Journal of Acute Care

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VOLUME 3 , ISSUE 3 ( September-December, 2024 ) > List of Articles

REVIEW ARTICLE

Transesophageal Echocardiography in Intensive Care Unit

Muralidhar Kanchi, Arupratan Maiti

Keywords : Critical care, Mitral valve, Right ventricular function, Transesophageal echocardiography, Transthoracic echocardiography

Citation Information : Kanchi M, Maiti A. Transesophageal Echocardiography in Intensive Care Unit. J Acute Care 2024; 3 (3):141-150.

DOI: 10.5005/jp-journals-10089-0149

License: CC BY-NC 4.0

Published Online: 15-01-2025

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

The use of transesophageal echocardiography (TEE) in critical care units provides a clear view of the heart and great vessels in patients with poor acoustic windows with transthoracic echocardiography (TTE). Importantly, TEE provides good-quality imaging, especially for visualization of posterior structures such as the left atrium (LA) and mitral valve. TEE is useful in the assessment of left/right ventricular (RV) function, valvular lesions, and evaluation of mechanical cardiac support devices in real-time. This review provides a brief outline of the utility of TEE in intensive care units (ICU).


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  1. Haji DL, Royse A, Royse CF. Clinical impact of non-cardiologist-performed transthoracic echocardiography in emergency medicine, intensive care medicine and anaesthesia. Emerg Med Australas 2013;25:4–12. DOI: 10.1111/1742-6723.12033
  2. Nagre AS. Focus-assessed transthoracic echocardiography: implications in perioperative and intensive care. Ann Card Anaesth 2019;22(3):302–308. DOI: 10.4103/aca.ACA_88_18
  3. Jensen MB, Sloth E, Larsen KM, et al. Transthoracic echocardiography for cardiopulmonary monitoring in intensive care. Eur J Anaesthesiol 2004;21:700–707. DOI: 10.1017/s0265021504009068
  4. Vieillard-Baron A, Millington SJ, Sanfilippo F, et al. A decade of progress in critical care echocardiography: a narrative review. Intensive Care Med 2019;45:770–788. DOI: 10.1007/s00134-019-05604-2
  5. Kanchi M, Tempe D, Chakravarthy M, et al. Practice guidelines for perioperative transesophageal echocardiography: recommendations of the Indian association of cardiovascular thoracic anesthesiologists. Ann Card Anaesth 2013;16(4):268–278. DOI: 10.4103/0971-9784.119175
  6. Longobardo L, Zito C, Carerj S, et al. Role of echocardiography in the intensive care unit: overview of the most common clinical scenarios. J Patient Cent Res Rev 2018;5(3):239–243. DOI: 10.17294/2330-0698.1631
  7. McNamara RL. Echocardiographic parameters important for decision making. In: Echocardiography in Heart Failure; 2012.
  8. Patil TA, Nierich A. Transesophageal echocardiography evaluation of the thoracic aorta. Ann Card Anaesth 2016;19(Suppl 1):S44–S55. DOI: 10.4103/0971-9784.192623
  9. Pérez-Casares A, Cesar S. Echocardiographic evaluation of pericardial effusion and cardiac tamponade. Front Pediatr 2017;5:79. DOI: 10.3389/fped.2017.00079
  10. Goldhaber SZ. Echocardiography in the management of pulmonary embolism. Ann Intern Med 2002;136(9):691–700. DOI: 10.7326/0003-4819-136-9-200205070-00012
  11. Lorusso R, Shekar K, MacLaren G, et al. ELSO interim guidelines for venoarterial extracorporeal membrane oxygenation in adult cardiac patients. ASAIO J 2021;67(8):827–844. DOI: 10.1097/MAT.0000000000001510
  12. Sedgwick JF, Burstow DJ, Platts DG. ECMO and ECHO: the role of echocardiography in the management of patients supported by extracorporeal membranous oxygenation (ECMO). Int J Cardiol 2011;147(Suppl):S16–S17. DOI: 10.1016/j.echo.2011.11.009
