Dzwonczyk, Roger; Fujii, Jeffrey T. ; Simonetti, Orlando ; Nieves-Ramos, Ricardo ; Bergese, Sergio D.
Electrical Noise in the Intraoperative Magnetic Resonance Imaging Setting
Anesthesia & Analgesia. 108(1):181-186, January 2009.
Abstract
BACKGROUND: Intraoperative magnetic resonance imaging (iMRI) is a tool now commonly used in neurosurgery. Safe and reliable patient care in this (or any other) operating room setting depends on an environment, where electrical noise (EN) does not interfere with the operation of the electronic monitoring or imaging equipment. In this investigation, we evaluated the EN generated by the iMRI system and the anesthesia patient monitor used at this institution that impacts the performance of these two devices.METHODS: We measured the EN generated by our iMRI-compatible anesthesia patient monitor as detected by the EN analysis algorithm in our iMRI system. We measured the EN generated by our iMRI system during scanning as detected in the electrocardiogram (ECG) waveform of our patient monitor. We analyzed the effects on EN reduction and signal quality of the ECG noise filters provided in our iMRI-compatible anesthesia patient monitor.RESULTS: Our patient monitor generated EN that was detectable by the iMRI EN analysis algorithm; however, this interference was within the iMRI manufacturer's acceptable limits for an iMRI scan (<10%>
Skubas, Nikolaos
Intraoperative Doppler Tissue Imaging Is a Valuable Addition to Cardiac Anesthesiologists' Armamentarium: A Core Review. [Review]
Anesthesia & Analgesia. 108(1):48-66, January 2009.
Abstract
Endocardial motion and surface/volume changes during the cardiac cycle are echocardiographic methods for regional (analysis of wall motion) and global (fractional area change, stroke volume, and ejection fraction) evaluation of cardiac function. These conventional methods can be subjective, and/or time consuming and, depending upon circumstances, may divert the anesthesiologist's attention from intraoperative activities. Doppler tissue imaging (DTI) is a novel echocardiographic technique, which displays and measures systolic and diastolic velocity from a myocardial region. DTI is simple to perform and independent of adequate endocardial imaging. The numeric information (velocity or time intervals) is easily obtained and measured. Assessment of systolic and diastolic function on regional (detection of ischemia) as well as global level (ejection fraction, grading of diastolic dysfunction) and evaluation of filling pressure can be derived from DTI signals and used by any practicing cardiac anesthesiologist. This review describes the principles, imaging modalities, and clinical applications of DTI.(C) 2009 by International Anesthesia Research Society.
Anesthesia & Analgesia. 108(1):48-66, January 2009.
Abstract
Endocardial motion and surface/volume changes during the cardiac cycle are echocardiographic methods for regional (analysis of wall motion) and global (fractional area change, stroke volume, and ejection fraction) evaluation of cardiac function. These conventional methods can be subjective, and/or time consuming and, depending upon circumstances, may divert the anesthesiologist's attention from intraoperative activities. Doppler tissue imaging (DTI) is a novel echocardiographic technique, which displays and measures systolic and diastolic velocity from a myocardial region. DTI is simple to perform and independent of adequate endocardial imaging. The numeric information (velocity or time intervals) is easily obtained and measured. Assessment of systolic and diastolic function on regional (detection of ischemia) as well as global level (ejection fraction, grading of diastolic dysfunction) and evaluation of filling pressure can be derived from DTI signals and used by any practicing cardiac anesthesiologist. This review describes the principles, imaging modalities, and clinical applications of DTI.(C) 2009 by International Anesthesia Research Society.
Tousignant, Claude
CON: Intraoperative Doppler Tissue Imaging Is a Valuable Addition to Cardiac Anesthesiologists' Armamentarium. [Editorial]
Source
Anesthesia & Analgesia. 108(1):41-47, January 2009.
CON: Intraoperative Doppler Tissue Imaging Is a Valuable Addition to Cardiac Anesthesiologists' Armamentarium. [Editorial]
Source
Anesthesia & Analgesia. 108(1):41-47, January 2009.
Kronzon, Itzhak MD
PRO: Intraoperative Doppler Tissue Imaging Is a Valuable Addition to Cardiac Anesthesiologists' Armamentarium. [Editorial]
Source
Anesthesia & Analgesia. 108(1):37-40, January 2009.
Source
Anesthesia & Analgesia. 108(1):37-40, January 2009.
Hilberath, Jan N. ; Shernan, Stanton K. ; Segal, Scott ; Smith, Brian et al
The Feasibility of Epicardial Echocardiography for Measuring Aortic Valve Area by the Continuity Equation
Anesthesia & Analgesia. 108(1):17-22, January 2009.
Abstract
BACKGROUND: Measuring the aortic valve area (AVA) remains an important component of a comprehensive intraoperative echocardiographic examination in patients undergoing aortic valve surgery. Epicardial echocardiography (EE) represents an accessible alternative to transesophageal echocardiography (TEE), however, its agreement and correlation with other imaging modalities for measuring AVA has not been systematically validated.METHODS: EE was used in 85 patients undergoing cardiac surgery to measure AVA (AVA-EE) using the continuity equation. AVA-EE was compared to measurements obtained by intraoperative transesophageal echocardiography (AVA-TEE) in the same population. In a subset of patients, AVA-EE was also compared to AVA measurements from either preoperative transthoracic echocardiography (AVA-TTE) (n = 65) or cardiac catheterization (AVA-Cath) (n = 35) that were acquired within 4 wk before the date of surgery.RESULTS: Adequate trans-AV Doppler recordings were obtained in 94% of patients for AVA-TEE and 100% of patients for AVA-EE. EE measurements of AVA showed close agreement with TEE measurements (mean difference [bias] +/- 95% CI = -0.09 cm2 +/- 0.18 cm2, r2 = 0.83, P < ci =" -0.03" r2 =" 0.87," ci =" -0.06" r2 =" 0.81,">
Abstract
BACKGROUND: Measuring the aortic valve area (AVA) remains an important component of a comprehensive intraoperative echocardiographic examination in patients undergoing aortic valve surgery. Epicardial echocardiography (EE) represents an accessible alternative to transesophageal echocardiography (TEE), however, its agreement and correlation with other imaging modalities for measuring AVA has not been systematically validated.METHODS: EE was used in 85 patients undergoing cardiac surgery to measure AVA (AVA-EE) using the continuity equation. AVA-EE was compared to measurements obtained by intraoperative transesophageal echocardiography (AVA-TEE) in the same population. In a subset of patients, AVA-EE was also compared to AVA measurements from either preoperative transthoracic echocardiography (AVA-TTE) (n = 65) or cardiac catheterization (AVA-Cath) (n = 35) that were acquired within 4 wk before the date of surgery.RESULTS: Adequate trans-AV Doppler recordings were obtained in 94% of patients for AVA-TEE and 100% of patients for AVA-EE. EE measurements of AVA showed close agreement with TEE measurements (mean difference [bias] +/- 95% CI = -0.09 cm2 +/- 0.18 cm2, r2 = 0.83, P < ci =" -0.03" r2 =" 0.87," ci =" -0.06" r2 =" 0.81,">
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