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Transösophageale Echokardiographie in der Notfall- und Intensivmedizin

Einsatzgebiet und Durchführung

Transesophageal echocardiography in emergency and intensive care medicine

Indication and implementation

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Medizinische Klinik - Intensivmedizin und Notfallmedizin Aims and scope Submit manuscript

Zusammenfassung

Die transösophageale Echokardiographie (TEE) ist in der Notfall- und Intensivmedizin eine zusätzliche semiinvasive echokardiographische Methode, um potenzielle Verdachtsdiagnosen bei Notfall- und Intensivpatienten bestätigen oder verwerfen zu können. Mittlerweile ist die dreidimensionale (3-D-)TEE-Untersuchung auch im klinischen Ablauf der modernen Notfall- und Intensivmedizin etabliert, da insbesondere Artefakte von Schnittbildphänomenen – u. a. durch Ergänzung simultaner Schnittbild-Cine-Loops und En-face-Darstellungen charakteristischer kardialer Strukturen – sicher abgegrenzt werden können und die diagnostische Aussagekraft dadurch weiter erhöht werden kann. Die wesentlichen Indikationen zu einer Notfall-TEE-Untersuchung sind hämodynamische Instabilität infolge von myokardialen, perikardialen oder valvulären Herzerkrankungen sowie der Verdacht auf Endokarditis oder Aortendissektion.

Abstract

Transesophageal echocardiography (TEE) in emergency and intensive care medicine represents an additional semi-invasive method to confirm or rebut suspected diagnoses in critically ill patients. Three-dimensional (3D)-TEE investigations are established in the clinical workflow of emergency and intensive care units because 3D-TEE investigations permit a differentiation of artifacts due to oblique views by simultaneous documentation of sectional planes and en face views of characteristic cardiac structures. Thus, the level of diagnostic validity can be significantly increased by 3D-TEE investigation. The main indications of TEE investigation in emergency medicine are hemodynamic instability due to myocardial, pericardial or valvular heart diseases as well as suspected endocarditis and aortic dissection.

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Authors and Affiliations

  1. Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland

    S. Stöbe,  M. Metze,  C. Spies &  A. Hagendorff

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  1. S. Stöbe
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  2. M. Metze
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  3. C. Spies
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  4. A. Hagendorff
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Correspondence to A. Hagendorff.

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Interessenkonflikt

S. Stoebe, M. Metze, C. Spies und A. Hagendorff geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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G. Michels, Köln

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Stöbe, S., Metze, M., Spies, C. et al. Transösophageale Echokardiographie in der Notfall- und Intensivmedizin. Med Klin Intensivmed Notfmed 114, 490–498 (2019). https://doi.org/10.1007/s00063-019-0549-8

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  • DOI: https://doi.org/10.1007/s00063-019-0549-8

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