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Clinical and economic impact of a TEE monitoring system in intensive care
Critical Care volume 15, Article number: P27 (2011)
Introduction
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 ClariTEEâ„¢). 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 ClariTEEâ„¢ was designed and cleared by the FDA to remain indwelling for 72 hours of episodic hemodynamic monitoring.
Results
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 [5], 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.
Conclusions
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 [4]. 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 [8]; also cost [1]. Although further study is needed, TEE monitoring has shown potential for significant clinical and economic impact.
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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
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DOI: https://doi.org/10.1186/cc9447