RT Book, Section
A1 Hudson, Jordan
A1 Shaw, Andrew
A2 Mathew, Joseph P.
A2 Swaminathan, Madhav
A2 Ayoub, Chakib M.
SR Print(0)
ID 6919938
T1 Chapter 22. TEE in the Critical Care Unit
T2 Clinical Manual and Review of Transesophageal Echocardiography, 2e
YR 2010
FD 2010
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-163476-2
LK accessanesthesiology.mhmedical.com/content.aspx?aid=6919938
RD 2024/04/16
AB In  addition  to  its  role  as  an  intraoperative  diagnostic  tool,  transesophageal  echocardiography  (TEE)  has  been  shown  to  be  increasingly  useful  in  the  critical  care  setting.  Patients  in  the  critical  care  unit  may  have  impaired  cardiac  function  due  to  comorbidities  or  as  a  result  of  their  critical  illness.  Indeed,  cardiac  dysfunction  is  one  of  the  most  common  causes  of  hemodynamic  instability  and  death  in  critically  ill  patients.1  Unlike  many  other  diagnostic  modalities  available  to  the  intensivist,  TEE  is  minimally  invasive  and  can  be  rapidly  performed  at  the  bedside.  It  can  be  used  to  provide  valuable  information  on  cardiac  function,  guide  resuscitation  and  management,  and  diagnose  a  wide  range  of  pathologies  that  may  have  a  negative  impact  on  the  critically  ill  patient  (Table  22–1).  TEE  was  initially  applied  in  the  intensive  care  unit  (ICU)  for  the  postoperative  evaluation  of  unstable  cardiac  surgery  patients.  However,  TEE  has  also  been  shown  to  be  beneficial  in  the  general  ICU  setting,  changing  management  in  up  to  two-thirds  of  cases.2,3  In  addition  to  the  fact  that  the  use  of  echocardiography  has  a  positive  impact  on  the  management  of  patients  in  the  general  ICU,4  there  is  also  evidence  to  support  its  therapeutic  impact  and  its  value  in  predicting  mortality.5  Surprisingly,  despite  all  these  advantages,  echocardiography  is  still  not  yet  available  in  most  ICUs,  being  largely  limited  by  the  availability  of  trained  providers.5