- Poster presentation
- Open Access
Clinical and economic impact of a TEE monitoring system in intensive care
Critical Care volume 15, Article number: P27 (2011)
The purpose of this study was to determine the clinical and economic impact of hemodynamic monitoring in intensive care with the ImaCor TEE monitoring system, including a miniaturized, detachable, single-use probe (the ImaCor ClariTEE™). TEE has been cited as especially appropriate for hemodynamic monitoring because abnormalities are multifactorial; or example, hypovolemia, LV and RV dysfunction, tamponade. Unlike conventional probes, the ClariTEE™ was designed and cleared by the FDA to remain indwelling for 72 hours of episodic hemodynamic monitoring.
In 46 postcardiac surgery patients, surgical re-exploration was avoided in five patients (11%), and fluid and pressor administration changed in 23 patients (50%). TEE monitoring also detected tamponade requiring reoperation and helped optimize the LVAD flow rate. Even without including likely reductions in acute kidney injury, a common complication , estimated hospital charges (see [1–4]) were reduced by $12,000 per patient. In 68 general ICU patients, fluid and pressor administration was changed in 28 patients (41%), reducing estimated hospital charges by $7,400 per patient.
TEE monitoring demonstrated the potential to improve hemodynamic management; expected to reduce hospital stay [6, 7]: even small amounts of mild instability significantly increase hospital stay and charges . TEE monitoring also demonstrated the potential to avoid reoperation postcardiac surgery. Reoperation significantly increases morbidity (low cardiac output, acute renal failure, sepsis), vent time, ICU stay and mortality ; also cost . Although further study is needed, TEE monitoring has shown potential for significant clinical and economic impact.
Speir AM, et al.: Ann Thorac Surg. 2009, 88: 40-45. 10.1016/j.athoracsur.2009.03.076
Trzeciak S, et al.: Chest. 2006, 129: 225-232. 10.1378/chest.129.2.225
Shorr AF, et al.: Crit Care Med. 2007, 35: 1257-1262. 10.1097/01.CCM.0000261886.65063.CC
Hravnak M, et al.: Intensive Care Med. 2010, 36: S163.
Hein OV, et al.: Ann Thorac Surg. 2006, 81: 880-885. 10.1016/j.athoracsur.2005.09.077
Pölönen P, et al.: Anesth Analg. 2000, 90: 1052-1059.
Charron C, et al.: Curr Opin Crit Care. 2006, 12: 249-254. 10.1097/01.ccx.0000224870.24324.cc
Ranucci M, et al.: Ann Thorac Surg. 2008, 86: 1557-1562. 10.1016/j.athoracsur.2008.07.114
About this article
Cite this article
Hastings, H., Roth, S. Clinical and economic impact of a TEE monitoring system in intensive care. Crit Care 15 (Suppl 1), P27 (2011). https://doi.org/10.1186/cc9447
- Monitoring System
- Acute Renal Failure
- Economic Impact
- Acute Kidney Injury
- Hemodynamic Monitoring