative patient benefits from its use.