Safety of transesophageal echocardiography in patients who are obese.
Safety of transesophageal echocardiography in patients who are obese.
复制标题
肥胖患者经食管超声心动图的安全性。
DOI：
10.1067/mje.2002.125919
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发表时间：
2002
期刊：
影响因子：
--
通讯作者：
M. Stoddard
中科院分区：
文献类型：
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作者：
S. Garimella;Rita A. Longaker;M. Stoddard
肥胖患者往往有较高的高血压、冠状动脉疾病和睡眠呼吸暂停的发病率，这些情况可能会导致经食管超声心动图（TEE）的并发症。此外，肥胖患者在上消化道内镜检查时更容易出现氧饱和度过低。然而，TEE在大量肥胖患者中的安全性尚未见报道。因此，我们比较了341例肥胖患者（体重指数>/= 27.5 kg/m(2)，平均41.0 +/- 10.3）和323例非肥胖对照患者TEE的安全性。轻微并发症（即不需要或仅需要简单干预的短暂并发症）在对照组和肥胖组中发生的频率相同（16.5% vs 16.7%, P =无统计学意义）。短暂性氧饱和度在对照组和肥胖组之间没有差异（2.5% vs 3.8%, P =无统计学意义），但在病态肥胖患者亚组（n = 150）中比对照组更常见（6.7%）（P < 0.05）。肥胖组出现短暂性低血压的比例为3.5%，对照组为7.4% （P < 0.05）。然而，10.6%的肥胖患者出现短暂性高血压，而对照组为6.5% （P = 0.072）。2例肥胖患者出现主要并发症，1例需要血管加压药物治疗持续性低血压，另1例需要药理学控制房颤。对照组有1例患者引起室上性心动过速和心绞痛。两组均未发生死亡。两组患者对手术的主观耐受性相似（P =不显著），84%的肥胖患者具有良好至极好的耐受性，而对照组为88%。因此，TEE可以安全地用于肥胖患者。
Patients with obesity tend to have a higher incidence of hypertension, coronary artery disease, and sleep apnea, conditions that could potentially predispose to complications during transesophageal echocardiography (TEE). In addition, patients who are obese are more likely to have oxygen desaturation during upper gastrointestinal endoscopy. However, the safety of TEE in a large cohort of patients with obesity has not been reported. Thus, the safety of TEE in 341 patients who were obese (body mass index >/= 27.5 kg/m(2), mean 41.0 +/- 10.3) and in 323 control patients who were not obese was compared. Minor complications (ie, complications of a transient duration and requiring no or only simple intervention) occurred with equal frequency in the control and obese groups (16.5% vs 16.7%, P = not significant). Transient oxygen desaturation did not differ between the control versus obese group (2.5% vs 3.8%, P = not significant), but was more common (6.7%) in a subgroup (n = 150) of patients who were morbidly obese as compared with control patients (P <.05). Transient hypotension was observed in 3.5% of the obese group compared with 7.4% in the control group (P <.05). However, transient hypertension was noted in 10.6% of the patients who were obese compared with 6.5% in the control group (P =.072). A major complication occurred in 2 patients with obesity, one who required vasopressor medication for persistent hypotension and another needing pharmacologic rate control of atrial fibrillation. One patient in the control group had provoked supraventricular tachycardia and angina. No deaths occurred in either group. Subjective tolerance for the procedure was similar (P = not significant) in both groups with 84% of patients with obesity having good to excellent tolerance compared with 88% in that of the control group. Thus, TEE can be safely performed in patients who are obese.