RevBrasAnestesiol.2017;67(3):318---320
REVISTA
BRASILEIRA
DE
ANESTESIOLOGIA
PublicaçãoOficialdaSociedadeBrasileiradeAnestesiologiawww.sba.com.br
CLINICAL
INFORMATION
Intraoperative
echocardiography
guidelines
in
Brazil
---Is
it
time
for
a
task
force?
Marcello
Fonseca
Salgado
Filho
a,baUniversidadeFederaldeJuizdeFora(UFJF),JuizdeFora,MG,Brazil
bCursodeEcocardiografiaIntraoperatória,SociedadeBrasileiradeAnestesiologia,RiodeJaneiro,RJ,Brazil
Received21May2015;accepted8September2015
Availableonline25November2016
KEYWORDS
Intraoperative echocardiography; Anesthesia; Transtoracic echocardiography; Transesophageal echocardiography
Abstract
Backgroundandobjectives: TheBrazilianSocietyofAnesthesiology(SBA)hasbeenpromoting continuingeducationinintraoperativeechocardiographyinBrazilsince2011,withthe imple-mentationofanIntraoperativeEchocardiographyCourse(ETI/SBA).Althoughechocardiography isarealityofanesthesiologypracticeinBrazil,westilldonothaveanestablishedpolicyon theareaofexpertise,jobtraining,andrecognitionbytheothersocieties,suchastheBrazilian SocietyofCardiology(SBC).The aimofthispaperistocontextualize theanesthesiologyin theintraoperativeechocardiographyinBrazilandpromoteadiscussionontheformationofa TaskForcealongwiththeSBCtobegindrawinguptheBrazilianGuidelinesonIntraoperative Echocardiography.
Casereport: ThefirstreportsontheinvolvementofanesthesiologyinBrazilwithintraoperative echocardiographyarefromthe80sand90s.However,thistechniqueimplementationinroutine practiceintheBrazilian anesthesiologyoccurred in2011withtheformationoftheETI/SBA Course.Sincethen,theSBAhasbeenpromoting acontinuing educationofitsmembersand disseminatingtheETI/SBACoursethroughoutBrazil.Morethan200associateshavetakenthis course,andthevastmajorityworkswithcardiacsurgery.
Conclusion:IntraoperativeechocardiographyisarealityinthepracticeoftheBrazilian anes-thesiology,andtheETI/SBACoursehasbeenpromotingitscontinuingeducation,however,we stilldonothaveagroundedguideline.Asoccurredinmajorworldwidecenters,we haveto promoteaTask ForcealongwiththeSBCinordertobegin thedrawingup ofthe Brazilian GuidelinesonIntraoperativeEchocardiography.
©2016SociedadeBrasileiradeAnestesiologia.PublishedbyElsevierEditoraLtda.Thisisan openaccessarticleundertheCCBY-NC-NDlicense( http://creativecommons.org/licenses/by-nc-nd/4.0/).
E-mail:[email protected]
http://dx.doi.org/10.1016/j.bjane.2015.09.002
IntraoperativeechocardiographyguidelinesinBrazil---Isittimeforataskforce? 319
PALAVRAS-CHAVE
Ecocardiografia intraoperatória; Anestesia; Ecocardiografia transtorácica; Ecocardiografia transesofágica
DiretrizesdaecocardiografiaintraoperatórianoBrasil---Chegouahoradeuma
forc¸a-tarefa?
Resumo
Justificativaeobjetivos: A Sociedade Brasileira de Anestesiologia (SBA) vem promovendo a educac¸ão continuada em ecocardiografia intraoperatória no Brasil desde 2011, com a implantac¸ãodoCursodeEcocardiografiaIntraoperatória(ETI/SBA).Apesardeaecocardiografia serumarealidadedoanestesiologistabrasileiro,aindanãotemosumadiretrizestabelecidano que dizrespeito àárea deatuac¸ão, capacitac¸ãoprofissional eao reconhecimento junto às demaissociedades,como,porexemplo,aSociedadeBrasileiradeCardiologia(SBC).Oobjetivo deste artigoé contextualizaraanestesiologianaecocardiografia intraoperatórianoBrasile promoverumadiscussãosobreaformac¸ãodeumaforc¸a-tarefajuntoàSBCparainiciarmosa formac¸ãodasDiretrizesBrasileirasemEcocardiografiaIntraoperatória.
Relatodocaso: OsprimeirosrelatosdoenvolvimentodaanestesiologianoBrasil coma eco-cardiografiaintraoperatóriasãodadécadade1980e90.Contudo,aimplantac¸ãodessatécnica napráticarotineiranaanestesiologiabrasileiraocorreuem 2011,comaformac¸ãodoCurso ETI/SBA.Desde então,aSBAvempromovendoaeducac¸ãocontinuadadeseus associadose divulgandooCursoETI/SBAemtodooBrasil.Jáfizeramessecursomaisde200associados.A grandemaioriatrabalhacomcirurgiacardíaca.
