Journal article
Transesophageal echocardiography for thoracic spinal cord imaging and confirmation of epidural catheter placement in pediatrics
Journal of clinical anesthesia, Vol.91, 111231
12/01/2023
DOI: 10.1016/j.jclinane.2023.111231
PMID: 37696242
Abstract
INTRODUCTIONTransesophageal echocardiography (TEE) use continues to expand to include extracardiac applications. However, there is limited research investigating the use of TEE as a tool to confirm the position of the epidural catheter. This prospective observational study aimed to evaluate whether TEE could be used to visualize the anatomy of the thoracic spinal canal in pediatrics. A subsequent prospective case series was conducted to evaluate whether TEE could be used to assist in the placement of epidural catheters in pediatric surgical patients. METHODSSeventy-five patients (50 pediatric and 25 adult subjects) were enrolled. The operators attempted to identify four structures (spinal cord, cerebrospinal fluid, dura mater, epidural space) within the thoracic spinal canal with TEE. After demonstrating the feasibility of this technique for observing the spinal anatomy, 20 pediatric surgical patients were enrolled in a case series. These patients had epidural catheter placement, and the final catheter position was confirmed with TEE. RESULTSThe total number of thoracic spinal segment visualized in pediatric patients was 542 out of 550 (99%) segments, and 191 out of 275 (70%) segments in adult subjects (difference, 29% [95% confidence interval, 23-34]; p < 0.001). Additionally, a case series of 20 pediatric surgical patients demonstrated successful caudal or epidural catheter placement at target spinal level in 17 cases. CONCLUSIONSThis observational study demonstrated the successful visualization of the thoracic spinal cord at virtually every level in pediatric patients. A subsequent case series demonstrated that TEE could be used to successfully confirm the position of the epidural catheter in the targeted thoracic spinal segment for pediatric surgical patients.
Details
- Title: Subtitle
- Transesophageal echocardiography for thoracic spinal cord imaging and confirmation of epidural catheter placement in pediatrics
- Creators
- Satoshi Hanada - University of IowaBenjamin Reinking - University of IowaSung Kim - University of IowaKenichi Ueda - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of clinical anesthesia, Vol.91, 111231
- DOI
- 10.1016/j.jclinane.2023.111231
- PMID
- 37696242
- ISSN
- 0952-8180
- eISSN
- 1873-4529
- Language
- English
- Date published
- 12/01/2023
- Academic Unit
- Cardiology; Stead Family Department of Pediatrics; Anesthesia
- Record Identifier
- 9984463078302771
Metrics
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