Critical care clinics
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Critical care clinics · Jul 1996
ReviewHypertensive, hypervolemic, hemodilutional therapy for aneurysmal subarachnoid hemorrhage. Is it efficacious? No.
Many neurosurgeons routinely use hypertensive, hypervolemic, hemodilutional, or hyperdynamic therapy (HT) in some form to prevent or to treat vasospasm. Despite the widespread use of this therapy during the past 20 years, however, there are no randomized, prospective, controlled clinical studies demonstrating that HT improves the short- or long-term neurologic outcome or survival after subarachnoid hemorrhage. Guidelines need to be developed to standardize the clinical application of HT, and well-controlled, prospective, randomized clinical trials must be conducted before HT can become an accepted treatment for vasospasm.
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Critical care clinics · Apr 1996
ReviewAutomatic border detection and three-dimensional reconstruction with echocardiography.
This article reviews two important innovations in echocardiography resulting from the recent advances in the capabilities of microprocessors. The first, automatic endocardial border detection, has been implemented on computers contained entirely within echocardiograph machines and is gaining wide clinical use. The second, three-dimensional imaging, is currently under intense investigation and shows great promise for clinical application. It requires, however, further development of the specialized transducer apparatus necessary for image acquisition and the sophisticated computer-processing capability necessary for image reconstruction and display.
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Critical care clinics · Apr 1996
ReviewMultiplane transesophageal echocardiography: examination technique, anatomic correlations, and image orientation.
Multiplane (TEE) transducer imaging is the most highly evolved TEE technology at present. New clinical applications of this technology will be realized as echocardiographers gain experience with it. Current limitations of TEE are likely to be surmounted as its use increases, and continuous improvements and miniaturization of the technology also will improve its usefulness in practice.
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Critical care clinics · Apr 1996
ReviewAssessment of left ventricular function and hemodynamics with transesophageal echocardiography.
Transesophageal echocardiography (TEE) plays an important role in the evaluation of left ventricular function and hemodynamics in the critical care setting. The technique provides immediate data regarding regional myocardial ischemia, global ventricular function, volume, and the presence of cardiac tamponade. This article outlines the role of TEE in the evaluation of left ventricular function in the intensive care unit and presents practical information for the use of TEE in evaluating systolic function, diastolic function, and cardiac tamponade.
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Critical care clinics · Apr 1996
ReviewEchocardiography and Doppler assessment of prosthetic heart valves with transesophageal echocardiography.
This article examines the use of transesophageal echocardiography (TEE) in the assessment of prosthetic heart valves. A summary of the commonly used artificial valves and their physiologic regurgitant flow patterns, as identified by color Doppler imaging, is presented. The hemodynamic evaluation of prosthetic valve stenosis using Doppler techniques is reviewed, and the diagnostic utility of TEE in identifying the complications of cardiac prostheses is discussed.