Factors predicting difficulty in insertion of real-time-three-dimensional transesophageal echocardiography probe in adult patients undergoing cardiac surgery.

Content Provider	Europe PMC
Author	Kiran, Molli Gadhinglajkar, Shrinivas Sreedhar, Rupa Sukesan, Subin Pillai, Vivek Panicker, Varghese
Copyright Year	2023
Abstract	Background:Transesophageal echocardiography (TEE) probe insertion may be associated with many complications. Demographic factors and airway conditions such as high Mallampati scores (MMC) and Cormack-Lehane grades (MCLG) are likely to have an impact on its ease of insertion. The primary aim of this study was to identify the predictive factors for difficult real-time-three-dimensional TEE probe insertion.Methods:A total of 153 adult patients undergoing cardiac surgery were prospectively evaluated. The upper airway manipulations required for TEE probe placement were jaw thrust, reverse Sellick's maneuver, and laryngoscopy. All the patients who required airway manipulations were grouped under difficult TEE probe placement group. We evaluated the patients’ predictive factors such as demographic characteristics and factors related to difficult intubation.Results:Out of 153 patients, 123 were males and 30 were females. Overall, 27.5% (n = 42) patients had difficulty in probe placement. About 31.7% (n = 39) males had difficulty in TEE probe placement against 13% (n = 4) females (P-value 0.045). Difficulty in TEE probe placement was found in 72.7% (n = 16) of obese patients (body mass index [BMI] > 30), compared to 18.6% (n = 17) in the patients with BMI less than 25 (P-value < 0.001). Probe insertion was significantly more difficult in the presence of MMC III and IV (50%, n = 18) compared to class I (19.2%, n = 10) (P-value 0.001) and MCLG III (73.3%, n = 22) compared to grade I (11.1%, n = 7) (P-value 0.001).Conclusion:Male gender, obesity, higher grades of MMC and MCLG were found to be the risk factors for difficult TEE probe placement in anesthetized patients.
ISSN	09719784
Journal	Annals of Cardiac Anaesthesia
Volume Number	26
PubMed Central reference number	PMC9997458
Issue Number	1
PubMed reference number	36722582
e-ISSN	09745181
DOI	10.4103/aca.aca_287_20
Language	English
Publisher	Wolters Kluwer - Medknow
Publisher Date	2023-01-01
Publisher Place	India
Access Restriction	Open
Rights License	This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. Copyright: © 2023 Annals of Cardiac Anaesthesia
Subject Keyword	Cardiac surgery difficult airway obesity probe three-dimensional echocardiography
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine Cardiology and Cardiovascular Medicine