The effects of transesophageal echocardiography on hemodynamic variables in small infants undergoing cardiac surgery

Objective: To assess the effects of transesophageal echocardiography (TEE) on hemodynamic variables during cardiac surgery in small infants. Design: A prospective clinical study. Setting: A medical college-affiliated tertiary care children's hospital. Participants: Twenty-three infants weighing 2 to 5 kg undergoing cardiac su rgery. Interventions: Baseline heart rate, arterial pressure, and central venous p ressure were recorded. A pediatric TEE probe was inserted, and the hemodyna mic variables were again recorded. Postoperatively the hemodynamic measurem ents were measured again before and after probe removal, with the addition of left atrial pressure and pulmonary artery pressure when available. Hemod ynamic parameters were carefully observed during all phases of the TEE exam inations for any changes attributable to probe manipulation. Measurements and Main Results: No statistically significant changes occurre d in this group of patients during TEE. No clinically significant changes i n any individual patient occurred during the measurement or during manipula tion of the TEE probe for the complete examination. Conclusion: Although hemodynamic compromise can occur in small infants, thi s study suggests that it is infrequent. Fear of hemodynamic compromise shou ld not prevent use of intraoperative TEE in small infants when otherwise in dicated. Copyright (C) 2000 by W.B. Saunders Company.