Transesophageal Echocardiography in Critical Care

In this article we describe the utility, indications, contraindications, limitations, and clinical situations in which transesophageal echocardiography (TEE) examination can be instrumental in managing patients in the intensive care unit (ICU).

TEE is a safe and semi-invasive diagnostic modality that can be used to differentiate pathologies, determine hemodynamic status, guide management, and determine response to therapy. Its presence has expanded beyond the operating rooms into the critical care world. Despite limited randomized trials, evidence indicates its significant benefits and potential for early diagnosis to reduce morbidity and mortality.

Patients in the ICU present with multifactorial form of shock, hypoxemia needing monitoring and mechanical circulatory support. TEE is a low-risk diagnostic and monitoring tool which is invaluable in the ICU. Its advantages include superior visualization of cardiac structures and accurate assessment of abnormalities. Judicious utilization of TEE holds the potential to significantly influence clinical decision-making in a favorable manner.