This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (9) Citing Articles via Google Scholar Google Scholar Articles by Jacka, M. J. Articles by Byrick, R. Search for Related Content PubMed PubMed Citation Articles by Jacka, M. J. Articles by Byrick, R.

---

CARDIOVASCULAR ANESTHESIA

The Use of and Preferences for the Transesophageal Echocardiogram and Pulmonary Artery Catheter Among Cardiovascular Anesthesiologists

Michael J. Jacka, MD FRCPC, MSc^*, Marsha M. Cohen, MD FRCPC, MSc^||, Teresa To, PhD^¶#, J. Hugh Devitt, MD FRCPC, MSc^||, and Robert Byrick, MD FRCPC

*Departments of Anesthesiology and Critical Care, University of Alberta, Edmonton, Alberta, Canada; The Clinical Epidemiology & Health Care Research Program, the Department of Anesthesia, The Centre for Research in Women’s Health and the Department of Health Policy, Management, and Evaluation, the ||Department of Anesthesia, Sunnybrook and Women’s College Health Sciences Centre, and the ¶Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada; and #Division of Population Health Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada

Address correspondence and reprint requests to Michael Jacka, MD, FRCPC, MSc, Department of Anesthesia and Critical Care, 3B2.32 Walter C. Mackenzie Health Sciences Centre, Edmonton, AB, T6G 2B7. Address e-mail to mjacka{at}ualberta.ca

The pulmonary artery catheter (PAC), although widely used in anesthesia for cardiac and vascular surgery, remains controversial. Use of transesophageal echocardiography (TEE) by cardiovascular anesthesiologists may be a substitute or a preference compared with the PAC, but this has been incompletely investigated. An anonymous, cross-sectional survey was mailed to anesthesiologists in Canada and the United States. Anesthesiologists described their use of the PAC and TEE during cardiac and vascular surgery, along with their demographic characteristics. Two hundred sixty-five (77%) of 345 anesthesiologists responded. All had the PAC available for use, and 56% had TEE available. Only 23 (11% overall) reported having undergone echocardiography training, half of whom had completed fellowships. Both the PAC and TEE were more often used in cardiac valvular surgery (P = 0.0001) than in aortocoronary bypass or abdominal vascular surgery. Among all anesthesiologists, the PAC remained the preferred monitor in either cardiac or vascular surgery (P = 0.0001), although many indicated a preference for neither monitor. Among anesthesiologists with echocardiography training, TEE was preferred (P = 0.0004). We found that TEE was accessible to more than half of the surveyed anesthesiologists in cardiovascular surgery, but relatively few of them had completed formal training in its use. Only those with completed formal TEE training indicated a significant preference for TEE use and also used it frequently. Given the continuing controversy about the appropriate application of the PAC, concern about the appropriate application of TEE is prudent. The PAC remains the more frequently used and preferred monitor among cardiovascular anesthesiologists.

IMPLICATIONS: A survey of anesthesiologists found that pulmonary artery catheter monitoring is currently more frequently used compared with transesophageal echocardiography during cardiac and vascular surgery.

This article has been cited by other articles:

				F. Mahmood, A. Christie, and R. Matyal Transesophageal Echocardiography and Noncardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2008; 12(4): 265 - 289. [Abstract] [PDF]

				B. Qizilbash, P. Couture, and A. Denault Impact of Perioperative Transesophageal Echocardiography in Aortic Valve Replacement Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2007; 11(4): 288 - 300. [Abstract] [PDF]

				A. B. Leibowitz and J. M. Oropello The Pulmonary Artery Catheter in Anesthesia Practice in 2007: An Historical Overview With Emphasis on the Past 6 Years Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2007; 11(3): 162 - 176. [Abstract] [PDF]

				I. Iglesias, D. Bainbridge, and J. Murkin Intraoperative Echocardiography: Support for Decision Making in Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2004; 8(1): 25 - 35. [Abstract] [PDF]