What question did this study set out to answer?

To evaluate the feasibility, clinical indications, diagnostic yield, and therapeutic impact of an intensivist-led critical care transesophageal echocardiography program.

September 6, 2018Journal of Intensive Care Medicine

Impact of Critical Care Transesophageal Echocardiography in Medical–Surgical ICU Patients: Characteristics and Results From 274 Consecutive Examinations

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Why the study?

Does critical care transesophageal echocardiography (TEE) impact clinical management in medical-surgical ICU patients?

Population

274 consecutive critical care transesophageal echocardiography examinations on medical-surgical ICU patients…

Design

Cohort

Authors

RARobert ArntfieldWestern University VLVincent LauAlberta Health Services YLYves LandryWestern University

Discussion

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Implication

Intensivist TEE may alter management in most ICU cases without complications; leaves open need for RCTs to confirm outcome benefits.

Key Points

To evaluate the feasibility, clinical indications, diagnostic yield, and therapeutic impact of an intensivist-led critical care transesophageal echocardiography program.
Retrospective observational review of consecutive critical care transesophageal echocardiography (TEE) examinations performed across two tertiary academic intensive care units in Ontario, Canada, between December 2012 and December 2016.
Included N=274 TEE examinations performed by 38 intensivist operators on medical-surgical ICU patients, excluding cardiac surgery patients and studies without finalized reports.
Leading indications for TEE were hemodynamic instability (45.2%), evaluation for infective endocarditis (22.2%), and cardiac arrest management (20.1%).
TEE examinations prompted a proposed change in patient management in 79.5% of cases.
Thirty-eight percent of examinations were performed during evening hours or weekends, with zero mechanical complications documented across all 274 studies.

Structured PICO

Does critical care transesophageal echocardiography (TEE) impact clinical management in medical-surgical ICU patients?

Population

274 consecutive critical care transesophageal echocardiography (TEE) examinations on medical-surgical ICU patients (excluding cardiac surgery patients and those without reports) at 2 hospitals in Ontario, Canada.

Intervention

Critical care transesophageal echocardiography (TEE) performed by intensivists.

Outcome

Feasibility, indications, and clinical impact (change in patient management).

Intensivist-performed critical care TEE is safe and frequently leads to changes in patient management across a broad range of indications in the ICU.

Cite This Study

Arntfield et al. (2018) studied this question.

synapsesocial.com/papers/6a8d07edc7b917c7ae39b217 https://doi.org/10.1177/0885066618797271

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Impact of Critical Care Transesophageal Echocardiography in Medical–Surgical ICU Patients: Characteristics and Results From 274 Consecutive Examinations

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Impact of Critical Care Transesophageal Echocardiography in Medical–Surgical ICU Patients: Characteristics and Results From 274 Consecutive Examinations

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider