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Upcoming Courses hTEE Course Dates:
May 19th Iselin, NJ
June 30th Chicago, IL
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Conference
Participation
Society for Cardiovascular Anesthesiologists
Boston, MA
April 29-May 1
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Maurizio Cecconi MD from St. George's Hospital UK, presents on hTEE management at the ISICEM pre-symposium course entitled, 'Hemodynamic Monitoring - Technical Aspects - Making the Right Measures'
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 | | Steffen Rex MD presents on hTEE in the perioperative setting at the ISICEM in March 2012 in Brussels. Currently, hemodynamic monitoring in the ICU in particular is notoriously difficult, and fails to tailor hemodynamic therapy and get instantaneous information. Here Dr. Rex depitcts the need for an hTEE probe. |
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Steffen Rex MD on titrating patients and adjusting individual therapy including volume, inotropes, pulmonary vasodilators, vasopressors, vent settings and circulatory support
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 | | Please link to view Dr. Rex's full ISICEM powerpoint presentation. |
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Physicians engaged in learning more about ImaCor technology
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Testimonial
 "ImaCor's probe is easy to learn, apply and interpret"
Paul Mayo MD Director of MICU North Shore LIJ Hospitals
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2:00 AM
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Contact Us
imacorinc.com
1-516-393-0970
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Should you wish to submit an article to our next monthly newsletter,
please contact:
Sheila McGarrigle at
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A Conversation with Drs. Nicholas Cavarocchi and Christopher Kang, TJU
Nicholas  | | On the left, Drs. Christopher Kang and Harrison Pitcher, on the right Dr. Nicholas Cavarocchi |
Cavarocchi MD and Christopher Kang MD of Thomas Jefferson University Hospital (Philadelphia, PA) sat down with ImaCor's Harold Hastings PhD to discuss their experience in using hTEE. Drs. Cavarocchi and Kang have published a number of case studies describing how hTEE provided the information they needed to improve patient outcomes. Their most recent case study, "TEE-Guided Hemodynamic Management of a Series of Patients with Mechanical Hemodynamic Support," was presented at SCCM in February 2012 (Critical Care Medicine. 39(12):63, December 2011). Can you describe how you learned about hTEE? DR. KANG: Standard bedside TTE is used widely at Thomas Jefferson University in the SICU, SCCU and in Neuro. Here in the SICU, I observed other residents applying the ClariTEE probe and the Zura system to cases, and it did not appear to be difficult to learn. I then applied hTEE to a case in the SCCU. I became really comfortable applying hTEE after using hTEE in several exams. How many exams did it take to become comfortable with hTEE? DR. KANG: It took about ten exams before I became really comfortable applying it to patient cases. DR. CAVAROCCHI: It is helpful to understand the anatomy of the heart and surrounding areas. From this you can understand the impact of the three views of the heart. The first view is that of the transgastric short-axis view. I can determine LV filling and function from that view. The second view of the heart is the mid-esophageal four-chamber view. This view demonstrates the biventricular function, which is essential in understanding RV performance and hemodynamic status in general. Finally, there is the Superior Vena Cava view, which determines fluid responsiveness. At TJU, we have observed that hTEE can be easily learned by a qualified resident. Most residents can pick it up quickly. . . . |
hTEE™ Guides Resuscitation of Patient with Septic Shock and ARDS Post-MVA
by Benjamin Kohl MD, Hospital of the University of Pennsylvania, Philadelphia, PA
A 72-year old male presented with multiple orthopedic injuries post-MVA. Given the nature and the severity of the injuries, the patient underwent several orthopedic interventions, as well as a tracheostomy.
The patient was discharged to a rehabilitation facility for further ventilator weaning. During early rehabilitation, the patient developed anasarca and worsening hypotension with subsequent development of ARDS. He was transferred back to the primary facility for further management.
The patient presented with ARDS secondary from septic shock, requiring multiple vasopressors (neosynephrine, norepinephrine, vasopressin) to support his hypotension. Additionally, a high mean airway pressure was required to sustain adequate oxygenation due to ARDS. . . .
