Purpose: Transesophageal echocardiography (TEE) has been slow to be incorporated in intensivist practice despite several studies showing how this diagnostic modality can change clinical management with improved reliability and clinical certainty. This study aimed to explore the feasibility of an intensivist-performed TEE program and its potential impact on management of critically ill patients. Materials and Methods: This single-center, retrospective cohort study used data from a multidisciplinary intensivist-performed TEE database at a quaternary care academic hospital. Consecutive TEE studies performed between January 1, 2020 and March 31, 2025 were reviewed. Results: A total of 120 examinations were reviewed. Intensivist-performed TEE altered clinical management in 83% of cases (99 of 120 patients). The most frequent abnormalities identified were right ventricular dysfunction (23%), reduced left ventricular ejection fraction (21%), and valvular pathologies (19%). The most common changes in management included fluid administration (23%), inotrope initiation (17%), and ECMO cannula repositioning or confirmation (13%). There was one minor complication of TEE (0.8%) without any incidence of bleeding or esophageal perforation. Conclusions: Our results support that an intensivist-performed TEE program is feasible, safe, and clinically useful in changing management in a diverse population of critically ill medical and surgical patients in a variety of clinical environments.
Alberter et al. (2025) studied this question.