Conclusão:Aecocardiografiaintraoperatóriaéumarealidadenaanestesiologiabrasileiraeo Curso ETI/SBAvempromovendoasuaeducac¸ãocontinuada.Contudo,aindanãotemosuma diretrizfundamentada.Comoocorreunosgrandescentrosmundiais,temosdepromoveruma forc¸a-tarefajuntoàSBCafimdeiniciarmosaformulac¸ãodasDiretrizesBrasileirasem Ecocar-diografiaIntraoperatória.
©2016SociedadeBrasileiradeAnestesiologia.PublicadoporElsevierEditoraLtda.Este ´eum artigo OpenAccess sobumalicenc¸aCCBY-NC-ND( http://creativecommons.org/licenses/by-nc-nd/4.0/).
Background
and
objectives
Intraoperativeechocardiographyisarealityinmajor Amer-ican,Canadian,andEuropeancenterssincethe1980s.1 In the1990s,itacquiredgreatpopularizationwiththe appoint-ment of Anesthesiology and Cardiology/Echocardiography Societies TaskForces.1 Thistaskforcehasformulated and published the guidelines and examination techniques for intraoperativetransesophagealechocardiography.InBrazil, thefirstanesthesiapapersonintraoperative echocardiogra-phydatefromde1980s/90s,withtwoscientific papersby Dr.JoséAulerpresentedasfreethemesinthe1987and1994 BrazilianCongressofAnesthesiology.2,3
Theaimofthispaperistocontextualizeanesthesiology inintraoperativeechocardiographyinBrazilandpromotea discussionontheformationofataskforcewiththeBrazilian SocietyofCardiologytodelineatetheBrazilian Intraopera-tiveEchocardiographyGuidelines.
Case
report
Inthe1990s,theUnitedStates,Canada,andEurope devel-oped their intraoperative echocardiography guidelines,1 which promoted a worldwide dissemination of this tech-nique.Whattheseopinionmakercentershadincommonwas theunionoftheanesthesiologysocietieswiththe echocar-diographyand/orcardiologysocieties.Thus,theypromoted ataskforceandvalidatedtheintraoperative echocardiogra-phyperformancebytrainedanesthesiologists.InBrazil,this
techniquebeganinthe1980s/90s.Dr.JoséAulerpresented twoscientificpapersasfreethemesintheBrazilianCongress of Anesthesiology in 1987 and 1994.2,3 Although we have worksdatedfromthe1980s,therewasawidespread contin-uationofthistechnologyinBrazilbetween1990and2000. Itwasthroughthepersonalcommitmentofsome anesthesi-ologistsandfewhospitalsspecializedincardiacsurgerythat intraoperativeechocardiographypickedupitsdevelopment againinBrazilmorerecently,especiallyaftertheAmerican Society of Cardiovascular Anesthesiology (ACS) guidelines andthe AmericanSociety of Echocardiography (ASE). The ACS/ASErefreshercourseswerealsoimportanttopromote thistechniqueinBrazil.1
Faced with an increasingly growing demand in the Brazilian scenario, the SBA formed a group in 2011 to promotecontinuingeducationinintraoperative echocardi-ography.Thus,theIntraoperativeEchocardiographyCourse of the Brazilian Society of Anesthesiology (ETI/SBA)4 is initiated.
320 M.F.SalgadoFilho
palatable and with better acceptance for the Brazilian anesthesiologists.Overfouryears,8ModulesIand5Modules IIwereperformed.4
ETI/SBAcoursehaseightanesthesiologistinstructors,in additiontoguestechocardiographers.Thecoursestructure isbasedonlectures,laboratorywithporcineheartmodel, realisticsimulationmannequinoftransesophageal echocar-diographywithmorethan20diseases,andatransthoracic echocardiographyworkshop.4
Of the 265 anesthesiologists who took the ETI/SBA Course,233(88%)worksregularlywithcardiacsurgeryand 107 (40%) have the echocardiography machine on their services.5Afactthatdemonstrateshowweneedtoexpand thisknowledgeinBrazilisthatofthe233anesthesiologists whoworkwithheartsurgery,only77(33%)usethe echocar-diogramtwiceormoreduringtheweekintheiranesthetic procedures.5
The interest andfamiliarity withechocardiographyare continuallyincreasing,andwecan seethisevolutionboth by the number of articles published by our associates6---12 andthemeanETI/SBACourseevaluations,whichhasgrown everyyear,andbythenumberofthird-yearresidentstaken the courses that already use the echocardiogram in car-diacandnon-cardiacsurgeryintheirEducationandTraining Centers(ETC).5
Conclusion
With the implementation of the ETI/SBA Course and theechocardiogrampopularizationamonganesthesiologists who are in the labor market and training in the ETCs, the first step was taken. However, we must continue to provide becausewe have to implementa task force with theBrazilianSocietyofCardiologysothatwecanformulate theBrazilianIntraoperativeEchocardiographyGuidelinesin ordertoprovidemore safetyand qualityin anesthesiato ourpatientsinastandardmanner.
Conflicts
of
interest
Theauthordeclaresnoconflictsofinterest.
References
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