  13. Firstenberg MS, Orsinelli DA. ECMO and ECHO: the evolving role of quantitative echo in the management of patients requiring extracorporeal membrane oxygenation. J Am Soc Echocardiogr 2012;25(6):641–643. DOI: 10.1016/j.echo.2012.04.005
  14. Platts DG, Sedgwick JF, Burstow DJ, et al. The role of echo in the management of patients supported by extracorporeal membrane oxygenation. J Am Soc Echocardiogr 2012;25(2):131–141. DOI: 10.1016/j.echo.2011.11.009
  15. Douflé G, Roscoe A, Billia F, et al. Echocardiography for adult patients supported with extracorporeal membrane oxygenation. Crit Care 2015;19:326. DOI: 10.1186/s13054-015-1042-2
  16. Stainback RF, Estep JD, Agler DA, et al. Echocardiography in the management of patients with left ventricular assist devices: recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr 2015;28(8):853–909. DOI: 10.1016/j.echo.2015.05.008
  17. Cioccari L, Zante B, Bloch A, et al. Effects of hemodynamic monitoring using a single-use transesophageal echocardiography probe in critically ill patients—study protocol for a randomized controlled trial. Trials 2018;19(1):362. DOI: 10.1186/s13063-018-2714-4
  18. Hlaing M, He J, Haglund N, et al. Impact of a monoplane hemodynamic TEE (hTEE) monitoring device on decision making in a heterogeneous hemodynamically unstable intensive care unit population: a prospective, observational study. J Cardiothorac Vasc Anesth 2018;32(3):1308–1313. DOI: 10.1053/j.jvca.2017.10.017
  19. Douglas A, Kumar N. Overview of transesophageal echocardiography and transthoracic echocardiography in critical care. In: Nicoara A, et al., editors. Savage & Aronson's Comprehensive Textbook of Perioperative and Critical Care Echocardiography. 3rd ed. 2022.
  20. Nicoara A, Skubas N, Ad N, et al. Guidelines for the use of transesophageal echocardiography to assist with surgical decision-making in the operating room: a surgery-based approach: from the American Society of Echocardiography in collaboration with the Society of Cardiovascular Anesthesiologists and the Society of Thoracic Surgeons. J Am Soc Echocardiogr 2020;33(6):692–734. DOI: 10.1016/j.echo.2020.03.002
  21. Hahn RT, Abraham T, Adams MS, et al. Guidelines for performing a comprehensive transesophageal echocardiographic examination: recommendations from the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr 2013;26(9):921–964. DOI: 10.1016/j.echo.2013.07.009
  22. Teran F, Prats MI, Nelson BP, et al. Focused transesophageal echocardiography during cardiac arrest resuscitation: JACC review topic of the week. J Am Coll Cardiol 2020;76(6):745–754. DOI: 10.1016/j.jacc.2020.05.074
  23. Teran F, Burns KM, Narasimhan M, et al. Critical care transesophageal echocardiography in patients during the COVID-19 pandemic. J Am Soc Echocardiogr 2020;33:1040–1047. DOI: 10.1016/j.echo.2020.05.022
  24. Cavayas YA, Girard M, Desjardins G, et al. Transesophageal lung ultrasonography: a novel technique for investigating hypoxemia. Can J Anaesth 2016;63:1266–1276. DOI: 10.1007/s12630-016-0702-2
  25. Butala B, Cormican D, Baisden J, et al. Intraoperative rescue transesophageal echocardiography in a prone patient. J Cardiothorac Vasc Anesth 2019;33:877–878. DOI: 10.1053/j.jvca.2018.08.207
  26. Dessap AM, Proost O, Boissier F, et al. Transesophageal echocardiography in prone position during severe acute respiratory distress syndrome. Intensive Care Med 2011;37:430–434. DOI: 10.1007/s00134-010-2114-z
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