Transesophageal Echocardiography (TEE) and Dysphagia in Lung Transplantation (LT)
University of California, Los Angeles
Summary
The primary outcome of this study is dysphagia (difficulty swallowing) on postoperative speech and swallow evaluation following lung transplantation. Transesophageal echocardiography (TEE) (creates pictures of the heart from inside the participants body) is routinely performed for all lung transplantations at the University of California, Los Angeles (UCLA) and it is the standard of care. Patients are randomized to two groups. The intervention group would limit the number of TEE clips (# pictures taken) per case. The control group would leave the number of TEE clips to the discretion of the attending anesthesiologist. The investigators hypothesize that reduction in TEE imaging during lung transplantation will reduce dysphagia.
Description
Dysphagia is a common complication after cardiac surgery and specifically after lung transplantation. The incidence of dysphagia after lung transplantation is approximately 40-50%. Dysphagia after cardiac surgery leads to a significant increase in mortality, morbidity, cost, and length of stay. There are several risk factors that have been identified retrospectively including patient comorbidities, length of surgery, length of intubation, and number of TEE clips obtained during surgery. Many of these risk factors are not modifiable, however, the number of TEE clips obtained is a potential area…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: 1. Adult patients 2. Single or double lung transplantation Exclusion Criteria: 1. Contraindications to TEE including: * perforated esophagus; * esophageal stricture; * esophageal tumor; and * history of an esophagectomy 2. Patients that require a tracheostomy postoperatively.
Interventions
- Diagnostic TestTransesophageal Echocardiography (TEE) with limited number of TEE clips
The intervention group would be limited to fewer than 20 TEE clips per case (versus the average of \~ 80-100 TEE clips per case).
- Diagnostic TestTransesophageal Echocardiography (TEE) with number of TEE clips per attending anesthesiologist
The control group would leave the number of TEE clips to the discretion of the attending anesthesiologist.
Location
- Ronald Reagan UCLA Medical Center, Department of Anesthesiology & Perioperative MedicineLos Angeles, California