Hemodynamic monitoring with a disposable echoprobe.

In a comparative prospective study a disposable TEE will be used to compare diagnosis of fluid responsiveness and ventricular failure in high risk surgical patients. The comparative monitoring will be a non-invasive haemodynamic monitor, providing beat-to-beat cardiac output and blood pressure variability (Nexfin).

This study aims to investigate the value and feasibility of a disposable TEE to monitor both fluid responsiveness and global contractile function of both left and right ventricles in high risk surgical patients, including both intraoperative management and postoperative follow up in a high dependency unit of a university hospital, against the information obtained from a non-invasive hemodynamic monitoring tool.

After induction of anesthesia, at each period of hemodynamic instability, before extubation, and in the postoperative phase on arrival in the high-dependency unit and every 4 hrs thereafter. Whenever hemodynamic instability occurs, an evaluation in addition will be performed.

Insertion of an echoprobe in the oesophagus via nose. The tool is used solely for hemodynamic monitoring. The final diagnosis is performed by the attending anesthetist.