The point of care, critical care ultrasound (CCUS) program at Western University has become enabled with transesophageal echo (TEE) capability. The arrival of new TEE transducers that function on the bedside, point of care machines in all our ICU’s will allow for expanded capabilities in properly trained hands. With several Critical Care Western program faculty (as well as some fellows) being trained in TEE use, the acquisition of these probes takes advantage of our program’s talent and brings our point of care ultrasound program and patient care to a new level.
The value of TEE in the ICU has been well substantiated since the early 1990’s. In the post-pulmonary artery catheter era that we now find ourselves in, investment in tools that may rapidly address hemodynamic questions for those in shock is sensible. While most commonly used in the immediately post-cardiac surgery patient, we (and many groups, especially the Europeans) are finding value in the difficult to image medical patient for basic indications or in those with advanced questions. Indications for CCUS of all types are well described in this internationally endorsed consensus statement.
Ironically, in offering dedicated transthoracic echo (TTE) training to our trainees we hope to need the imaging advantage of our TEE probes relatively infrequently.
See images below to see the probe in use.
Example TEE image from our point of care machines. Note the exceptional resolution of cardiac structures in this RV inflow/outflow view was obtained at point of care for exam on septic shock in an IV drug user.[wpvideo 6wC6ZGTG]
Next stop for TEE? The emergency department for those in cardiac arrest. Click here to learn more via a 5 minute grand rounds.