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User-Derived Training
Report on hTEE use at St George's Hospital London
by Nick Fletcher MD FRCA FFICM
Director Cardiothoraic and Vascular ICU,
St George's Hospital, London, UK
 I have had the good fortune to investigate the utility of the hTEE and Zura system over the last 5 months at St Georges. I am grateful for the technical assistance Scott [Roth], Peter [Pellerito] and the team have provided. We have employed the device mainly for the haemodynamic management of our difficult cases alongside other monitoring modalities. I have particularly identified the following: right ventricular monitoring for the ventilated post cardiac surgery patient; managing the ventilated patient following acute myocardial infarction; managing the unstable septic ICU patients. The benefits are clear to me for weaning inotropes, intra-aortic balloon pumps and modifying ventilation settings.
We have trained a number of colleagues and ICU residents in the use of hTEE. My colleague Maurizio Cecconi MD, from our general medical and surgical ICU, and I are setting up an education programme for hTEE. This will complement our popular existing programmes for ICU echocardiography and haemodynamics at St. George's. Our first course will take place in October before the ESICM meeting in Lisbon. The day will involve lectures, tutorials, simulation and practical bedside hTEE use. I am interested in investigating and passing on any benefit that continuous echocardiography haemodynamic management can bring for ICU patients. Hope to see you at ESICM in Lisbon or ACTA Newcastle in the UK to share some of our results with hTEE.
For more information, please visit Dr. Fletcher's website at http://www.echotrainer.co.uk .
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On Usability
by Rich Lanzillotto, Director of Regulatory Affairs and Quality Assurance
Hemodynamic stabilization is vital in critical care patients. Poorly controlled resuscitation processes can increase the incidence of hemodynamic instability and associated consequences. Indirect monitoring devices have been shown to be of limited utility when assessing circulatory perfusion and fluid responsiveness. Effective interventions that support early hemodynamic stability are critical to improved clinical outcomes. ImaCor Inc. recognized the need for a direct visualization technology that could be used to assess cardiac performance while also being purpose-built for critical care settings. The hTEE approach using the Zura™ system and ClariTEE® probe fill this need. . . . Read More Share: |
 . ImaCor was pleased and honored to participate in Professor Jean-Louis Vincent's exceptional 32nd Annual International Symposium on Intensive Care and Emergency Medicine (ISICEM) from March 19th-23rd in Brussels, Belgium. We valued the opportunity to take part in an organization whose esteemed faculty members are international thought leaders in the field of intensive care medicine. With over 6,000 attendees focused on best practices in critical care, it was a great privilege to exhibit and experience such a high level of engagement from top-notch academics and clinicians from around the world. Thanks to all who shared their current approaches to managing hemodynamic stability - I greatly valued the candid feedback, and look forward to hearing more from you. My sincere thanks to Professor Vincent and to his entire team, in particular to Véronique De Vlaeminck & Colette Dutillieu for their guidance and kind reception. The week started off on Monday with the pre-symposium hemodynamic monitoring course attended by over 60 physicians. Michael Pinsky MD, Professor of Critical Care Medicine, Bioengineering, Cardiovascular Disease and Anesthesiology at UPMC, chaired the course. The learned Maurizio Cecconi MD from St. George's Hospital presented on hTEE during the didactic session; the afternoon included hands-on training with hTEE simulators. Another highlight was Steffen Rex MD's presentation of hTEE in the central auditorium during the Symposium. Indirect hemodynamic monitoring is notoriously difficult and fails to recognize the underlying cause of hemodynamic instability; Dr. Rex identified a path forward with hTEE to address this issue. I offer many thanks to Dr. Rex for his exceptional ongoing research.
I greatly appreciate the work of those who submitted articles to our newsletter this month. I would like to thank Nicholas Cavarocchi MD and Christopher Kang MD for their thoughts on hTEE for new users. Also many thanks to Nick Fletcher MD who has been leading our European education efforts. Finally, be sure to read this month's clinical case from Benjamin Kohl MD at the Hospital of the University of Pennsylvania.
Please join me in offering a warm welcome to Di Fitzgerald, our European Director of Clinical Operations & Business Development. She will be working with our installed sites throughout Europe, including welcoming new users like the University Medical Center Groningen and Erasmus MC University Medical Center. With kind regards, Peter Pellerito President & CEO Share: |
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