Resuscitative transesophageal echocardiography in the emergency department: a single-centre case series
Abstract Background Transesophageal echocardiography (TEE) is an emerging tool that can aid emergency physicians in treating patients in cardiac arrest and undifferentiated shock. TEE can aid in diagnosis, resuscitation, identify cardiac rhythms, guide chest compression vectors, and shorten sonograp...
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13049-023-01077-x |
| _version_ | 1797822647206150144 |
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| author | Fraser Kegel Jordan Chenkin |
| author_facet | Fraser Kegel Jordan Chenkin |
| author_sort | Fraser Kegel |
| collection | DOAJ |
| description | Abstract Background Transesophageal echocardiography (TEE) is an emerging tool that can aid emergency physicians in treating patients in cardiac arrest and undifferentiated shock. TEE can aid in diagnosis, resuscitation, identify cardiac rhythms, guide chest compression vectors, and shorten sonographic pulse checks. This study evaluated the proportion of patients who underwent a change in their resuscitation management as a result of emergency department resuscitative TEE. Methods This was a single-centre case series of 25 patients who underwent ED resuscitative TEE from 2015 to 2019. The objective of this study is to evaluate the feasibility and clinical impact of resuscitative TEE in critically ill patients in the emergency department. Data including changes in working diagnosis, complications, patient disposition, and survival to hospital discharge were also collected. Results 25 patients (median age 71, 40% female) underwent ED resuscitative TEE. All patients were intubated prior to probe insertion and adequate TEE views were obtained for every patient. The most common indications for resuscitative TEE were cardiac arrest (64%) and undifferentiated shock (28%). Resuscitation management changed in 76% (N = 19) and working diagnosis changed in 76% (N = 19) of patients. Ten patients died in the ED, 15 were admitted to hospital, and eight survived to hospital discharge. There were no immediate complications (0/15) and two delayed complications (2/15), both of which were minor gastrointestinal bleeding. Conclusions The use of ED resuscitative TEE is a practical modality that provides useful diagnostic and therapeutic information for critically ill patients in the emergency department, with an excellent rate of adequate cardiac visualization, and a low complication rate. |
| first_indexed | 2024-03-13T10:12:12Z |
| format | Article |
| id | doaj.art-0794cfbafa514a39a138cbc7d051c6c3 |
| institution | Directory Open Access Journal |
| issn | 1757-7241 |
| language | English |
| last_indexed | 2024-03-13T10:12:12Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| spelling | doaj.art-0794cfbafa514a39a138cbc7d051c6c32023-05-21T11:25:34ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412023-05-0131111110.1186/s13049-023-01077-xResuscitative transesophageal echocardiography in the emergency department: a single-centre case seriesFraser Kegel0Jordan Chenkin1Department of Emergency Medicine, Faculty of Medicine, University of TorontoDepartment of Emergency Medicine, Faculty of Medicine, University of TorontoAbstract Background Transesophageal echocardiography (TEE) is an emerging tool that can aid emergency physicians in treating patients in cardiac arrest and undifferentiated shock. TEE can aid in diagnosis, resuscitation, identify cardiac rhythms, guide chest compression vectors, and shorten sonographic pulse checks. This study evaluated the proportion of patients who underwent a change in their resuscitation management as a result of emergency department resuscitative TEE. Methods This was a single-centre case series of 25 patients who underwent ED resuscitative TEE from 2015 to 2019. The objective of this study is to evaluate the feasibility and clinical impact of resuscitative TEE in critically ill patients in the emergency department. Data including changes in working diagnosis, complications, patient disposition, and survival to hospital discharge were also collected. Results 25 patients (median age 71, 40% female) underwent ED resuscitative TEE. All patients were intubated prior to probe insertion and adequate TEE views were obtained for every patient. The most common indications for resuscitative TEE were cardiac arrest (64%) and undifferentiated shock (28%). Resuscitation management changed in 76% (N = 19) and working diagnosis changed in 76% (N = 19) of patients. Ten patients died in the ED, 15 were admitted to hospital, and eight survived to hospital discharge. There were no immediate complications (0/15) and two delayed complications (2/15), both of which were minor gastrointestinal bleeding. Conclusions The use of ED resuscitative TEE is a practical modality that provides useful diagnostic and therapeutic information for critically ill patients in the emergency department, with an excellent rate of adequate cardiac visualization, and a low complication rate.https://doi.org/10.1186/s13049-023-01077-xResuscitative transesophageal echocardiographyResuscitationEmergency medicineUltrasoundShockCardiac arrest |
| spellingShingle | Fraser Kegel Jordan Chenkin Resuscitative transesophageal echocardiography in the emergency department: a single-centre case series Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Resuscitative transesophageal echocardiography Resuscitation Emergency medicine Ultrasound Shock Cardiac arrest |
| title | Resuscitative transesophageal echocardiography in the emergency department: a single-centre case series |
| title_full | Resuscitative transesophageal echocardiography in the emergency department: a single-centre case series |
| title_fullStr | Resuscitative transesophageal echocardiography in the emergency department: a single-centre case series |
| title_full_unstemmed | Resuscitative transesophageal echocardiography in the emergency department: a single-centre case series |
| title_short | Resuscitative transesophageal echocardiography in the emergency department: a single-centre case series |
| title_sort | resuscitative transesophageal echocardiography in the emergency department a single centre case series |
| topic | Resuscitative transesophageal echocardiography Resuscitation Emergency medicine Ultrasound Shock Cardiac arrest |
| url | https://doi.org/10.1186/s13049-023-01077-x |
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